Quebec emergency departments tend to be less overwhelmed during the summer, but that does not mean emergency physicians get a break.
The president of the Quebec Association of Emergency Physicians, Dr. Marie-Maud Couture, says the work has become increasingly complex in recent years, and the health-care system can no longer rely on the “same recipe.”
Emergency physicians see an average of 15 to 20 patients during an eight- to 12-hour shift.
Couture says the pace has remained relatively consistent over the years, but patients are increasingly complex, even in smaller emergency departments.
When she began practising 20 years ago, she could see about 30 patients per shift. Now, cases take longer, in part because of an aging population.
Couture says the health-care system has not adapted enough to the growing number of older and seriously ill patients.
She also says emergency physicians are increasingly following up with patients because they cannot be certain those patients will have access to outpatient care.
“We’re not family doctors, but we can’t abandon the population,” Couture said.
A particularly busy summer
Quebec emergency departments have seen stretcher occupancy rates hover around 115 per cent in recent days.
Couture says stretcher occupancy is often confused with patient volume or workload, but those figures do not tell the whole story.
She says June and July were particularly challenging because of the number of patients seeking care for less urgent health problems, classified as P4 and P5 cases.
In Montreal, she describes stretcher occupancy levels as “extreme” this summer.
There are several possible explanations, including multiple clinics closing in the same area during the summer without necessarily coordinating with one another.
Patients who continue to need care may then turn to emergency departments. Couture also says there are fewer appointments available through Quebec’s GAP, or primary-care access desk.
Occupancy rates can be misleading
Some Quebec hospitals report emergency department occupancy rates below 50 per cent, but Couture says those numbers need to be viewed with caution.
In rural areas, hospitals generally perform fewer major surgeries and have fewer inpatient teams, which can contribute to lower emergency department occupancy rates.
Staff shortages can also mean some stretchers are no longer counted as available.
Couture points to Fleurimont Hospital as an example, saying there is not enough staff to cover all of its available stretchers.
She estimates that 10 to 15 stretchers may never be occupied because there is no staff to cover them.
That can artificially lower the occupancy rate, she says, while emergency physicians continue working at full speed.
Couture says some of the sickest patients can still end up waiting in emergency department waiting rooms despite the availability of physical stretcher space.
She says she has never felt that she was working less when stretcher occupancy was lower.
However, lower occupancy does reduce pressure on physicians because they know the sickest patients will be seen within appropriate time frames.
–This report by La Presse Canadienne was translated by CityNews
–The Canadian Press’s health coverage is supported by a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for this content.
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