Locums aren't the only ones who need incentives, says N.W.T. doctor

Locum doctors travelling north to fill gaps in the N.W.T.'s health care system shouldn't be the only ones benefiting from incentives from the territorial government, says one northern physician.

Dr. Katherine Breen, an emergency room doctor at Stanton Territorial Hospital and an executive member of the N.W.T. Medical Association, said the people who have kept the system going feel disrespected and uninformed, as the territory rolls out financial incentives to attract short-term physicians.

The Northwest Territories Health and Social Services Authority announced last week that it was increasing pay for locum physicians. This move followed a warning from doctors who told a territorial committee that the emergency department at Stanton Territorial Hospital was in danger of closing this summer if something wasn't done to boost staffing levels.

Breen said she has worked through holidays, night shifts, pregnancy, the pandemic and wildfire evacuation. She said she's watching short-term doctors get better pay and more flexibility than those who have built their lives in the North.

"It feels like a slap in the face," she said. "Not only does that reflect a lack of respect, but a lack of value."

Breen said while local staff appreciate the extra support from locums, long-term physicians bring expertise and experience, are committed to the North, and care deeply about their patients.

"Some days, I'm the only physician scheduled to cover the department for 72 hours straight," she said. "I can't safely or legally work for 72 hours."

Although the health authority has said closing the emergency room is not an option, Breen said there has been no communication with the N.W.T. Medical Association on the plan to resolve staffing issues and work conditions.

Breen said doctors, nurses, specialists and support staff are all being pushed to the limit.

She said there's growing tension on the floor and a disconnect between staff and leadership, especially when public messaging doesn't match the reality frontline workers face. On the same day the territory announced there would be no service reductions at the hospital, she said patients were waiting up to 12 hours to see a doctor.

"Meanwhile, the health authority issued a message saying there were 'no service reductions to announce,' as if this level of strain is normal, safe or acceptable. It isn't," she said.

As of Monday, Breen said over 30 shifts in the emergency department remain unfilled.

She said the N.W.T. Medical Association is asking for better transparency and for the government to include frontline workers when planning for long-term solutions.

"We're not asking for applause. We're asking for leadership," she said.

'Recruitment is full blast'

On Thursday morning, Health Minister Lesa Semmler and Northwest Territories Health and Social Services Authority public administrator Dan Florizone told CBC that while the system is under pressure, efforts are underway to stabilize staffing.

"Around this time of the year, tensions get high," said Semmler. "It is a 24-hour a day service. People that are here permanent want vacation … and they deserve that. And so this time of the year, recruitment is full blast."

Semmler also said that while they did raise the rate for locum doctors, they are still earning less than permanent staff. She said the total compensation package for full-time doctors, including benefits, leave and training, is still competitive.

"There are many benefits that full-time staff get that locum staff don't get," she said. "[Permanent staff] negotiate that."

Semmler added staffing issues within the health-care industry are still being felt across the country. 

Florizone said this year has been more challenging than most when it comes to staffing, but added that this is also the most competitive their rates have been. He said the increase in locum pay is just one part of the overall plan to improve the system. 

While Breen said over 30 emergency room shifts were unfilled earlier in May, Florizone said that many have since been covered. He also said it's understandable that doctors feel anxious about unstaffed shifts, but said it's unfortunate they are sharing their concerns with the public.

"We need to do a better job in communicating both ways so that we understand where things are at," he said. "But the anxiety that this has created is really unfortunate."