Concerned councillors and rural municipal representatives went looking for answers from the Sunrise Health Region in regards to the current doctor shortage issue and Preeceville Hospital bypass situation.
A special meeting was held on July 29 between councillors from the Town of Preeceville, Town of Sturgis, RMs of Hazel Dell, Clayton, Preeceville and the Village of Endeavour and Sunrise Health Region representatives Roberta Wiwcharuk, vicepresident of Integrated Health Services; Dr. Phillip Fourier, vice-president of Medical Services and senior medical officer; Sandy Tokaruk, vicepresident of Integrated Primary Health Services; and Derek Keller, Director of Medical Services and EMS.
The group posed a set of questions to the Sunrise Health Region representatives to which answers were written in a letter format and returned on August 17.
In response to the question: why can’t Preeceville Hospital get a locum and why can Canora obtain a locum when it already has two doctors? The response from the SHR was that locums are physicians who cover the shortterm absences of permanent physicians.
The Saskatchewan Medical Association maintains a small locum pool that physicians can apply to for coverage of their clinic practices during vacation and short leaves of absence. SMA locums cover only shortterm periods to enable vacation or educational leaves of absence.
The practice in Canora requires four physicians for proper coverage, however there are currently only two physicians working in the community. Several Yorkton physicians were interested in assisting Canora to cover the 12hour clinic and the daytime hours of the emergency department. Evening coverage is not needed due to Canora being large enough to run a collaborative emergency centre model of care.
To be able to provide uninterrupted emergency coverage in Preeceville requires a 24hour commitment, which means Yorkton physicians providing locum coverage would be away from their home community for 24 hours at a time. When asked what the situation was with Dr. Kabongo and why did he leave the SHR, the answer was that many attempts were made by SHR to encourage Dr. Kabongo to continue his practice in the health centre or if he preferred as a separate medical practice in the community. Dr. Kabongo made the decision for personal reasons to move to Regina in June.
SHR was asked if it has an existing budget for two doctors in Preeceville and now that there is only one doctor where was that funding going for the second doctor. The response was that the health region receives funding for two physicians in Preeceville and the funds cannot be reallocated by the health region for other purposes and any unused funding goes back to the province.
The group posed the question of who is dictating Dr. Adedeji’s hours of work. SHR said that in order to retain physicians in Preeceville, it needs to try a different approach to help improve their worklife balance. It was Dr. Adedeji’s request to not be on call for emergencies every second week so he can focus on the clinic practice without interruption.
Addressing the question of periods in the last month when Preeceville was without ambulance services while on bypass while the ambulance was on a transfer or a call, the response was that there are circumstances that can affect the availability of ambulances.
There are three ambulances which serve Preeceville and Canora areas and these are owned and managed by a private company in Canora. In the month of May, prior to the change to alternating weeks of service interruption there were 28 hours in which all three ambulances were on calls at the same time. In June, there were only seven hours when all three ambulances were on calls.
The strategic long term plan for the Preeceville and District Health Centre is based on current needs in Preeceville and the plan is for continued support for two physicians and a nurse practitioner, as well as diagnostics in the community. There are 38 LTC beds, two respite and 10 inpatient beds in the health centre which the region utilizes.
The region continuously evaluates and adjusts the use of all beds in the region. The current situation is that that inpatient beds in Preeceville are not always needed for acute care, so these beds are used for convalescence, palliative, respite or for patients awaiting care in another type of bed. It is the region’s goal to have reliable emergency services with timely response by a paramedic and ambulance. The numbers of beds have not been affected by the doctor shortage.
The community wanted to know why was SHR not taking measures in advance to avoid or prepare for a doctor shortage.
The health region has enhanced primary health care in Preeceville to improve services and to attract health care professionals to the community. The health region negotiated for funding to hire the Preeceville nurse practitioner and has integrated the clinic and hospital locations to improve connection and communications between care providers.
The health region has actively recruited for Preeceville each time there was a shortage. Recruitment cannot begin until Sunrise receives formal notification that a physician will be leaving the community.
The current model of care in Preeceville is not attractive to physicians. The ongoing concern is the on-call coverage needed to sustain 24/7 emergency and inpatient coverage which does not allow the physicians uninterrupted time for family and personal pursuits.
A full version of all questions and answers can be viewed on the Town of Preeceville website.
