The British Columbia government and the province's anesthesiologists took competing shots at each other Tuesday in a bitter labour dispute, with each side accusing the other of getting in the way of contract negotiations and preventing more of the specialists from being hired.
The B.C. Anesthesiologists Society set the tone for the day, scheduling a Tuesday morning news conference as it threatened to withdraw services for elective procedures unless the government agrees to increase pay and change the way contacts are negotiated.
The provincial government pre-empted that with an announcement of its own, declaring that the Health Ministry and the B.C. Medical Association, which negotiates the fees on behalf of doctors, had reached a $2.5-million deal to fund round-the-clock obstetrical anesthesiologists at three hospitals.
Health Minister Mike de Jong insisted the timing of the government's announcement, just hours before the anesthesiologists levelled their threat, was merely happenstance.
"Today's announcement is the product of discussions and combined efforts to find the funds to address the issue," de Jong told reporters in a conference call.
"The fact that it's occurring on a day when the (B.C. Anesthesiologists' Society) has decided to issue their threat is entirely coincidental."
The dispute between anesthesiologists and the provincial Health Ministry has been steadily ramping up for the past several months.
The Anesthesiologists' Society's former president, Dr. James Helliwell, resigned in November, alleging the province was putting patients at risk by refusing to resolve his group's concerns.
Two months earlier, the society used a stillbirth at the Victoria General Hospital as evidence the province didn't have enough anesthesiologists. A review by the local health authority later concluded anesthesiologist staffing at the hospital had no impact on the health of the pregnant woman or her fetus, contradicting the society's claims that a staff shortage could be to blame.
And just last week, the anesthesiologists put out a news release offering up $3 million of their own funding to pay for dedicated obstetrical services, although the province has questioned where that money would actually come from.
The Anesthesiologists' Society's demands largely focus on pay, coupled with the desire to negotiate their own rates directly with the Health Ministry, rather than through the B.C. Medical Association. The society wants an arbitrator appointed to settle the dispute.
But De Jong said the province isn't prepared to open up separate negotiations with anesthesiologists, and he suggested the society chose to sit out of talks with the B.C. Medical Association.
He accused the society of preventing the province from hiring additional anesthesiologists, although he didn't elaborate on how that was happening.
"What is essentially taking place is a contractual dispute, a desire for more money, and to threaten to hold not just other physicians but patients themselves hostage to those demands I think is inappropriate and unprofessional," said de Jong.
"In the past, where successful efforts have been made to recruit anesthetists, efforts have been made by members of the society to frustrate their hiring and their deployment."
The province has previously accused the society of refusing to allow its members to fill obstetrical anesthesiologist positions.
Dr. Roland Orfaly, executive director of the B.C. Anesthesiologists' Society, disputed much of what de Jong said.
Orfaly insisted the medical association and the province have refused to invite his group to the negotiating table, and he contradicted de Jong's assertion that there is no anesthesiologist shortage in B.C.
"What we would like is a process where we can actually sit down, in a reasoned and intelligent way, probably with the requirement of an arbitrator, to review it independently, to discuss what the problems are and target resources at the problems and not at the symptoms," Orfaly told reporters in Vancouver.
"I think there's no questions that there's a recruitment and a retention problem and a shortage of anesthesiologists in the province that leads to closed operating rooms, longer wait lists, delays in emergency care and certainly patient safety issues, as well."
Dr. Nasir Jetha, the president of the B.C. Medical Association, wasn't available for an interview Tuesday, but he issued a statement the day before.
"The B.C. Medical Association does not support the possible withdrawal of services by anesthesiologists," Dr. Nasir Jetha said in the statement
Jetha said the College of Physicians and Surgeons of B.C. requires doctors to exhaust all other options before threatening to withdraw services, and he said the Anesthesiologists' Society hadn't done that. Jetha also said anesthesiologists have the ability to initiate a review of patient care, but he said the society hasn't done that, either.
