The Reminder is making its archives back to 2003 available on our website. Please note that, due to technical limitations, archive articles are presented without the usual formatting.
Jonathon Naylor Editor Residents opposed to 24-hour ER shifts at the Flin Flon General Hospital have no ally in the Manitoba government. The province has no plans to intervene to end the controversial shifts despite growing concerns over patient safety. 'Physicians and the RHA together determine the hours of work for each physician and how shifts in emergency are covered,' said a spokesperson for Manitoba Health. 'This is done by taking into account ER scheduling needs, availability of physicians and other service requirements of the physicians in the community. We expect that the health of physicians themselves is taken into account in the decision-making process.' Added the spokesperson: 'Further, doctors have a professional duty to ensure they are working safely, delivering quality patient care and meeting professional standards dictated by (the College of Physicians and Surgeons of Manitoba regulatory body).' Physicians across North America have long worked 24-hour shifts, but the practice has come under increasing scrutiny over the years. Studies have found that medical residents who work shifts that long are more likely to make medical mistakes than those on shorter shifts. Opponents of 24-hour shifts in Flin Flon had hoped the Northern RHA would shorten the shifts in its latest ER agreement with doctors, which took effect July 1. Up to doctors But RHA CEO Helga Bryant said it is up to the ER physicians to decide how they provide around-the-clock coverage. 'The length of the shifts aren't delineated in the agreement,' she told The Reminder over the summer. 'That's up to the physicians to organize their work. So they could anytime work something different. But because we place on them the expectation of providing that 24-hour, seven-day-a-week uninterrupted service, we don't then go and say, 'Oh, but you need to do it this way and this way and this way' because we have laid that expectation on them.' See 'Physicians..' Pg. 7 Continued from Pg. 1 Bryant, who is herself concerned with the length of the shifts, said if she refused to okay the ER agreement unless doctors took on shorter shifts, she believes the physicians would not sign. 'We'd be closing our ER. That's a risk I'm not prepared to take,' she said. While the doctors would have the right to refuse the contract, this would not have to end ER services in Flin Flon, according to the government spokesperson. 'In a hypothetical situation that all physicians in the area refused to sign an ER agreement with the RHA, it would not necessarily result in closure of the ER,' said the spokesperson. 'It is quite possible, given the present contract ER rates, that several physicians would nonetheless offer to staff the ER on an individual basis. This occurs in some communities. Further, we understand that currently Flin Flon has both qualified physicians participating in the (ER) contract and qualified physicians who do not participate, so there are arguably resources from which the RHA could draw to staff the ER with or without a contract.' The spokesperson said physicians themselves, in consultation with the RHA, 'are best suited to determine the best coverage arrangement for the (ER) and the physicians.' The spokesperson reiterated that ER contracts are a matter between doctors and individual RHAs. 'If the RHA was to be concerned about the quality of care provided to patients at the hospital,' said the spokesperson, 'it would be obliged to discuss these concerns directly with the physicians and work to resolve the matter in a manner agreeable to all.' At least some of the local concerns around 24-hour shifts have abated over the last three years given that the Flin Flon ER has become less busy. Figures from the Northern RHA show ER visits totalled 10,645 in 2011-12. That was down 18 per cent from 2010-11, when there were 12,912 visits. And it marked a drop of 29 per cent from the 15,024 visits recorded in 2009-10. While fewer residents from both Manitoba and Saskatchewan are using the ER, the percentage of Saskatchewan patients is steadily growing. In 2009-10, Saskatchewan patients represented 37 per cent of all ER visits. That number rose to 40 per cent the following year and again to 41 per cent in 2011-12. Of the 38,581 ER visits between 2009-10 and 2011-12, 61 per cent involved Manitoba patients and 39 per cent Saskatchewan patients.
