MacDiarmid understands pressures of ER

B.C. Health Ministry in talks with Emergency Medicine docs.

BC Minister of Health Margaret MacDiarmid

BC Minister of Health Margaret MacDiarmid

In recent days the doctors who work in B.C.’s emergency departments have declared a “state of emergency,” launching a campaign to deal with declining staffing levels and increasing ER visits.

This campaign was detailed in a story in the Daily Townsman on Thursday, March 6.

On Thursday, Margaret MacDiarmid, B.C. Minister of Health, told the Townsman the Ministry of Health was in discussions with the Emergency Medicine Section of the B.C. Medical Association, but also that she herself was sympathetic to the pressures ER doctors face.

“I’m well aware of the contribution that emergency room physicians make,” MacDiarmid said.

“Unlike many Ministers of Health, I’ve actually been that doctor in emergency — in the Trail emergency department — when the three ambulances rolled in and I was the only doctor. So I know the ebbs and flows, and how hard it can be, from personal knowledge.

“We really want to work cooperatively with emergency doctors. I’ve had one meeting with Dr. David Haughton (President of the emergency medicine section of the B.C. Medical Association) and some of his colleagues who are in the leadership of the emergency division. And I’ve made a commitment to them to work with them closely.”

MacDiarmid said an agreement negotiated between government and the BCMA has allocated $90 million in new funding — $20 million  for specialists to address priority areas. “So there are a number of places in that funding that could go to emergency physician services if it was agreed that that was a priority,” she said.

But in some ways, health care funding can be somewhat of a zero sum game. MacDiarmid said the difficulty for government is then to find new monies for any of the specialty sections, including the emergency doctors. “If we get into that situation, many of the (BCMA) sections would say that they have needs that are not met, and that they need more funding?” MacDiarmid said. “If we do it one time, how do we keep from doing it 30 times?

“But that doesn’t mean we can’t work together. The physicians are a very important part of the team, and the emergency room physicians are as well. Some of the things they say we need to do, we absolutely are attending to.”

The ER doctors issued a five-point short term plant to address overcrowding and understaffing:

• Increase physician staffing in ERs to reflect increased ER patient visits;

• Make annual adjustments to ER physician staffing to ensure safe patient care;

• Set and enforce standards regarding how long sick ER patients wait for an inpatient bed;

• Continue and expand initiatives that will reduce the number of ER visits that could otherwise be served by other practitioners;

• Hold administrators in Ministry of Health and Health Authorities accountable for meeting the standards set.

MacDiarmid said a long-term government goal is to build and reallocate capacity.

“Every emergency room I’ve visited since I’ve been Minister of Health, they’ve told me they have patients in the emergency department that are admitted to hospital, but there’s no place for them to go,” she said. “One of the key issues is there are other patients within that hospital that should be in some alternative level of care. It’s moving those patients into either residential care, or home with increased home care services.

“And that is exactly where we’re focussing resources now so that we free up space, And that makes a huge difference to how those departments function.”

MacDiarmid added that Health Authorities are making an effort to have some of these patients actually go home, with additional support at home, and that pilot projects have showed this program to be very successful.

“The problem is that if we shift funding to actually pay doctors more, other than the $90 million that’s already there, then how do we attend to those other needs? How do we build capacity where we need to build it.

“It becomes a very fine issue. I’m very sympathetic to what they’re saying, and I’m absolutely committed to working with them. We want to try it within the agreement that we have with them.”