Docs warn future of local ER is in jeopardy



In an ongoing and so-far fruitless effort to ensure the long-term viability of the South Okanagan General Hospital’s (SOGH) emergency room, three physicians on Monday sought support from Oliver town council.

Drs. Madia Smallwood, Peter Entwistle and Jacob Bellingan painted a bleak picture of the current state of affairs where a burned-out group of doctors continually scramble to cover emergency room (ER)  shifts. But their efforts often fall short, leaving the only emergency care facility south of Penticton shuttered.

One of the roots the problem is the way that ER doctors are paid, Bellingan said. Currently, they are paid on a fee-for-service basis. That is, they get paid for actually treating patients. If nobody shows up at the ER on a shift they don’t get paid.

That’s bad enough for local doctors who take time from their own practices to cover ER shifts. But for out-of-town physicians who come to work occasional shifts, it can be a deal killer, particularly when they have the option of working at Penticton General, where the pay is better and the medical environment is better resourced and less stressful.

The Penticton ER pays its doctors on an hourly basis under an Alternative Payment Program (APP), which SOGH has been trying to have implemented here but has been rejected by Interior Health.

“The biggest issue is that no one will take responsibility,” said Entwistle, expressing his frustration at Interior Health and the provincial Ministry of Health.

“We are facing closure,” he said. “And when it closes, it won’t open again.”

Entwistle, who ran in last year’s provincial election as an independent in an effort to make local health care an issue, told councillors they need to “step up and demand to know who is responsible.”

Council took no immediate action following the presentation, but indicated a concern and a willingness to get involved.

Bellingan told councillors that the group will a make a pitch to Osoyoos council  in December.

Councillor Petra Veintimilla suggested Oliver and Osoyoos and the doctors should get together and form a “united front” in their efforts to retain emergency health service in the South Okanagan.

24 Replies to “Docs warn future of local ER is in jeopardy”

  1. I just want to add, when I was on council not that long ago…having Carl Meadows come talk to council was like IH sending a talking head….he is a better politician then most politicians….he throws platitudes around….circles around questions and actually says nothing….whatever IH’s plan is for Oliver’s ER, the council will not be informed….IH is an empire unto themselves…the Doctor pay equity is definitely at issue….throwing money into renos when your doctors may walk out for lack of compensation is like putting lipstick on a pig….until IH can actually be honest…things will not improve

  2. The IHA has earmarked close to $1,000,000 to upgrade our hospital Emergency next year. There are no plans to close down our hospital.
    The issue of Doctor pay equity is a separate matter.
    AND; I do know what I am talking about.

    Publisher: Ok smarty pants time for a Q and A.

    1. Who speaks for IH in the South Okanagan and why is the wisdom on your side in such a juxtaposition to those represented by doctors (Enthistle et al) ?
    2. The million dollar contract for ER improvements in Oliver has been let? Or reduced to a few more chairs for the reception area?
    3. Are the doctors just negotiating? or are they trying to save a facility for me, you and 20 thousand potential clients in the catchment area?
    4. Get serious Pat – you do not know what you are talking about? Do you?

    1. With all due respect to you Pat, I would suggest that Doctor pay equity cannot be a separate matter. It seems nonsensical to spend $1 million on upgrades to the Oliver Emergency Department in 2019 if the pay equity issue is not resolved so that doctors are willing to fill ER shifts 24/7.

    2. Good comment Larry but the Town rarely, if ever, takes capital funds and uses them for operating expenses.

      The Okanagan Similkameen Regional Hospital District is contributing 40% and the Province is contributing the remaining 60%. March 1, 2018.)
      These expenditures are; ‘part of a long term plan for the hospital and will create an Emergency facility with separate rooms to maintain patient privacy rather than a curtained area, and additional equipment. Construction upgrades will include: developing a new waiting and triage area, a separate public emergency department entrance and the relocation of admitting and administration services. Once complete, patients requiring emergency treatment will access the emergency room from a separate entrance, ensuring privacy. The project will also include new exterior signage to improve finding the emergency department.’

      Publisher: The key question not being answered – when will construction begin – one report said fall of 2018, now it is 2019 the third is that the scope of work has changed – why will not IH do two things – be honest with the public and do something to solve the Dr. Crisis ?????

    3. Pat, the Town also rarely, if ever, makes a capital expenditure if it doesn’t have the operating funds to run the capital infrastructure effectively.

    4. Excellent point! However you will recall it is very difficult to get the Feds to contribute money towards our critical irrigation water supply. Similarly, it takes a long time to develop a funding plan which involves a contribution from the Province. Once Provincial funding is allocated there would be a contract signed which would likely have a clause requiring the funds to be committed within a specific budget deadline and purpose or be lost. If Capital is transferred to operating there will be a delay implementing the project; the Province could easily re-allocate the money.
      I agree that the method of funding our Emerg Doctors is pathetic and unfair and I understand the position our Doctors find themselves. No ‘Emerg’ patients/no compensation. If they treat a patient in ‘Emerg’ they are paid at a lower rate than Penticton. Doctors are independent professionals who must generate money to build a pension plan. If they work ‘Emerg’ during the night they lose sleep and maintaining a practice the next day could compromise patient care. There are prospective Doctors who look at the lack of privacy in our emergency room facilities and observe the lack of patient space and want at work at a facility which offers a better environment and newer equipment. Thus we have a Doctor shortage in Oliver. An exacerbating factor is the number of people who experience a non-emergent problem and rather than visit a clinic, they show up at Emerg and request treatment for coughs, colds, sprains etc. When an Emerg has only three curtained areas there is a serious space problem and combined with a Doctor shortage we have a problem for which there appears to be no easy answer.

