Staffing crisis means emergency rooms in northern Ont. face closure, Ontario doctors warn

The Ontario College of Family Physicians and the Ontario Medicial Association's section on General & Family Practice say emergency departments in northern Ontario are struggling to remain open because of staffing shortages.

“Many family doctors are working around the clock to keep the emergency rooms in their communities open,” the college said in a news release Wednesday.

“For these doctors, closing the ER is not an option as the next ER is often two to three hours away and could mean life or death for patients requiring care.”

The college is calling for “quick and immediate action” to support these family doctors and their patients.

“The situation is critical as many northern communities are struggling to ensure ER shifts are covered while facing significant population increases in the summer months,” the release said.

“Family doctors face unique and extraordinary challenges in the north. In other parts of the province, the next nearest hospital may be 20-40 minutes away. In the north, if an ER closes, the next hospital could be more than two hours away, leaving patients with life-threatening illness or injury dangerously at risk.”

As a result, “many of these doctors are doing the impossible right now,” the release said.

Across the north, hospitals are struggling to get temporary doctors (locums) to cover shifts for many reasons, including inexperience with the demands of working in a northern emergency room.

“Without the support of these temporary doctors there remain significant scheduling gaps – some hospitals regularly face gaps of 40-50 shifts in the ERs every month,” the release said.

“These shifts are often then filled by family doctors in order to avoid a closure.”

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Adding to the crisis, when family doctors must take extra shifts to keep an ER open, they cancel their primary care clinics. There is already a shortage of more than 200 family doctors in the north, the college said, leaving patients in almost every community without adequate access to a family doctor.

"Yeah I know, it's a crisis. It's frankly dangerous for our emergency departments to close for hundreds of kilometres from the next emergency department,” said 2022’s Ontario Family Physician of the Year Dr. Anjali Oberai in an interview with CTV News.

“You know no community should have to be in that position where if you have an emergency your local emergency is closed and it's a hundred kilometres, 200 kilometres to get to the next emergency room – so I think really robust locum support will help us in the short term and get us through that crisis so we can be innovative and creative in solving this crisis in the short term."

To address the crisis, the group is calling on the province to:

• Immediately enhance locum program supports to ensure temporary doctors are available where they are most needed right now. Longer-term rethinking of how locums are used in the north is necessary.
• Urgently fund recruitment programs to bring new physicians to the north.
• Retention is critical. Implement a comprehensive strategy and ensure positive working conditions to retain the remaining physicians in the north.
• Provide immediate peer support for family doctors working in these difficult conditions to maintain their mental health and well-being.

The college represents more than 15,000 family doctors in Ontario in both urban and rural communities.