No family physician, no referrals: How the doctor shortage is affecting one family in Labrador West

·4 min read
Annabella Ringer used to see a gastroenterologist at the Janeway children's hospital in St. John's, but since she turned 18 she hasn't been able to see one, and has not been transferred to adult services. (Submitted by Lisa Ringer - image credit)
Annabella Ringer used to see a gastroenterologist at the Janeway children's hospital in St. John's, but since she turned 18 she hasn't been able to see one, and has not been transferred to adult services. (Submitted by Lisa Ringer - image credit)
Submitted by Lisa Ringer
Submitted by Lisa Ringer

For Annabella Ringer, a young Labrador West woman with the inflammatory bowel diseases Crohn's and colitis, her diagnosis means monthly blood work to check up on her inflammation markers — but Ringer doesn't have a family doctor to follow up with the family.

Without a family doctor, says her mother, Lisa Ringer, they never know when her inflammation markers are elevated, a very dangerous situation.

"My only avenue is to continue going to the outpatients department, emergency department when she becomes ill," Lisa Ringer told CBC News. "Things are not getting better for her and this is my fight now because she has exceeded the age for the Janeway."

Annabella Ringer was being seen by a gastroenterologist at the Janeway, but since she was 18, her mother said, she hasn't been able to access those services. Lisa Ringer says her daughter was not given a referral by the specialist at the Janeway and that every time they visit the emergency room when their daughter is ill, they are told to follow up with their family doctor.

Emergency room doctors haven't given Annabella a referral to see a gastrointestinal specialist for adult services, said Lisa Ringer, who believes that if they had a family doctor, they could get that referral.

"We need a doctor that we can go to regularly or discuss options with and for them to have knowledge. Every time we go to the emergency department it's the same thing. They want the history on her illness and when it started," said Lisa Ringer.

"We're at a real disadvantage not having that consistency of care. I'm bouncing from doctor to doctor.… I just don't think it's fair that we're put on the back burner for health care here in Labrador West."

Submitted by Lisa Ringer
Submitted by Lisa Ringer

In an emailed statement, Eastern Health said that if patients require specialist care after their 18th birthday, the specialist they are seeing is responsible for referring them to the adult service and the patient can continue to be seen at the Janeway until they have their first adult gastrointestinal appointment.

But while Eastern Health says specialists at the Janeway are responsible for referring patients to adult specialists, Lisa Ringer says that hasn't happened for her daughter.

Annabella Ringer hasn't been seen at the Janeway for over a year, she did have appointments that her mother says were cancelled due to COVID restrictions and until May she had been "maintaining her health."

'Glaringly obvious' issue

The Ringer family's problem is not unique. Labrador West MHA Jordan Brown says it's something that he hears from constituents "on an hourly basis" and is a battle Labrador has been facing for a long time.

Brown says the shortage of services has created a two-tiered health-care system in Labrador.

"People are forced to pay thousands of dollars to travel to receive health care and treatments, and testing that was normally done in Labrador now has to be done on the island."


Brown says recruitment and retention strategies that involve training Labradorians to fill these vacancies are a potential solution.

"We need to have a long-term health-care plan that involves our own people here in Newfoundland and Labrador," said Brown.

In an interview with the CBC's Labrador Morning, Health Minister John Haggie acknowledged there is a "significant issue" with access to primary care across the province.

"We've never hid that and it's glaringly obvious to anybody who looks," he said.

Haggie said the long-term approach to recruitment and retention will be informed by the Health Accord report, but there are short-term operational problems, including the time it takes to train health-care professionals.

"We are now graduating over 200 LPNs this fall. That decision to increase those numbers from what was essentially half that was taken two years ago but it takes 18 months to two years to train an LPN," said Haggie.


Haggie also said recruitment and retention has always been a problem for rural and remote areas and Labrador is no different.

"Physicians are a mobile group, just like the rest of the workforce.… We need for factor that into our recruitment and retention strategies and we do have those that are specific to Labrador," said Haggie.

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