Internal medicine docs at QEH to send back some referrals due to 'unsafe' wait times
Wait times for some cases are stretching from weeks to months to years, according to doctors' memo
Five internal medicine specialists at the Queen Elizabeth Hospital in Charlottetown say they will no longer accept non-urgent referrals starting Jan. 21 because wait times for their services have become "unsafe and unsustainable."
The five doctors who work at the internal medicine clinic at the QEH advised their colleagues of the change in a memo sent on Dec. 20 that was shared with CBC News.
The memo says the clinic is "experiencing increasingly unsafe and unsustainable wait times for new consults and follow-up patient visits," and that the decision by the doctors to limit referrals "was made only after reaching a point where we can no longer provide sustainable and safe care."
The doctors said wait times for their services have grown from weeks, to months, to more than a year in some cases. According to the memo:
- Patients who were flagged as urgent by emergency room doctors are waiting three months for an initial consult where the wait time used to be less than two weeks.
- Semi-urgent cases from the ER are waiting more than a year, where the wait times used to be eight weeks.
- Semi-urgent cases referred by primary care providers are waiting 12-18 months instead of two to three months.
- Three-month followup appointments for medical and cardiac patients are instead taking up to a year, with similar delays for six and 12-month followups.
According to the Canadian Medical Association, specialists in internal medicine are trained to diagnose and manage diseases involving any of the organ systems, and to manage seriously ill patients suffering from advanced illness and/or diseases of more than one system.
The memo signed off by the five physicians says all referral requests will be acknowledged within 14 days, and an estimated wait time for a consult will be communicated. The doctors ask that all referring health-care providers continue to monitor their patients for "clinical stability."
One problem they cite, however, is that about a 2,000 of their current patients — representing one of every four patients at the clinic — have no primary care provider, meaning they require additional support for followup care.
The physicians say they will gradually start accepting new non-urgent referrals once wait times reach "an agreed-upon safe level."
In a statement, Health P.E.I. confirmed the QEH internal medicine clinic will no longer accept non-urgent referrals and said it understands "the impact this change will have on patients and referring providers."
"This difficult decision is necessary due to a substantial increase in demand for internal medicine services, leading to unsustainable wait times," the agency said.
Until the clinic resumes accepting non-urgent referrals, Health P.E.I. has suggested doctors who want to refer patients to internal medicine could do so using a virtual service.
Health P.E.I. said it is in the process of recruiting 15 internal medicine specialists, including seven positions for general internal medicine — the type of doctors who would work at the QEH clinic.
It also said it is committed to supporting the clinic by increasing positions for support staff, and working to connect unaffiliated patients with a primary care provider.
CBC News reached out to both the Department of Health and Wellness and the Queen Elizabeth Hospital internal medicine clinic for further comment but has yet to receive a response.
'Completely blindsided'
In 2023, Health P.E.I. shut down the intensive-care unit at Prince County Hospital in Summerside because of a lack of internal medicine specialists. The ICU was transitioned into a progressive-care unit, which can be operated by family physicians, hospitalists and nursing staff. The intensive-care unit remains closed.
Interim Green Party Leader Karla Bernard said the new limit on access to internal medicine at the QEH will be devastating for Islanders who have already been struggling to get care.
"This is a cut to services. So we are cutting Islanders' access to health care," she said.
Bernard said the change will also leave physicians trying to get their patients into the clinic "scrambling."
"They took an oath to ensure that they do everything in their power to take care of someone's health. And now they're going to be knowingly not doing that because they don't have the resources to send people to."
Bernard also questioned the lack of a public announcement from Health P.E.I. advising Islanders of the change.
"So who is that transparency with? The people that it impacts the most were completely blindsided."
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