Fraser Health is planning to fire all its anesthesiologists working at Surrey Memorial Hospital (SMH) if they fail to provide on-site, around-the-clock obstetric service.
It’s the latest in a long and festering dispute between anesthesiologists and the region over staffing and pay rates.
Fraser Health Authority (FHA) says patient care is at risk and has sent out a warning letter to 28 anesthesiologists saying their privileges to practise at SMH will be revoked as of March 1, 2017.
Women in labour are being forced to deliver children without epidurals because of the staffing shortfall, Fraser Health says.
More than 50 per cent of women at hospitals in Canada use epidurals, a painkiller injected into the back, allowing moms-to-be to stay awake for delivery.
The epidural rate is considered the marker for the availability of an anesthesiologist. Only about one-third of women at SMH get epidurals.
Dr. Roy Morton, vice-president of medicine at Fraser Health and a retired anesthesiologist, said his plan is to have the doctors work two 12-hour day shifts, two 12-hour night shifts, and have four days off. In addition, there would be two months of holidays per year.
It’s the same schedule followed by emergency room nurses, Morton told The Leader Thursday.
Fraser Health also says there are delays in getting anesthesia for C-sections.
Occasionally there is only one anesthesiologist on staff at night and Fraser Health says that’s not enough.
That doctor may be busy with another patient and can’t get to a pregnant woman in labour who needs anesthesia.
B.C. Anesthesiologist Society CEO Dr. Roland Orfaly said Morton’s plan doesn’t make sense as what’s really required are more anesthesiologists.
A shortage of obstetric anesthesiologists has been a long and storied problem at SMH.
In July, 2009, FHA advertised for 10 anesthesiologists for the region.
For two months, the jobs were posted on Healthmatch BC, ads in daily and national newspapers, and personal letters were sent to every anesthesiologist in the country.
Orfaly said the province has yet to hire one from that requested batch.
Morton said five years later, FHA and the doctors are still trying to get a round-the-clock obstetric anesthesiologist into the hospital.
How that will happen seems to be a matter of opinion.
Morton said currently is there are young crops of anesthesiologists coming up through the ranks who are quite happy to do the job.
“There is no doubt in my mind that we will be able to replace these individuals,” Morton said. “We have a lot of really keen people who are very interested in being part of this new model of care.”
There were 4,300 babies born at SMH last year.
The anesthesiologists are not staff, but are given privileges to work at SMH.
Orfaly said firing the existing doctors will only make matters worse.
“We actually have a provincial process where we’re trying to fix these issues for Surrey Memorial, and also every other hospital in the province,” Orfaly said, adding threats of firing 28 anesthesiologists is unproductive.
“Please explain to me how that’s supposed to improve patient care,” Orfaly said. “If you had difficulty recruiting anesthesiologists seven years ago, imagine what that recruitment is going to look like now.”