Even after a call went out for the delivery of additional chairs, it was standing-room-only in the Memorial Composite High gymnasium in Sydney Mines for the rally where doctor after doctor passionately outlined their fears about the implications if the pool of doctors continues to erode and if the Northside General emergency department is ultimately shut down permanently.
“I cannot speak for all of my colleagues, but I know a lot of us are tired, stressed, frustrated and struggling to keep up,” said Dr. Irina Ghenea, who has been in family practice in North Sydney for 17 years.
“If we are not already there, we are rapidly approaching a crisis situation.”
“I have a message for the Nova Scotia Health Authority,” noted Dr. Jeanne Ferguson, a geriatric psychiatrist. “Hear us clearly — this is not working.”
Ghenea noted the Northside General has seen reduced emergency department hours, an in-house internist has retired and was not replaced, a radiologist has not been replaced, and there are hundreds if not thousands of patients without family doctors.
Standard wait time for a mental health referral in Cape Breton now stands at 354 days, compared to 80 days in Halifax, she said, eliciting gasps from the crowd. Two more psychiatrists are due to leave the area this summer.
The area has also lost vascular surgery, thoracic surgery, infectious disease and geriatric specialists, Ghenea said, and there is only one child psychiatrist in Cape Breton.
“We do not have anywhere near the number of adult psychiatrists needed to deal with our current mental health crisis,” Ghenea said. “If these losses were not taxing enough, many family physicians have recently left the area and others are changing or leaving their practices as they get older.”
That leaves fewer doctors trying to keep up with the increasing needs of an aging population.
“We need help, instead our government is threatening the viability of our emergency room and limiting our ability to recruit more doctors,” Ghenea said. “The public is being told that the health authority or our government are looking for more doctors or trying to recruit and I am here to tell you that this is simply not true.”
The Department of Health seems to have an arbitrary number of family physicians allotted to the community, she said, and they are being told the area is at capacity. Ghenea said she has asked numerous times how that number is calculated but hasn’t gotten an answer.
“The only thing I do know with certainty is that the number of people who don’t have a family physician is not part of the equation,” Ghenea said.
Decisions are being made unilaterally by government at a distance and aren’t based on the knowledge of front-line physicians, she said, adding that morale in the local medical community is at an all-time low.
On days when the Northside General emergency department is closed because a doctor isn’t available to staff it, patients are directed to go to the Cape Breton Regional Hospital in Sydney, causing “critical overcrowding” there, said Dr. Joan Salah, a family doctor.
“If North Sydney has further decreases in its resources and funding we will have decreased hours and we are certainly at risk of closing,” she said.
Salah said there seems to be a lack of understanding of the complexities of primary care and emergency room care.
“The difficulty here is that access is being removed piece by piece, hour by hour from the emergency department but not being replaced by anything else,” she said.
The discussion of collaborative practices is welcome but that’s of little immediate help if they’re expected to open over the next five to 10 years, Salah added.
Dr. Margaret Fraser has a family practice in Sydney and has worked in many communities around Cape Breton. She noted that doctors aren’t normally ones to speak out about the state of health care but they are also obligated to act as patient advocates.
“Today, we’re here to advocate for our community, for the health of Cape Breton,” she said.
The conditions that she sees some emergency department patients have to endure for days as they’re kept on stretchers in hallways — constant noise, no dark area where they can go to sleep — are considered recognized forms of torture, Fraser said.
“We are doing it to our elderly, to our young people, to children every day,” she said.
There are many patients whose conditions are compromised because they lack a family doctor and the continuity of care that comes with it, she said. There are some medications that cannot be prescribed to patients because they don’t have a family doctor to monitor their effects.
In the three emergency department shifts she has worked in Sydney in the past week, every hallway has been crammed with patients for the duration of the shift, Fraser said.
If the regional hospital emergency department had to deal with the 10,000 patients a year currently seen at the Northside General’s department “the place will fall apart,” she said.
Members of the public also expressed their frustrations with the system. Marlene Gallant of Englishtown noted her husband requires a stem cell transplant and expressed her frustrations with the system and the lack of response from government.
“They really should be enraged, because when it happens to you, let me tell you, it’s not pretty,” she said. “I’m sorry for being upset about this but it’s the truth, and I think I’m speaking the truth for everybody here.”
