Doctor shortages are once again plaguing St. Alban's, with the health authority for central Newfoundland saying the south coast town is just one of several communities dealing with worsening physician staffing challenges.
Since June 15, emergency services have been diverted from the Bay D'Espoir Medical Clinic in St. Alban's because of a lack of physicians, with patients being sent hours away to either Harbour Breton or Grand Falls-Windsor. That diversion comes on the heels of multiple disruptions in the spring and summer of 2020.
Each time, it's the same problem — a lack of doctors — and it's repeatedly causing anxiety among the 3,200 people who rely on the ER services.
"Once again, residents are on edge," said Mayor Gail Hoskins. "We thought we had the doctor shortage resolved in the last little while. We were fortunate enough to get two doctors here, but now they're gone again."
St. Alban's is the only area in Central Health's jurisdiction experiencing service disruptions due to a lack of doctors, but other rural communities are feeling the physician pinch. Springdale is down to two doctors, while Fogo Island lost one of its two doctors months ago.
"It has been a challenge for a long time to get physicians to come and stay in these smaller communities … but it is a little bit more of a challenge this year than it has been in past years," said Dr. David Carroll, Central Health's chief of staff and interim vice-president of medical services.
Salary doesn't seem to be the determining factor in St. Alban's, said Hoskins. She's been making calls herself to attract doctors to the area, but sees systemic issues at play in the local emergency department, such as work-life balance.
"We had those two doctors for emergency, and they were working four, five, six weeks straight. Is that the type of stuff that deters doctors from staying in places like ours?" she said.
A few things have changed over the course of the last year amid the continued service disruptions in St. Alban's, Hoskins said, with a committee struck between local communities and Central Health. Meetings happen regularly and communication is open, she said, and out of that Bay D'Espoir communities came up with a plan of how they'd like to see health care move forward in the region, with a different approach to delivery.
Change is needed when it comes to health-care delivery, and we have to jump on board and we have to embrace it. - Gail Hoskins
That plan involves better technology and more virtual care, she said, and has now gone before the Department of Health to review.
"We're ready to put that plan in place, more so now than ever, because we don't have the emergency department," she said.
About 90,000 people in the province don't have a family doctor, according to the Newfoundland and Labrador Medical Association. With Newfoundland and Labrador health care under the microscope in both the recent Greene report and the Health Accord NL task force, Hoskins said the status quo no longer stands.
"Change is needed when it comes to health-care delivery, and we have to jump on board and we have to embrace it. Basically because if not, we won't have emergency departments any more. We won't have clinics."
Carroll said Central Health is exploring new ways to address its doctor gaps.
"We're actually exploring the rotational worker model of having physicians," he said, a model of having doctors do two- to three-week shifts.
"We actually have a couple of candidates who are interested in providing that type of arrangement for Central Health to help us provide some of these services," he told CBC Radio's Newfoundland Morning.
More locum physicians are on their way, he said, and Central Health has a company contracted to handle recruitment and retention.
"We have a fairly strong recruitment plan," he said.