Baffin hospital faces doctor drought

JOHN THOMPSON

Doctors and nurses at the Baffin Regional Hospital are in such short supply that it was impossible for sick Iqaluit residents to book a medical appointment for much of last week.

Instead, patients were told to queue in the emergency room or phone back next week.

Dr. Isaac Sobol, Nunavut’s chief medical officer, could be seen hovering near the appointment desk this week – he had been pulled from office duties to help treat patients.

The hospital has money to hire 10 doctors, but this Monday, only four were scheduled to work.

What happened?

The departure of two long-term doctors earlier this year, followed by a slump in the number of locum doctors who normally cover off for such vacancies, produced “a perfect storm,” says Dr. Steve Gray, acting director of medical affairs.

Gray said the doctors on duty are in good spirits, but “they can’t last forever doing this.”

To deal with the shortage, some doctors on staff have deferred vacations. Other doctors who left Nunavut, such as Dr. Terry Brennan, are returning for week-long periods. And doctors on duty are more likely to work for 12 hours, rather than eight.

Gray himself, while working as an administrator, also pitches in to treat patients in the emergency room and clinic through the week.

“I’m not just sitting on my butt here,” he says.

Nurses, who themselves are understaffed, have been picking up the slack around the Baffin, Gray said.

That’s allowed the hospital to continue to provide emergency services, surgery and in-patient care, and for Baffin nursing stations outside Iqaluit to continue to provide care, with limited correspondence with doctors.

Specialist visits have not been interrupted by the doctor shortfall, and continue as scheduled.

As well, earlier this year a nurse practitioner began providing family practice clinic services in the public health building, and a second nurse practitioner is helping with clinic services at the hospital.

That meant on last Friday, hospital staff could book more appointments for the following week.

But Gray wouldn’t venture to guess when the hospital would return to providing regular appointments.

He also couldn’t say whether the doctor shortage will affect the opening of the new hospital, which stands adjacent to the existing building, later this year.

Hospitals across Canada have trouble recruiting doctors, so Nunavut isn’t alone, Gray says. But he also has a small pool of candidates to draw on, because not every doctor is willing to move to a small, isolated community, with Nunavut’s welter of problems,

“Here, we’re a long way from help,” Gray says. “It’s a fairly small group we’re trying to reach.”

But Nunavut could do more to recruit doctors, Gray admits. In the next few weeks, he says staff will consider how to improve the search for potential candidates, such as using more aggressive advertising over the Internet.

Keeping doctors in Nunavut is another problem. As Gray says, a doctor in Nunavut is expected to “work like a fiend,” which can lead to burn-out.

Dr. Madeleine Cole, who has worked in Iqaluit on and off since 2000 and is currently on parental leave, says there are many rewards to working in Nunavut. Colleagues are friendly. Patients are appreciative. And the medicine is challenging.

Still, it’s unlikely she will return to work as a full-time doctor in Iqaluit’s hospital.

“The workload is completely out of control. That’s probably the number one reason why people decide to leave,” she says.

Add to this a large number of patients burdened with histories of sexual abuse, depression and different varieties of mental illness, and it doesn’t take long for doctors to feel overwhelmed.

“You get to a point where you feel like you’re just patching people up and sending them back out into the world,” Cole says.

“For most physicians who have a heart, it’s challenging to deal with so much sadness.”

Nunavut has one visiting psychiatrist, but Cole says the territory lacks much-needed mental health and addiction services, and transitional homes.

She also acknowledges such “thorough and holistic care” is well beyond the financial capacity of the Government of Nunavut.

But that doesn’t change the end result: “it can be pretty depressing.”

Cole says that when she worked full-time at the Baffin Regional Hospital, it wasn’t unusual for her to be at work, in some capacity, every day for a month. Turning off her pager wasn’t an option.

To go snowmobiling, she’d have to book an unpaid day off in advance.

Having time available “when the pager is off would probably make a difference,” she says.

Hospital staff encourage residents to phone the appointment line for the latest availabilities, at 979-7352.

“You will see someone,” says hospital director Lloyd Searcy. “You will have to wait.”