Island Health, Ministry Dragging Feet on NorthIsle Healthcare Crisis

“We can't afford to let this collapse because people will die," ER doc warns

Hospitals closures, fuel calls for allowing physician assistants to practice in BC

It’s no secret that the healthcare system across Canada is in crisis. It’s not new, even if we only became aware of it because of the pandemic.

But you might be surprised just how serious this crisis is becoming.

Residents of Port Hardy will become even more acutely aware of the problem on July 1, when the town’s number of emergency doctors will drop to just one.

Yes, one emergency doctor for a community of 4,000 people.

The Port Hardy ER has been closed overnight, from 5 p.m. until 7 a.m., since Dec. 22. Those closures will continue indefinitely, along with the ER in Alert Bay.

About 40 kilometres south of Port Hardy, Port McNeill Hospital will remain the only acute-care hospital ER open 24 hours a day.

The closures continue despite an influx of $30 million for north Island Health announced last week by Health Minister Adrian Dix. The ministry’s solution is to run shuttles between affected communities.

“We believe in these three hospitals… and we believe in the region,” said Dix at a Jan. 27 news conference.

Dr. Alex Nataros will soon be Port Hardy’s lone ER physician. He says we need to look at the situation in context.

“It’s a classic situation seen right across Canada and BC, where a local community hemorrhages doctors and nurses because of lack of support and services, and then basically the situation collapses,” Nataros said on the CTV News website.

“We can’t afford to let this collapse because people will die.”

But Nataros has a solution that is worth considering. And quickly. He’s even offered to pay for it out of his own pocket.

He is asking the province for permission to hire a physician assistant (PA) after the town’s two other emergency doctors recently gave their notice. Another doctor resigned last March.

He says a physician assistant could go a long way to improving healthcare in the North Isle.

PAs are certified healthcare workers who practice under the supervision of a licensed doctor. They conduct physical exams, order and interpret tests, prescribe medication and treatment plans, provide patient counselling and can assist with surgeries.

There are currently about 900 PAs working in Canada. They have long been employed by the Canadian military and by provinces like Alberta, New Brunswick, Manitoba, and Ontario. Other provinces are starting pilot programs.

However, BC’s health ministry has yet to approve them.

Before moving to BC, Nataros worked with a physician assistant in Dauphin, Manitoba, where he says it made a big difference to his practice and the community.

Likewise, the Green Party’s new second deputy leader, Dr. Sanjiv Gandhi, said on Jan. 23 that he supports adding PAs to BC’s roster of healthcare professionals.

“Why we don’t have them in British Columbia is beyond me,” Gandhi told the Victoria Times-Colonist.

Gandhi, a former chief of surgery at BC Children’s hospital and a professor at UBC, said, “I would rather work with PAs every day than anybody else… They knew my next steps. I didn’t really have to instruct them on anything. It made the operation go very smoothly.”

The Canadian Association of Physician Assistants (CABC) also says it’s time BC allowed Physician Assistants.

“Today, restrictive policy and regulatory statutes are holding PAs back from filling the gap in BC’s health workforce,” CAPA said in an open letter posted on its website. They call on the BC government to “start using PAs to help fix some of the issues that have plagued the health system for years.”

CAPA also recommends hiring PAs in rural and remote communities like Port Hardy.

“Adding multiple PAs in rural communities, under the supervision of just one physician, can have an immediate impact,” CAPA’s statement reads.

The organization says that PAs can improve continuity of care in remote communities through homecare, nursing homes, and hospital visits, and provide after-hours consults and on-call work, among other services.

PAs could support the healthcare system in many ways. Not the least of which is for Indigenous folks.

“We have a large Indigenous population here in the North Island, and the majority of the illnesses we see are from the Indigenous population because of historical trauma, disparities, and health and social care,” said Nataros.

The situation is already dire in Port Hardy.

“The extended emergency room closures has had and continues to have a significant negative impact on Port Hardy residents, our healthcare professionals and the broader north Vancouver Island population,” Mayor Pat Corbett-Labatt wrote in a letter to Health Minister Dix.

“Frankly, Island Health is not taking the crisis on the North Island seriously,” Nataros said.

As far back as 2013, Doctors of BC, a professional association of 14,000 physicians, medical residents and students, said it supports having PAs in the province.

Ten years later, the BC government still isn’t making any promises. However, in a statement sent to CBC News, a health ministry spokesperson said they are monitoring the situation in other provinces.

“Introducing a new health profession requires careful consideration, management and significant resources to properly understand and address the inevitable team function issues that emerge from overlapping scopes of practice,” the ministry spokesperson said.

Does this sound like a stalling tactic to you? Could they not at least try a pilot program? This isn’t a new profession. And there is no overlap of service on a team of one.

When will Island Health and the ministry step up to the plate meaningfully?