We write to you as physicians working at the High River Hospital to express our concerns with the state of health care in our community. Our health care system is significantly stressed. It is difficult to find a family physician accepting new patients in our community, and patients are experiencing long wait times in our emergency room – often reaching five hours or more.
There is a now a shortage of family physicians in High River. Over the last 3 years, nearly a quarter of our physicians have changed or left their practice due to illness, retirement or burnout. Our hospital has faced the possibility of closures in both our emergency department and inpatient ward due to the shrinking number of local physicians.
Recent closures have been averted by having our local physicians rearrange their schedules or convincing physicians from Calgary to provide coverage. In 2024, we anticipate dozens or more closures of our emergency room and the equivalent of months without physicians to provide care to patients admitted to hospital.
Care at the High River Maternity Clinic has also been under stress due to staffing challenges. The maternity clinic has been struggling to recruit new physicians for several years. We have lost two out of three local obstetricians, and now rely on a single obstetrician to provide 24/7 coverage with few breaks. With several other rural communities recently losing their maternity services, we worry that we are on the same path.
In our community, the majority of the care provided in our hospital ER, maternity and inpatient ward is provided by local family doctors. For this reason, potential closures are directly linked to a shortage of family doctors in our community and the primary care they deliver.
There is overwhelming evidence that adequate primary care, delivered by a trained family physician, not only saves money to the health system, it increases longevity and overall well-being. As patients lose access to comprehensive primary care with a trusted family doctor, more people end up in the ER or hospital.
An ER visit costs many times what it does in your family doctor’s office for the same issue, not to mention the huge cost of a hospitalization. Lack of timely access to care can also result in delayed diagnosis and treatment and worse prognosis for many conditions, including many cancers.
Unfortunately, help is unlikely to arrive soon. Medical student interest in primary care as a career is at an all-time low. Alberta, in particular, has struggled to recruit and retain medical learners with an unprecedented 22 family medicine training spots in Alberta empty this year following the medical training “match.” This accounts for 81 per cent of all vacant family medicine spots Canada-wide, excluding Quebec. Recent strained relations between the provincial government and physicians have likely played a large role in the province’s struggles to recruit family physicians.
In High River, we pride ourselves on being a training hub to both medical students and residents. Of late, we have been disappointed to see a lack of interest in our community from these learners as local clinics have unsuccessfully been trying to recruit new family physicians for over three years.
None of this should come as a surprise as, in the last several years, rural primary care in Alberta has been inadequately funded, prioritized and supported. This has sent the message to current and prospective family physicians that they are not valued.
Furthermore, reported government and Alberta Health Services (AHS) initiatives have mostly focused on surgical and hospital-based interventions rather than prevention. This seems to prioritize the crisis in our hospitals rather than the factors that led to it. Namely, a lack of accessible primary care.
We need our government to properly fund, prioritize and support primary care. Regardless of who wins our upcoming election, we need advocacy to make quality and sustainable rural health care a priority. We believe that everyone deserves access to a family physician and that without strong and sustainable primary care, rural health care will fail.
Dr. Rae Cantlon, Dr. Beatrice du Prey, Dr. Alex Fay, Dr. JoAnna Fay, Dr. Sarah Fever, Dr. Stephen Finnegan, Dr. Amy Gausvik, Dr. Ashref Jeeva, Dr. Brian Jensen, Dr. Mike Kapusta, Dr. Alicja Kennedy, Dr. Derek Kuechler, Dr. Patricia Lee, Dr. Amelia Leskiw, Dr. Scott MacLeod, Dr. Sarah Makhdoom, Dr. Charmaine Mamogobo, Dr. Colin McCready, Dr. Troy McKibbin, Dr. Nicole Mensik, Dr. Harry Mueller, Dr. Chris Powell, Dr. Scott Rapske, Dr. Lee Rehak, Dr. Nicole Roper, Dr. Aaron Slusar, Dr. Rorie Slusar, Dr. Mark Smilie, Dr. Alek Szmigielski, Dr. Kelli Taylor, Dr. Adam Vyse, Dr. Nancy Vyse, Dr. Kevin Walsh, Dr. Daniel Zimmerman