Some Island doctors are pushing back against Health P.E.I.’s wait-time advisories for hospital emergency departments, saying they may be doing more harm than good.
The agency sends out the advisories to warn Islanders when ERs are especially busy and the wait for care could last many hours.
When Monica Bambrick runs into health issues, she often turns to the ER. That is, unless she reads one of the advisories that Health P.E.I. posts, like the one it issued Thursday afternoon.
“It makes me not want to go,” said Bambrick. “Even at eight months pregnant, I’ll sit at home and wait and talk to my doctor the next day. I would have to be in a lot of pain.”
Health P.E.I. posts the public advisories at an emergency department’s request when its wait times are longer than usual. The notes say that Islanders in need of less-urgent care should seek it elsewhere, by calling 811 to speak to a registered nurse, accessing the Maple virtual care portal, or going to a walk-in clinic.
But Summerside ER doctor Kay Dingwell posted on social media this week that she is among those who won’t be sharing any more of the notices. Dingwell worries they’re deterring people who need care from going to the ER.
I won’t be sharing any more notices about the ED being busy. <br><br>There’s a couple reasons for it but most importantly: I don’t want people not going in if needed because they’re worried about the wait.<br><br>Let me explain how emerg works from my side.
Dr. Trevor Jain, a Charlottetown emergency department doctor and the spokesperson for the Canadian Association of Emergency Physicians, agreed with Dingwell’s assessment.
“When patients are asked to stay away from the emergency department for things that are minor, some of those things could be major,” he said.
“We don’t need advisories for that. We’re overcrowded 99 per cent of the time. My concern is that we’re using a culture of victim blaming, and I don’t want to blame patients for coming to the emergency department if they can’t access care anywhere else.”
We’re the only game in town that can actually see folks, so it puts people in a very precarious decision-making process.— Dr. Trevor Jain
Jain said there’s a misconception that what’s putting pressure on ERs across the country is the number of patients who don’t really need to be there.
He says the actual issue is the backlog of patients with serious issues who are waiting for a hospital bed to free up.
“We have 25 years of evidence that demonstrates that ER overcrowding is an outflow problem. We cannot get admitted patients in our emergency departments out,” he said. “Patients aren’t a burden on the system. That’s why we’re here — we’re here for the patient and we’ve got to be able to provide timely acute-care services to Islanders.”
In a statement Thursday, Health P.E.I. stood by its advisories. The agency said it’s important to be transparent with people, to manage their wait-time expectations — and to help avoid rumours about just how bad the situation is.
Health P.E.I. said its advisories make it clear that anyone who needs urgent care should still go to the ER, where they will be seen more quickly than people with less serious issues.
But Jain said it can be difficult for people to know just how serious their issue is. He advised Islanders to get emergency care if they feel they need it, no matter how long they have to wait.
“We’re open 24-7,” said Jain. “We may not be the appropriate place for them to [get] help with a minor issue or a primary-care issue — we’re not primary-care specialists — but we’re the only game in town that can actually see folks, so it puts people in a very precarious decision-making process.”