      1. do the fix of 990 thousand on the hospital
      2. satisfy local drs. and those wanting to work shifts in ER/ED

      There are no more problems right. Laff – someone will create a new problem. If you do not fix the hospital and rely on LARGE donations from the ladies that seem to solve all equipment and tech stuff problems – we are doomed.

    5. I love a challenge so here goes!
      I am Oliver’s representative on the South Okanagan Similkameen Medical Foundation. Health Services Administrator, Carl Meadows confirmed at a recent Foundation meeting that Oliver is one of three communities identified by IHA for upgrades to facilities.
      I can only repeat what was stated at the Board meeting; pay inequity is a totally separate issue between IHA and the Oliver Doctors.
      A call to Carl Meadows will confirm what I am stating and go a long way to dispel speculation.

  3. The stakeholders are all of the people in the SOGH catchment area. It is imperative that every stakeholder contacts our MLA Linda Larson, and tell her that she needs to represent us in Victoria in this matter. The provincial government is responsible for disbursement of health care funds. Letters should be addressed to Linda Larson, Health Minister Adrian Dix, Premier John Horgan, and Green Party leader Andrew Weaver. A few thousand letters should do it.

  4. I have to ask the following:
    Why can’t a doctor in Oliver emergency department get the same rate of pay pay as a doctor in Kamloops, Kelowna Prince George or any other hospital in B.C.?
    Is a doctor not a doctor no matter where she or he works?
    Didn’t interior health say something to the effect that Oliver hospital was going to get a face lift? Now we hear different. Where and what is our MLA doing about this matter? Very obvious, as nothing has changed in the last 10 years or more. Yes Lou I agree with you 100%. Being seniors, my wife and I have used the emergency room many times over the last 10 or so years. I have nothing but praise for ALL the staff at Oliver hospital. I thank each and every one of them. Without this hospital Oliver will die a slow death

  5. I would suggest that the people of Osoyoos e-mail our Mayor Sue McKortoff at right now and let her know that this is unacceptable. Our hardworking ER doctors should be paid an hourly wage for being there just like the nurses, security, janitors and everyone else who works there. And it needs to happen NOW before we lose this most precious resource. The more people who write to their mayor and demand action, the sooner this will be corrected! Do it now or risk losing our Emergency Room! I’m going to e-mail her immediately! It’s too important to wait!

  6. I think that the closure of our ER was started long ago, and to blame this council or any of the past councils is not founded on facts or is in no way remotely RIGHT. Just like we can’t blame the doctors, nurses care aids or technical staff , they don’t sign the cheques. If anyone is to blame it’s the Health Authorities who bow to Provincial Government dictating that they have to come in under, or come in on, a yearly bugget that is forced on them by the political party in control . Governments waste money left, right and center, but don’t seem to have the money to fund the required things, the necessities, properly. One of the cost cutting measures taken so far was to cut food costs in the entire system. Another cost cutting measure is to pay our ER doctors less than those in the bigger centers like Penticton, Kelowna, Vernon or Kamloops. And the cost cutting goes on, did you know care aids are no longer in the hospital proper. Is it just the start, ask Armstrong, Sumerland, Princeton, Grandforks or any other community in the province that has had cuts or closures to their Hospitals. We have local groups or individuals that support the Penticton Hospital with cash donations or in kind, so we can have better care in Penticton. This is a noble gesture, but at what cost in the overall scheme of things will this have on the Oliver Hospital and those who expect to be looked after here. Those in charge turn this generosity into, they give us cash and support, it must be because they want Oliver’s Hospital to close and get their care in Penticton or Kelowna. That’s the way thinking goes in these circles. We all realize that the big centers will have better heart or cancer units, that is to be expected, there is a bigger demand for those types of care, and we can be sent to those centers for that type of care. Will they turn the Oliver Hospital into a care facility for the elderly, instead of building new facilities for this purpose. Or a place to hold those waiting to go into private care homes, maybe more offices for Interior Health, we have lost many beds for the sick already. When you have a system run on a tight bugget by people not trained in medicine or medical procedure you will not have a system for the sick people but one that is run for the healthy. They don’t need help so they’ll close our hospital. Right now we have the tail wagging the dog, things must change soon or we won’t have doctors in any small town rural BC.

  7. If I read this right, Dr’s in emerg. are only paid when they treat someone ? I would guess that nurses are paid weather the call load is heavy or light ( not to say that they are not busy at the best of times ) . It would be hard for me to ask our staff to come in for a certain period of time, but not pay them if no jobs came in. There is legislation about this for the average hourly worker. It seems unfair that we would ask someone to be at work and not pay anything. Maybe a flat rate plus calls ? Maybe an hourly wage ?

