B.C. health care crisis: No doctors available for hospitalized patients

Some patients admitted to a Vancouver Island hospital over the long weekend were stunned to receive a notice telling them that even though they’d been admitted, there wasn’t a doctor available to care for them.

CTV News has obtained a copy of the document, which tells patients at the Nanaimo Regional General Hospital that while an emergency room physician determined they needed to be there, “you are admitted to hospital but without a physician overseeing your ongoing care.” 

The letter, which is not on letterhead and written by staff, provides contact information for senior leaders at the Island Health Authority and the leaders, explaining that hospitalists on shift were overwhelmed.

"You will not have a most responsible physician assigned to you until their capacity as a service permits this,” it says.

The health authority's vice president for clinical services and acute care in the central and south island said there were hospitalists on shift through the weekend, but not enough, leading to long delays.

“The situation is not ideal and it's not a situation we want to find ourselves in,” said Marko Peljhan. “We do have a shortage of physicians on the site, that is not unusual for us at Nanaimo Regional General Hospital and you’ll find that in many jurisdictions across the island and across the province and the country.”

Several sources at the hospital tell CTV News the facility has been on the brink for some time, and Peljhan acknowledges the departure of just two hospitalist doctors “that provided the majority of in-patient care” was enough to tip the scales. 

A 'MONSTROUS' IMPACT

The founder of British Columbia’s most high-profile patient advocacy group called the situation scary and alarming. 

“We can easily have that perception 'once I'm in the hospital I'll be safe, I'll be protected,' but what this letter is telling us is that's not what’s happening,” said Camille Currie. “The impact on patients is monstrous.”

One patient who spoke to CTV News on the condition we not identify them, said they were told they may be cared for by nurses alone for days until a doctor had capacity to see them, and that given their condition “it could’ve gone dramatically bad.”

Peljhan insisted that in most cases, it was only a day or two wait for hospitalized patients to be attended and “attached” to a hospitalist doctor who would be responsible for their care.

CONTRACTS AND STAFFING LEVELS

Hospitalists doctors have the same training as family physicians, who often practice in both settings. However, while primary care physicians have a collective contract on what they’re paid by the province for their services, each health authority negotiates with the hospitalists in each facility on an agreement; it’s restricted by the conditions and terms imposed by the provincial government, meaning it’s very difficult to provide special incentives or compensation for difficult-to-staff hospitals. 

Nanaimo’s hospitalists have been without a contract for years and have similar issues as doctors in the Lower Mainland who went public with their issues and related patient safety concerns earlier this year. 

Fraser Health and Vancouver Coastal Health told CTV News they didn’t have any emergency department diversions or closures over the long weekend and staffing levels have been “stable,” but Northern Health acknowledged that four of their hospitals had both planned an unscheduled disruptions to emergency services over the long weekend, which “varied in duration and were the result of either nursing staff or physician coverage gaps.”