Resignations and retaliation: B.C. health-care workers see increasingly 'toxic' workplaces

There are more signs that tensions are high in British Columbia’s health authorities as an outspoken doctor on Vancouver Island has faced professional repercussions and nearly all the critical care doctors at a northern hospital have resigned.

A wave of health-care workers – from frontline medical providers to administrators – have reached out to CTV News in the wake of our reporting exposing a culture of fear, intimidation and retaliation for speaking up about issues ranging from alleged patient quality of care issues to purported workplace toxicity.

Now there is a high-profile example of a physician who’s being disciplined just days after calling for updates to B.C.’s medical practices and the resignation of a senior health official. 

Dr. Alex Nataros, who practices family medicine while working as a hospitalist and emergency care physician, has had his emergency privileges suspended by the Vancouver Island Health Authority.

“This has sent my colleagues scrambling here in Port Hardy to fill my shifts as well as on Salt Spring (Island) to fill my shifts,” he said in an interview with CTV News.

“This is having a huge impact on patient care. It is undeserved, it is cruel and it is having significant personal and professional ramifications on my life as a physician that just wants to provide care to my patients.”

Nataros said his use of a therapy dog for palliative and long-term care patients was cited as the reason for the limitations placed on his practice.

“This is not about pets at work, this is about a serious patient safety incident and concerns raised by other members of the health-care team about Dr. Nataros' ability to safely work in the emergency department,” insisted VIHA chief medical health officer Dr. Ben Williams, outlining an ongoing investigation that had preceded Nataros’ suspension.

He cited privacy concerns in the small community for not going into details of the allegations. Typically, the BC College of Physicians and Surgeons does its own investigation into serious cases, but the college's policy is not to confirm any ongoing work, and it only publishes results if wrongdoing is found.

The Minister of Health addressed the question of whether the action against Nataros was due to his criticism of the health authority, particularly Williams.

“No, and that would never happen,” insisted Adrian Dix. “When issues are brought forward, (Williams) has a duty to patients and everyone else on Vancouver Island to act on what he knows.”

Dix did not specify what the “issues” are, claiming he had a duty to Nataros not to speak publicly on the matter.

NORTHERN HEALTH RESIGNATIONS

Meanwhile, the intensive care unit at the University Hospital of Northern BC is being staffed mostly by temporary physicians after seven of the eight intensivists on staff there resigned.

Multiple sources tell CTV News workplace conditions at northern B.C.'s largest hospital have deteriorated further since last year, when local officials were calling for an audit of the Northern Health Authority. 

Northern Health did not dispute the figures and claims one intensivist has been hired to start this summer and that “a number of additional candidates have expressed interest in joining the permanent ICU staff.” A spokesperson says the health authority is looking at a different payment model in the future, with all shifts covered with full patient care in the meantime. Dix was vague when asked about the situation.

“They're working through some issues there and they're going to come to a resolution because everyone's aiming in the same direction,” said the Health Minister.

CTV News has obtained a March 2022 letter sent by several intensivists to the board of directors and a number of political leaders and bureaucrats claiming that “there can be no doubt that NHA’s lack of preparation for the fourth wave of the pandemic, during which the Delta variant became dominant, led to the unnecessary morbidity and mortality of patients from the region,” which could’ve been mitigated, they insist, if their earlier warnings had been heeded.

They also note that in the first two years of the pandemic, Northern Health trained about 10 ICU nurses while losing roughly 40.

Northern Health appears to be the only health authority to have a senior administrator tasked with handling “problem” employees. According to an internal memo sent last April, Dr. Becky Temple is the medical director enhanced medical affairs support, and her top focus is “supporting medical leaders with management of medical staff whose performance or behaviour in the work environment is challenging or raises professional concerns.”

NOT ISOLATED ISSUES

Sources within the system emphasize examples on the island and in Northern Health are not isolated, but rather indicative of issues in many hospitals and public health-care facilities in the province.

In December, a meeting with pediatric specialists was heated, as they discussed patients in labour being turned away, children’s surgeries being cancelled and families waiting hours on the floor of a hospital “in disarray.”

The professional repercussions Nataros is now facing after speaking up won’t help the morale issues already plaguing the system. He insists he’s not the only one being targeted by what he describes as harassment from senior leadership.

“It's led to us bleeding physicians from the North Island and, from my perspective, enough is enough,” said Nataros. “(This is) what happens in bureaucracies and institutions when they're toxic and, unfortunately all too often, (to) those of us who are working on the front lines when we're trying just to serve our patients and do our work and provide high-quality, evidence-based clinical care.”