After-hours emergency room service will no longer be offered at the Kaslo hospital after November 2.
Interior Health announced late Thursday that the Victorian Community Health Centre in Kaslo will soon only offer emergency service Monday to Friday, from 9 a.m. to 5 p.m.
Dr. Alan Stewart, medical director of Interior Health's community integrated health services, said the change was demanded by doctors tired of being on-call 24-7.
"We've known for awhile that the physicians were finding their jobs very stressful," Stewart said. "They informed us about a month ago that they'd reached the breaking point, that they were burned out, and that they wouldn't be able to continue providing the after hours and weekend coverage."
Interior Health receives funding from the province to hire two full time physicians in Kaslo. Because it's a rural community, and the workload is inconsistent, doctors there are paid based on a set contract rather than following the fee for service model used in more populated areas.
Ideally the doctors would work in the clinic during the day and be on call to respond to emergencies that occur outside regular hours. But Stewart said it's been impossible for Interior Health to find anyone to do this.
"We know it's not an attractive model because we haven't been able to recruit anyone to do it," he said.
Instead, the two full-time equivalent positions have been spread between three doctors each working 0.5 FTE and a variety of locum doctors from outside the area that travel to Kaslo to pick up the additional hours.
Ideally, the doctors would split the on-call work, however it's become obvious to Interior Heath that that isn't happening.
This year the emergency department has been closed 60 times because doctors or nurses were unavailable. (According to Tina Coletti of the BC Nurses Union, only 14 of the closures can be attributed to a lack of nursing staff, while the rest were for a lack of doctors.)
Stewart said rather than having an infrequent and unreliable emergency service — and exhausted doctors — it makes more sense to strengthen the daytime service.
"The time that doctors would have spent in emergency will instead be spent in clinic during the day," he explained. "We'll be adding a rapid access service at the clinic, so people who would usually go to the emergency department can be seen quickly at the clinic instead."
Stewart said most people who use the emergency room aren't actually facing emergency situations. And when an emergency does occur, he said, BC Ambulance can transport people to the hospital in Nelson or Trail.
"It's understandable that people who are used to having ready access to an emergency department wouldn't find that to be a good alternative," he acknowledged.
Indeed, some 300 people from Kaslo and the surrounding communities attended a public meeting with Interior Health on Thursday night. The vast majority did not support the reduction in ER hours.
Kaslo Mayor Greg Lay, who organized the meeting, said he and fellow residents were upset that Interior Health came to them after the decision was already made, rather than consulting with them earlier.
"I'm a little resentful, frankly, that we're being told what we need by so-called experts," Lay said. "We're the experts because we live here. Interior Health is treating us like peasants out on the countryside, like we don't know what's good for us."
Last week, Kaslo council unanimously supported a motion put forward by Lay to request Interior Health impose a two year moratorium on any changes to emergency room hours.
Lay said the community could use that time to become involved in recruiting doctors and, perhaps, offer incentives for doctors to work there.
"Any doctor that comes to Kaslo should realize that they're part of a community and there are community expectations that they're going to be subject to, which includes providing emergency service and being on call," he said.
Lay admitted Interior Health wasn't likely to respect his request. (According to Stewart, the decision is final.)
Even so, Lay said he plans to form a committee to come up with alternative ways to provide around the clock emergency services. He's requested Interior Health provide an outline of their existing service mode.
"We'll work with their information to come up with something they can bring to their bosses to show them what the community is offering to do to help them find solutions," Lay said. "We're not going to sit back and accept this as the way it has to be."