Doctor's punishment leaves Sheet Harbour ER understaffed

There's anger in Sheet Harbour, N.S., following a decision by the College of Physicians and Surgeons of Nova Scotia that prevents one of the community's family doctors from returning to work in the local hospital's chronically understaffed emergency room.

Dr. Bradley Charles Atkinson was suspended in 2016 and a recent settlement between the doctor and the college includes a lengthy remediation plan to return to work. Under the plan, Atkinson can't apply to have his emergency room privileges at the Eastern Shore Memorial Hospital reinstated for at least another year.

"In these days of doctor shortages in Nova Scotia, simply to add to the problem exacerbates it and it hurts people medically," said Chris Snow, one of dozens of people in the community who has reached out to CBC in frustration with the situation.

Complaint about treatment

The problems began in 2016, when Atkinson was suspended after the college received a complaint about the treatment of a woman at Eastern Shore Memorial Hospital.

The complainant said he declined to act on treatment recommendations for patients with cancer. 

An audit of his work found that he kept poor records and there were "virtually no histories" recorded by Atkinson. 

The college placed conditions on his return to practice. They include supervision by another physician with fees to be paid by the doctor, reviews of his records and a final audit. There is also a restriction on the number of patients Atkinson can see in each stage of the process.

Atkinson was one of three family doctors in the community who kept the emergency department open.

Constant ER closures

With only two doctors remaining, the department has faced constant closures.

The physician shortage meant the emergency department was closed for 11 days in May.

"They let it go on for two years," Snow said of the college and its lengthy disciplinary process.

"People are missing their doctor's appointments. They've given up addressing medical issues and are just living with them and the trouble is, they just don't have a voice against it."

The community hasn't wavered in its confidence in the physician who has worked in the town for 25 years, despite the investigation and suspension, Snow said.

"They are extremely frustrated. Extremely disappointed," he said of the people who live in the area.

"The community itself has been, and continues to be, put in an unstable medical situation because the service isn't there."

'It's going to be tough'

The Nova Scotia Health Authority admits that filling the gap created by Atkinson's conditions is going to be a challenge.

"Our hope is we can keep things open and good, but it's going to be tough," said Dr. David Petrie, the senior medical director of the emergency program of care.

But he said people in Sheet Harbour can still be confident in the emergency services offered to the area, pointing to ambulance and air ambulance services.

"Often times people have better outcomes if they're transported directly to higher-capacity hospitals," Petrie said. "Not because there's any problems with care in the smaller ones, it's just that sometimes what really makes a difference with outcomes is getting to the operating room quickly or getting a CAT scan quickly."

Petrie said ideally, recruiters will find a family physician to live in the area who can cover off emergency department and nursing home shifts.

"The Eastern Shore, unfortunately, isn't the only small rural emerge that has some trouble filling all their shifts, so we're constantly trying to recruit as well."

Situation is 'abhorrent'

Without a quick fix, the health authority is looking at lining up emergency physicians who are willing to do locums —temporary fill ins — to try to keep the emergency department open.

Petrie just returned from a meeting in Calgary with recruiters. He said the group had discussions with several physicians who may consider the option.

But the time of year isn't helping. 

"The summer has always been difficult with staffing. For years, it has been but usually through physicians supporting each other, working a little more over a two- or three-week period so they can take a week off, that's what's been done, especially in the rural areas where family docs have taken the brunt of all of this."

Meanwhile, in Sheet Harbour, Snow said people in the community will continue to speak out as their hospital continues to face staffing challenges.

"It's just abhorrent what's gone on," he said.