Alberta’s plan to add extra ER shifts delayed amid sticking points with AMA over pay, liability, paperwork

Alberta’s recently announced effort to add physician shifts to help triage patients in crowded emergency rooms has been delayed.The program was to have started over the weekend.The president of the Alberta Medical Association says doctors want to participate but there are issues to be worked out including over pay, billing, liability and paperwork.Dr. Brian Wirzba said Monday he’s optimistic a deal can be reached soon between the association’s section of emergency medicine and the government to decide exactly how the job will be structured.“I would hope that maybe by the end of this week or next week we would start seeing some of these positions being filled,” he said in an interview.Dr. Wirzba said the shifts are a temporary “Band-Aid” to provide support for emergency room colleagues and address the concerns of patients who are waiting “far too long.”“It obviously doesn’t fix the entire acute care crisis, but it will provide some benefit,” he said.Hospitals Minister Matt Jones announced the new triage liaison physician roles last month after the death of a man who waited for hours for care in an Edmonton hospital. Prashant Sreekumar, who was 44, died at Edmonton’s Grey Nuns Community Hospital on Dec. 22. His family said he had been there for nearly eight hours with chest pains and increasing blood pressure. Premier Danielle Smith’s United Conservative government has ordered a judge-led inquiry into the man’s death.The new doctor triage shifts are meant for doctors to help speed up patient assessments and diagnostic work, and in some cases begin providing care in the waiting room.They were originally expected to begin Sunday at six of the province’s busiest hospitals, with three other facilities joining in September.Dr. Wirzba said that after the minister’s announcement, the government reached out to physicians, but its proposal was based on an “older methodology” that raised concerns doctors wanted addressed before they would sign on. Kyle Warner, press secretary to Jones, said in a statement Monday they were working to launch the role as quickly as possible to improve care for patients and families.“The work to recruit for the triage physician liaison role is ongoing. This role will provide much-needed support to some of the busiest emergency departments in Edmonton and Calgary,” he said. “We will continue to work with the Alberta Medical Association and physicians to ensure they can provide the best care for Albertans, when and where they need it.”The positions are expected to be staffed with existing physicians and will add an additional two shifts per day, seven days a week.Warner confirmed Alberta has never had a provincially co-ordinated permanent physician triage model in place, but it won’t be the first time the idea has been tried on the front lines.A 2007 study of a pilot project at the University of Alberta Hospital in Edmonton concluded that triage liaison physician shifts showed the potential to shorten how long patients spent in the emergency room and the number of patients leaving without being seen.Warner said that at the time, no permanent funding source was available to continue that program.“Acute Care Alberta is confident that this provincewide investment will deliver similar benefits for patients and the health system,” Warner wrote in a statement last week.Heather Smith, head of the United Nurses of Alberta, has said the triage liaison position likely won’t fix all that ails the province’s emergency departments, based on her members’ past experience.“It didn’t do anything to deal with the real issue, which is capacity beyond the emergency department,” she said following the government’s announcement last month.Smith also said some things have changed since 2007.She said a lot of the tasks physicians were doing in emergency rooms in the past are now part of protocols that nurses carry out, and triage liaison doctors will still be limited by the need for nursing staff to help them.Sarah Hoffman, the Opposition NDP health critic, said Monday it appears doctors aren’t clambering to take the positions because the lack of emergency room capacity hasn’t been fully addressed.“I’ve spoken to a number of emergency physicians to say, ‘Are you going to move into that role?’ And they said, ‘for what point?’ If there aren’t beds to be able to admit patients into, then it feels to a lot of physicians like this is an exercise in communications and not actually in putting any new resources into the front lines,” said Hoffman.

Alberta’s plan to add extra ER shifts delayed amid sticking points with AMA over pay, liability, paperwork

Register for free access or login.

Related Topics