Two hospitals in Quebec City have been increasingly unable to staff their emergency rooms with doctors, a problem that health-care advocates warn will affect more hospitals in the coming months.
The emergency room at Saint-Marc-des-Carrières hospital, located halfway between Quebec City and Trois-Rivières, had 26 shifts in 2015 with no doctor present. That number jumped to 54 last year. In the first three months of 2017, there have been 26 shifts with no doctor in its ER.
A similar problem is occurring in the emergency room of the city's only bilingual hospital, the Jeffery Hale.
This holiday weekend alone there will be no doctor on duty in the emergency room of the Jeffery Hale Hospital on Saturday evening and all day Sunday. There were none present Friday evening either.
Last month, the hospital didn't have a doctor for its ER shifts twice. In both February and January it was worse with three ER shifts not having a doctor.
The hospital only had three shifts in all of 2016 without a doctor.
Doctors in demand
The local health authority responsible for Jeffrey Hale and the Saint-Marc-des-Carrières health centre, the CIUSSS de la Capitale-Nationale, said the ER shortages result from an inability to find doctors willing to work particular shifts.
Smaller emergency rooms, such as those at the Hale, do not have many doctors assigned exclusively to the ER.
Instead they use general practitioners who split their time between the ER and other types of work, such as treating patients as part of a family practice.
Doctors tend to be co-operative in helping the hospital cover its work schedules, but they remain independent workers, said Patrick Duchesne, assistant director of professional services at the Quebec City health authority.
"We don't have the leverage to necessarily force them to work a minimum number of shifts," Duchesne said.
Health reforms blamed
Such doctor shortages in emergency rooms are on the rise across Quebec, said Simon-Pierre Landry, a spokesperson for a coalition of politically engaged doctors known by its French acronym, ROME.
Landry blames the problem on the health-care reforms implemented by Health Minister Géatan Barrette in 2015.
In an effort to ensure more Quebecers have access to family doctors, Barrette struck a deal with Quebec's federation of family doctors: to avoid having patient quotas imposed, the federation agreed to ensure 85 per cent of Quebecers had a family doctor by 2017.
As a result, the federation has established a system that encourages doctors to devote more time to their family practice.
"These doctors are leaving emergency rooms to take on patients," said Landry.
His own emergency room, at Hôpital Laurentien in Sainte-Agathe-des-Monts, has yet to go a shift without a doctor.
But Landry noted the health centre in Temiskaming had no doctor to staff its emergency centre at night for three weeks last month.
Problem will get worse
Emergency rooms without doctors are a health hazard, he said. So are ones that are so understaffed that patients leave before they have a chance to be treated.
"At some point, patients just feel that they are never going to be seen and they leave. This is very dangerous," he said. "They can still be sick with something that is dangerous."
Landry also said the problem will become more pronounced when doctors begin to take more vacation time during the summer months.
In the National Assembly earlier this week, Parti Québécois critic for the Quebec City region, Agnès Maltais, confronted Barrette about the situation at Jeffery Hale.
"Where do we send patients right now? To the emergency room? There's no doctor in the emergency room," she said.
Barrette replied by saying he was surprised to learn about the shortages. He accused the local health authority of not following the law, adding that staffing emergency rooms should be a scheduling priority.
He said his staff will look into the matter.