    When a Dr. is not needed in an emergency department it’s a good thing. It means people are well and safe, but when they are needed it can be life and death. We need them there and ready dang it. Nobody wants to work for nothing.

  8. My family and I have needed this ER and the hospital so many times over the last 20 years. We are very lucky and so grateful for the exceptional care provided by all the wonderful staff st SOG.
    This situation needs to be fixed right now!!!
    We can not allow this issue to endanger our lives.
    As a community we need to get behind supporting the Dr’s an staff to secure a proper level of care right here, where it matters most for all of us.
    It’s not just about money… it’s lives!

    1. I so agree with you Lou. Like you we have had to use the emergency quite often and we have such great hard working nurses & Drs. To get paid only when they have a patient is so very wrong. Everyone gets paid by the hour & if anyone deserves it its the Drs. I’ve had to go in at night as well as very early morning and the Dr was right there, so your telling us they don’t get paid staying there all night??????

  9. This issue needs to be addressed now. What can we, as individuals, do. Petitions? Getting council members involved? We can bitch…but we need to do something positive. Any ideas?

  10. I think it`s a disgusting state of affairs what is happening at SOGH.Interior Health & our politicians neeed to step up and work with the doctors in Oliver & Osoyoos to fix this NOW

  11. We have a new Mayor and a new council. This looks like #1 priority to me. Standing by and allowing this to continue is quite frankly, unacceptable. The ER doctors should have similar contracts to those in Penticton, thus encouraging better ER coverage at SOGH.

    The sitting council would have little chance of reelection if it did close on their watch, without any action.

    I agree with Rob, we need to speak out before it is too late.

    1. I am not aware on what basis Interior Health has determined to pay our local ER different compared to that in Penticton .

      Does anyone on this forum know ?

      If so , please post .

  12. What about rural Oliver (RDOS Area C) and Osoyoos (RDOS Area A)? The ER service is important to the residents of these areas too. Can our Area Reps bring this matter to RDOS board for support?

  13. The general public should be concerned. If you have a house fire, you would expect the fire truck and crew to show up. If you have a medical emergency, you expect the ambulance and paramedics to show up. Likewise, we have a hospital and a staffed emergency dept that we expect to be there when we need it. Penticton is too far away. These are the basics of our universal health care that identify us as proud Canadians. We allowed house prices to increase to an average of 1 million dollars in Vancouver, but apparently don’t have enough money to provide basic health care to our citizens. We seem to be regressing as a society and it is troubling. Why do more people not speak up like I am doing right now. Come on people, if you are reading this right now you have no excuses. Act now!

    1. There’s a missing piece here. Why is Interior Health not being held accountable? Why is there a pay differential between the Penticton and SOGH ERs? What is the rationale? Whose decision is it? What is the formula in terms of local, provincial and federal contributions?

      Both Town Councils and Regional Districts should stop wringing their hands and invite IHA officials to appear before a joint public meeting to explain the reasons – if there are any – for the situation. Saying “There’s just not enough money” is no excuse. If not, why not? Is there a quiet move at the provincial level to starve our hospital of funding and close it down? Inviting our MLA to enlighten us about what’s going on in Victoria would be useful, too.

      Our medical system is a great source of pride, certainly, but it’s barely creaking along and under constant assault from those who want to privatize it. We take it for granted at our peril. Just look over the border to Oroville and the many community fundraisers to help people pay their massive medical bills. We who are old enough remember when it was like that here, too

      We also pride ourselves on our politeness. Unfortunately, that often translates into passivity. Yet when we make up our minds to tackle something, our energy and commitment get things done.

      Remember a few years ago when the promised provincial funding to build the long-needed patient tower at Penticton Regional Hospital was suddenly and mysteriously rerouted to Vernon? Remember when Dr. Paisley and his colleagues spearheaded the resistance and petitions suddenly appeared everywhere? Just as mysteriously, the funding returned. Why? What changed? Who made that decision, and who are they accountable to? Perhaps our MLA can explain the process to us and the factors that determine who gets what.

      As a resident of Delta some years ago, I saw their excellent community hospital get decommissioned, allegedly for lack of funds. The quality of patient care immediately plummeted, as their doctors could not follow up with them in the Richmond and Surrey hospitals they were taken to. The mortality rate increased, too, among patients being rushed to the more-distant ERs. A few years ago the Delta Hospital was incrementally reopened. Why?

      I know several of our local doctors and how overstretched they are. I voted for Dr. Entwistle in the last election to support his effort to bring this crisis – for that’s what it is – to light. He did. But what’s happened since?

      We have a choice: We can keep bemoaning the situation and looking to somebody else to fix it (who would that be?) or we can insist that our wellbeing and that of our dedicated medical professionals become a priority for our elected and appointed officials.

    2. Maureen Parriott, good letter, and we do need to get on to it, I.H. is not doing its job, and we, the people who live in the area need answers; Our council needs to start demanding those answers from I.H. and the M.L.A.

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