By Ruby Pratka
Local Journalism Initiative
For weeks, emergency rooms across the Eastern Townships have been full to overflowing. On Jan. 14, according to the health data website IndexSanté, Granby Hospital had an occupation rate of 145 per cent, the Hôtel-Dieu de Sherbrooke 105 per cent, the Fleurimont Hospital 104 per cent and Brome-Missisquoi-Perkins (BMP) Hospital 81 per cent – down from 131 per cent two days earlier.
Health Minister Christian Dubé told reporters at a Jan. 13 press conference that the situation in the province’s emergency rooms would “continue to be difficult” in the coming days and weeks. Dr. Gilbert Boucher, president of the Association des spécialistes en médecine d’urgence du Québec, said emergency room personnel “are struggling to provide adequate service to the population.”
“We are always there for you if you’re sick, [and] urgent cases won’t wait, but if you are low priority, you probably won’t be seen,” Boucher added.
Dubé said about half of the 10,000 people seeking care in the province’s emergency rooms every day are patients with minor health issues, who should ideally be treating their symptoms at home or seeking care or health advice elsewhere – from a family doctor, a pharmacist or a nurse through the province’s 811 helpline.
Two members of a Waterloo-area family wish it was that easy. Nadine and her daughter Abbie, who asked that their last names not be used, are among the nearly 540,000 Quebecers – including more than 64,000 Townships residents – waiting for a family doctor.
Both have chronic health conditions – Nadine, 46, is a cancer survivor with a liver condition and Abbie, 28, is diabetic. Their family doctor retired more than four years ago and was replaced by a doctor who took fewer patients. The new doctor “took my five-year-old son, but not me,” Nadine said. “Knock on wood, so far I haven’t been sick, but if I was, I would have to go to the emergency room and hopefully wait less than 12 hours.”
“I’ve just been staying away from everyone so I don’t get sick,” said Nadine, who isn’t working at the moment. “If I was able to see a doctor, I’d feel a lot safer. I have been trying to get a prescription renewed for three months, and the pharmacy said they couldn’t fill it unless I saw a doctor.” Nadine’s own mother, who is in her 70s, doesn’t have a family doctor either, despite recent surgery. “She had a hip operation and now her feet are starting to turn black…she doesn’t want to go sit in the hospital. She’s just been staying home and trying to keep blood flowing.”
“It would be nice to start getting regular checkups and blood tests, get back on proper medication and get [my health] under control,” said Abbie, who has been trying to keep a handle on her diabetes as best she can, with regular blood sugar self-checks. Although private care is out of reach, she has driven three hours to be seen at an Ontario hospital on several occasions.
Cowansville resident Jill Glover’s mother lost her family doctor in 2017, and was unable to see a doctor between 2017 and March of last year, when she had a heart attack. She tried and failed to make an appointment at the Knowlton Clinc, but wasn’t seen there. “They gave me a number for a nurse practitioner’s clinic in St. Alphonse…but my mother is English and didn’t want to go too far from home, so we didn’t go there.”
Dubé said the Ministry of Health and Social Services has been in discussions with the Fédération des médécins omnipraticiens du Québec (FMOQ), the family doctors’ professional association. The federation’s president, Dr. Marc-André Amyot, said he’s aware that many people go to the ER because they don’t have a family doctor. He said the province was short about 1,200 family physicians, and one in four practicing family doctors was over 60. However, he said, “we don’t just want to sit on the fact that there’s a shortage.” According to the FMOQ, possible solutions include getting rid of the “patient ceiling” – the number of patients beyond which doctors are paid a smaller amount per patient – scaling up the number of appointments available via Info-Santé during peak virus season, and allowing those who call 811 or show up at emergency rooms to make an appointment with a doctor or another health professional, such as a dentist or a physical therapist.
“The emergency room is the one place everyone can go,” said Dr. Pierre Fontaine, co-spokesperson for Médecins québécois pour le régime public, a doctors’ group which advocates for a more accessible public health system. “We agree that they shouldn’t be in the ER, but it’s their only option. We need strong frontline services and better working conditions [and] it needs to be easier to make a doctor’s appointment. We really need to reinvest in local clinics.”
Stéphanie Goulet is the interim president of the Syndicat des professionnelles en soins des Cantons-de l’Est (SPSCE), the union representing nurses in the Townships. “There are people in the ER who should not be there, but it’s not their fault, and if we took them away, we’d still have a problem, because there aren’t enough beds on the wards.” She said a shortage of doctors in the region is compounded by a lack of nursing home beds and a labour shortage among nurses – there are at least 800 vacant public sector nursing jobs in the region. “We have a chronic personnel problem that we need to solve – we need to improve working conditions and then we can open beds.” The SPSCE is a member of the Fédération interprofessionnelle de la santé du Québec (FIQ), the nurses’ union federation, which is currently negotiating a new collective agreement with the government. “Our network is imploding.”