Doctor shortage in northwestern Ontario remains dire with no clear relief in sight

Emergency rooms in northwestern Ontario remain critically short-staffed, and hospital leaders across the region warn the risk of emergency-roomclosures could continue wellinto the summer.

Three months ago, the emergency room in Red Lake, Ont., closed for 24 hours during a weekend because no physician was available. Officials say a similar situation could happen elsewhere if relief isn't found.

"To be frank, if health-care workers across our region did not continue to work hours that are putting their personal health at risk and are far beyond reasonable expectations, many more service closures would have occurred," saidDr. Sara Van Der Loo, chair of the Northwest Regional Chief of Staff Council.

Physicians are burning out from working excessive hours while trying to keep services open, she said, and the situation isn't isolated to one particular hospital.

Patients in emergency rooms across Ontario are waiting record lengths of time to get admitted to hospital, asituation medical professionals say is getting worse.

Ray Racette, chief executive officer of theLake of the Woods District Hospital in Kenora, warns the public of "a very tough challenge this summer" in the hospital'semergency departmentas it faces an all-position vacancy rate of 41 per cent.

"There's heroic efforts people picking up extra shiftsand so on, maybe giving up on their summer vacations and things of that nature, just to try and keep these services open," Racette said. "But it does mean that people can be waiting longer for service."

Have you or someone close to you recently endured a long stay in an emergency room in northwestern Ontario?Email CBC Newsto tell us about your experience.

The Ontario government announced an expansion of its COVID-19 temporary summer locum program on June 1, which allows hospitals to offer premiums to help attract temporary fill-in staff to emergency rooms in rural and northern hospitals.

Dr. Sarah Newbery, associate dean of physician workforce strategy for the Northern Ontario School of Medicine (NOSM), is skeptical that program will make much of a difference.

"Without the people in the system to do the work, it may not be as successful as I think had been hoped."

Work on several possible short-term solutions to the physician shortage thatwere put forward by physicians and recruiters themselveswas delayed by the recent provincial election, Newbery said.

Since then, there have been regular conversations about those proposals.They include funding for postgraduate learners to accompany locums from their institutions who come to serve in the province'srural north, and providing real-time virtual access to specialists for physicians working alone in rural northern emergency rooms,something Newbery said would allow more doctors to feel comfortable taking such shifts.

"We are in a window of time now where we do need to move quickly to implement many of those initiatives," she said, addingshe hoped to see progress in July.

The physician recruiter for the Fort Frances and Rainy River area said he'sstill running into roadblocks trying to meet the supervision requirements for physicians working on restricted licences, such as international medical graduates seeking licensure in Canada.

In 2015, Todd Hamilton said, he went through the process of bringing an American-trained physician to the Fort Frances and Rainy River area, and had to arrange for three other local physicians to provide supervision and mentorshipin accordance with college requirementssomething many small communities don't have the resources to do.

The College of Physicians and Surgeons of Ontariotold CBCNews in March that it permits small communities to have a single supervisor orhave supervision provided remotely by physicians outside the community.Hamilton said he had never been made aware ofthose options.

However, hesaid, the region recently responded to interest from a surgeon who was seeking to re-establish his licence with the collegedue to a gap in service, "not through any fault of his own."

The College of Physicians and Surgeonsdenied the remote supervision option, Hamilton said.

"We did spend quite a bit of time on it, so it was a bit disappointing for us," he said.

"You get these lifelines once in a while. And then, as quick as they're shown to you, you go through the process, you realize, well, that's not going to work for us either."

Shae Greenfield, aspokesperson for the College of Physicians and Surgeons, said it's impossible to discuss a specific case without knowing the name of the physician in question, something Hamilton said he could not disclose.

"We want to work with people to address as many issues as we can within our mandate andwithin the limitations placed on us by the law and other factors," Greenfield said.

Racettesaidhe hopes to get help in his ER this summer from Manitoba physicians vacationing in the region,but that delays in licensing them to work in Ontario created a barrier.

"A three-month turnaround on a licence would be viewed as, you know, potentially doable. But if we have somebody coming up in two weeks, that's maybe coming to their cottage how do we get that physician licensed?" he asked. "Because that might be the notice."

Hospital leaders appeal for help

Greenfield denied the college takes three months to process licence applications from out-of-province doctors, saying its standard istwo to three weeks.

But Dr. Sean Moore, chief of staff at Lake of the Woods District Hospital, said that hasn't been his observation.

"We've had several people just say, 'I would never apply for an Ontario licence. I did that many years ago, and it took so long I would never go through that again."

Greenfield said delays in processing licence applications could be caused by missing documentation or incomplete applications.

In Kenora, hospital chief executive officerRay Racette pleaded with "anybody who has any discretion at all" to use it to help hospitals in the northwest this summer.

"Everybody's in trouble," he said.