© Guardian photo
Queen Elizabeth Hospital medical director Dr. Rosemary Henderson, here outside the building’s emergency department, says recent issues involving extra patient loads have been resolved.
One emergency room doctor has quit and another threatened to leave the Queen Elizabeth Hospital over the extra patient loads facing their department during periods of physician shortages.
The resignation came after ER doctors recently had to see patients in other parts of the hospital because of a shortage in hospitalists.
Dr. Rosemary Henderson, the QEH’s medical director, said the situation does create problems for ER doctors and they have legitimate concerns because patients get transferred from shift to shift, which increases the risks.
“It’s not a good situation,” Henderson said Thursday.
The issue arose because the QEH was temporarily down one hospitalist, which is a doctor that sees patients who have been admitted to the hospital, but don’t have a family physician who can care for them there.
Dr. Trevor Jain, an ER doctor at the QEH, raised the issue in a public forum Tuesday through a series of messages on Twitter.
In one message he warned of delays, diversions and long waits as ER doctors coped with the shift in responsibilities. Other messages mentioned the doctor quitting over safety concerns and the potential of a second resigning.
“Doctors outside the ER need to pull their weight,” one message said.
Attempts to reach Jain for comment were unsuccessful.
As for the doctor who quit, Henderson said she was filling a locum, which is a temporary position, and felt the situation was unacceptable so she resigned with about six shifts left.
“That was her decision to make,” said Henderson.
She said some of the doctor’s ER shifts have been filled and work is underway to fill the rest.
Another doctor, who works part-time, has also threatened to quit if asked to take on inpatients again.
Henderson said the hospital would prefer if people who left the ER did so for reasons other than how it organizes its services, but in dealing with the issue for many years the hospital hasn’t been able to come up with a better, more acceptable solution.
“People do have to make their individual choices about what they do in life,” she said.
Henderson said there are normally the equivalent of 3? hospitalists looking after patients at the QEH who see a maximum of 60 people per day. This week the hospital was short one of those doctors, she said.
“That’s not happened to us before.”
Henderson said the QEH has reached its maximum capacity for its hospitalist service before, but it hasn’t been very common.
Between July 2012 and July 2013, there were only four days when the QEH reached its maximum capacity, she said. Since July 2013 it has happened seven times.
When that happens ER doctors are asked to temporarily care for extra patients until the capacity returns to normal.
“Normally that doesn’t take very long,” Henderson said.
Henderson said the hospital hires ER doctors to work in emergency department patients and that is where their focus should be.
“If we’re asking them to do a job they don’t normally do and shouldn’t really be doing then their focus is split between the two populations,” she said.
Those extra responsibilities can lead to longer wait times in the ER and inpatients may not get the kind of attention they should be getting from a physician, Henderson said.
A combination of factors led to the shortage this week including doctors out on maternity leave, vacation time and other commitments that couldn’t be changed.
Henderson said ER doctors have made their concerns well known to the hospital’s administration for a long time and the administration agrees with them.
“None of us think that this is a good way of handling the situation of what we do when we hit hospitalist capacity,” she said.
She also said the hospital is concerned the situation may have left people with the impression they should question the care they will get from the emergency department.
“We have our struggles but they shouldn’t feel that they should stay home if they really feel they need to be in the emergency department.”