Patients spent the first two weeks of September waiting as long as four days in Peace Arch Hospital without treatment for serious conditions, a concerned health-care professional charges.
Such waits – which affect unassigned patients not registered with family physicians – are due to a shortage of ‘hospitalists’ assigned to treat them, according to the source, who has worked years in the community.
The professional – who spoke to Peace Arch News on condition of not being identified – added that patients have been imperilled and nurses have felt “abandoned” – some reduced to tears – because of the situation.
Responding to these concerns, Dr. Dave Williams, medical program director for Fraser Health, said that, while there have been challenges getting a ‘house-doctor’ program off the ground by the scheduled launch date of Sept. 1, the authority has been working to recruit doctors and put infrastructure in place. All necessary shifts are covered for the rest of the month and into October, he said.
The professional, however, said that as of Friday, there were still gaps in the schedule for doctors to treat unassigned patients through October.
Patients not registered with family practitioners with admitting privileges amount to as many as 40 per cent of those currently being admitted to the hospital. As of last week, some had been waiting for days for doctors to administer treatment for such conditions as heart attacks, strokes, bleeding disorders, pneumonia and serious infections.
“These are acutely ill patients who are not being treated,” the source said, adding that in “the hospital’s busiest ward, the one with the sickest patients,” there was as much as a five-day wait to see a physician this month.
“The consequences not only could be dire, they have been dire,” the source said.
Contacted by Peace Arch News last Wednesday, Williams said Fraser Health had not heard of any instances of patients suffering.
“We have not had any reports of that,” he said, acknowledging “there have been delays in having continuity of physician care.”
Williams noted the night-time doctor program administered by the Division of Family Practice – in which area family doctors attend overnight urgent calls at the hospital – has been successful in seeing that all unassigned patients have received treatment.
But the source said doctors on-call during the night have found themselves treating patients with medical problems that have reached a critical stage as a result of not being addressed during day shifts – along with dealing with anger from family members.
Many of the unassigned patients are coming to Peace Arch from outside of its catchment area, the source added, noting that for many English is a second language.
“We don’t have translators here like they do at Surrey Memorial.”
The professional said there are records, diagnoses and patient names on file to back up such claims.
A meeting of medical staff at the hospital was called for Monday night (after Peace Arch News press time) to discuss the issue.
Although there have been enough unassigned patients for three daytime shifts for hospitalists at Peace Arch, there are ongoing difficulties finding enough doctors to cover them. Yet still patients are being admitted for which there are not enough hospitalists available, the source said.
“Patients will always be admitted to hospital,” Williams confirmed.
But leaving unassigned patients in hospital without a doctor’s care is unacceptable, the source said.
“Fraser Health has been promising to do something about this in January, in April and September – that’s nine months,” the source added.
Williams said the problem of finding enough doctors for the house-doctor program has been compounded by a population growing by three to four per cent each year, as well as “an aging physician population.”
But the source charges that Fraser Health’s reaction, to date, has been “very cynical and not very healthy.”
Before the beginning of this year, orphan patients were being covered among family doctors with hospital privileges, the professional said, but there were too many cases to be covered adequately on an improvised basis – “it became overwhelming.”
As a result, a daytime hospitalist system was established in January, first run by area family doctors, then taken over by Fraser Health with the help of family doctors, on April 1.
Each successive attempt to address the problem has become bogged down, the source said, calculating that as of the beginning of September, 25 per cent of hospitalists’ ward work is not being covered.
The source acknowledged Fraser Health has now created a fourth position for the house-doctor program, but said the roster showed that as of Friday, three positions are covered but there are still vacant shifts for the extra position for the rest of September. There are also gaps of eight to 10 days uncovered for other house-doctor positions during October.
“Fraser Health can say it’s going to put on another shift, but you can’t have a shift if there’s no one to work it,” the source said.
The current shortage of such hospitalists, the professional says, is exacerbated by inequities in payment for doctors between Peace Arch and Surrey Memorial Hospital.
The professional alleges that payment for doctors at SMH is being subsidized, apparently as a means of attracting more doctors.
“Why would someone come here when they can make 50 per cent more there? Fraser Health is aware of it and has promised to correct this, but hasn’t done anything.”
Williams denied there is any difference in compensation for area doctors: “All hospitalists are paid the same rate per hour at Peace Arch, at Langley and in Surrey.”
The source disagreed – “there’s the same hourly rate, but in Surrey you can work four hours and get paid for seven, or work seven hours and get paid for 11.”
Skepticism remains over Fraser Health’s attempts to address the problem, the source said. “It’s gotten worse since Sept. 1, not gotten better.”
It’s not just patients, but also families that have been in distress, and nursing staff have been bearing the brunt of frustration and anger, the source said.
“Apart from the concerns about the patients, if something goes wrong, we’ll all be painted with the same brush.
“The nurses in the hospital’s busiest medical ward have felt abandoned – I’ve seen some of them in tears about this.”