HHHS changes tack with ER docs

By Jenn Watt

Sept. 20 2016

With the number of local doctors willing and able to staff the Haliburton emergency room dwindling Haliburton Highlands Health Services has decided to try recruiting them.

In the past doctors who came to the community to practise family medicine would be asked to take a few shifts a month at the ER in Haliburton. That method doesn’t work anymore.

“A lot of small towns are struggling across Ontario with not being able to attract doctors that are interest in doing both [clinic hours and ER hours]” said chief of staff Dr. Greg Karaguesian.

As of this January Karaguesian expects to be down to two full-time ER doctors three local physicians putting in hours at the ER and a handful of locums from the city. It’s not enough to adequately staff the service which sees more than 12700 patients a year.

“We definitely do have a challenge although we are working on some strategies to address that challenge” said HHHS CEO Carolyn Plummer.

“We are going to be doing something different than we’ve done as an organization in the past and that is we ourselves are going to be recruiting an emergency room physician. In the past emergency room physicians a lot of them have been the physicians that work in the Family Health Team so the recruitment of physicians to this community has typically happened through the Family Health Team as opposed to being done by the hospital” she said.

HHHS will be consulting with local doctors on where to post the recruitment materials and what needs to be included in the call-out. Plummer is also planning to meet with current staff to talk about scheduling.

The number of physicians HHHS needs to recruit has to do with the kind of medicine they want to practise she said.

“If we had somebody that was interested in coming here permanently … we would probably only need one” she said. However if the doctor wanted to work with the Family Health Team and pick up hours at the ER one wouldn’t be enough.

Emergency room doctors don’t work for hospitals they are self-employed and bill the Ministry of Health for their work. That means while HHHS isn’t the doctors’ employer it is still responsible for ensuring its ER is staffed.

HHHS has been in touch with the regional health authority the Central East Local Health Integration Network about the coming shortage as well as Health Force Ontario (HFO) which will be helping with posting recruitment material.

“We haven’t needed a huge amount of support from them [CE LHIN] in this regard yet but we may need support from them in the future. We are trying to look internally first” Plummer said.

In the interim locums may be relied on more heavily. Some of those are doctors who already do regular shifts at the hospital despite not living in the area and others could come through Health Force Ontario.

Karaguesian said he hopes it doesn’t come to that.

“If you make an application to HFO they don’t guarantee that they’ll fill your spots but they’ll look because they have doctors on retainer” he said.

He said the HFO system is more expensive and doesn’t offer the stability that regular staff can provide.

Plummer said there is a cost to using the service but that it could be needed in the short term until someone is found to work permanently in the ER.

HHHS is changing the way it finds and retains doctors for the emergency department to address the current dilemma the CEO said while praising current staff and doctors for their efforts to keep the shifts filled.

“We’re committed to making sure we have the appropriate services for the people of the County of Haliburton. … We’re doing everything in our power to make sure those services are consistently there for people.”