The Ontario Medical Association and Ontario’s Ministry of Health have said they are in active negotiations to find a more permanent solution. As of Monday, when the temporary program was set to end, no agreement was in place.
Anxiety is rising in rural Ontario as a temporary program credited with helping to keep hospital emergency departments open in recent years comes to an end.
Both the Ontario Medical Association and Ontario’s Ministry of Health have said they are in active negotiations to find a more permanent solution to ensure there is adequate physician coverage to prevent temporary emergency department closures. But, as of Monday, when the temporary program was set to end, no such agreement was in place.
In a statement, Hannah Jensen, who is spokesperson for Health Minister Sylvia Jones, said hospitals “can continue to schedule physician coverage as required as we work with the Ontario Medical Association to transition the temporary locum program into a permanent program through the new physician services agreement.”
It was unclear whether that means a top-up in physician pay to help fill gaps will continue even after the temporary program had expired.
Temporary emergency department closures, especially in rural and northern hospitals, have become increasingly common since the beginning of the pandemic, fuelled by nurse and physician shortages. Last year was the worst in Ontario’s history for ER closures, according to groups and advocates that monitor them.
Evening Update
Emergency doctors, though, say the temporary locum program has helped prevent some emergency department closures, which is why there is concern about the end of the temporary program before an alternative is in place.
The program, which offered an hourly pay increase, made it easier to fill physician gaps in emergency departments by incentivizing doctors to take on an extra shift.
With the end of the program, some doctors are already talking about scaling back the number of emergency department shifts they take on, raising fears of more emergency department closures heading into what is the busiest season in many rural hospitals.
In a memo to emergency department physician leads, Dr. Angela Marrocco, who chairs the Ontario Medical Association’s section on emergency medicine, noted that the temporary locum program, put in place during COVID, “has transitioned into a lifeline that many (hospital) sites rely on to maintain coverage.”
Marrocco said the OMA is working to “mitigate any negative impacts” related to the gap between the end of the crucial program and the introduction of a more permanent program.
“We remain optimistic that a permanent, new solution is possible to continue to allow (emergency departments) to have stable staffing at appropriate hours of coverage and compensation levels.”
Dr. Alan Drummond, an emergency doctor in Perth, said the program has worked as an incentive at a time when many health professionals find emergency medicine increasingly difficult because of crowding, hallway medicine, frustrations that sometimes turn to violence, and a sense among medical professionals that they aren’t able to give the kind of care they should.
“We are still pretty tenuous — just one sick call away from being closed at times,” he said. Although Perth’s emergency department has not seen recent closures that other rural hospitals have, Drummond said there are up to four or five shifts a month that are not covered, forcing people to jump in to prevent the department from being closed during that shift.
Without the temporary program, he said, “I think we are going to have people with young families who are not willing to drop everything who will say, ‘Forget it, if you have to close, you have to close.’ ”
Potential shortages are more acute in the northern part of the province, he added.
Other rural emergency physicians have echoed those concerns that “heroic efforts” that have been made to prevent emergency department closures are less likely with what amounts to a funding cut, making closures inevitable.
