Doctor shortage forces closure of Sussex ER on holiday Monday

No emergency care will be available at the Sussex Health Centre's ER this holiday Monday because of a lack of emergency physician coverage, says Horizon Health Network.

Patients with "urgent but non-life-threatening medical needs," such as vomiting and diarrhea, mild respiratory issues, mild aches and pains and minor infections can still receive virtual or in-person care at the hospital, according to the social media post Thursday.

But patients who need emergency care will be transported to "another facility," and anyone experiencing a life-threatening emergency should call 911.

This change in services is temporary, Horizon said.

The president of the New Brunswick Medical Society, however, contends further closures are inevitable" unless Horizon reverses a decision, effective this Saturday, to end the financial incentives it provided to doctors to work at the Sussex ER, as well as the Charlotte County Hospital ER in St. Stephen.

"For the past two quarters, these targeted incentives have played a crucial role in keeping rural emergency departments open in these communities," said Dr. Lise Babin, noting similar incentives are widely used across the country to help sustain access to emergency care in rural areas.

"The impact of this decision is already being felt."

Babin was referring to the Sussex ER staying closed on the holiday Monday, "forcing patients to seek care in larger urban centres — adding strain to already overburdened hospitals and increasing risks for patients."

With no ER physician on-site, an emergency department is "effectively closed," Babin said in an emailed statement.

"It appears that a successful, proven measure is being removed — potentially to justify the introduction of a virtual care pilot project that cannot replace in-person emergency care," she alleged.

Horizon did not respond to repeated requests for comment.

Doctors seek end to virtual ER pilot

Earlier this week, the medical society called on Horizon and the Department of Health to cancel the virtual care service being tested at the Sussex and Charlotte County ERs.

The professional association, which represents more than 2,000 physicians, contends that Horizons contract with Teladoc Health Canada is a misuse of $866,000 in a time of crisis, and that it will lead to more small ERs closing.

The money would be better spent on incentives for doctors to provide in-person ER coverage and increased access to urgent and primary care after-hours in these communities, Babin said.

Under the pilot, patients who visit the ER are assessed by an on-site triage nurse and registered. If they have non-life-threatening medical issues that can be dealt with virtually, they're offered the option to see a Canadian-based emergency-trained physician working remotely, via video.

On-site nurses and other health professionals assist the virtual doctor to diagnose and prescribe by performing assessments using Teladoc technology, such as electronic stethoscopes and handheld cameras.

The virtual doctors see mostly non-urgent or less urgent patients, which frees up doctors in the ER to focus on more critical patients, Horizon officials have said.

Horizon president and CEO Margaret Melanson has defended the pilot, saying that 656 patients had received virtual care as of Jan. 31 — about 20 per cent of all patients who visited the two ERs.

"We know face-to-face care provided by an emergency physician is the gold standard for emergency and urgent care. However, face-to-face care is not always possible," she said.

In its social media post Thursday, Horizon said it's "working hard to ensure New Brunswickers have access to the care they need, when they need it, and … actively recruiting physicians and other health care workers to staff all vacancies."

"This interim solution allows us to keep the Sussex Health Centre Emergency Department open while recruitment is ongoing."

Babin said the medical society is working with the doctors affected by the incentives decision, Horizon and the Department of Health to "advocate for solutions that ensure patients in these communities continue to have access to timely emergency care.

"Decisions that fundamentally alter access to care for rural communities must not be made behind closed doors."

Patients who are unsure what level of care they need can call Tele-Care 811 or visit Horizon's SoWhyWait.ca.