The resignations of four psychiatrists from Vernon Jubilee Hospital, coupled with the recent resignations of seven obstetrician-gynecologists (OB-GYNs) who cited safety concerns and an unmanageable workload at Kamloops’ hospital, show a health authority on the back foot when it comes to retaining health care specialists at a time of widespread shortages of these professionals, both within and far beyond the B.C. Interior.
Following news of the psychiatrist resignations, BC Conservatives were quick to cast blame on Interior Health, claiming in an evening Oct. 23 press release that the resignations were the result of “overwhelming workloads and a lack of support” at the hospital. New Interior Health CEO Sylvia Weir, who assumed the top job less than three weeks ago, was given a short leash by Kelowna-Mission MLA Gavin Dew, who said he’d given her “the benefit of the doubt, but frankly, this has not been a strong start.”
The health authority, embattled by the exodus of specialists across the two hospitals, is managing a critical shortage of health care professionals that is being seen around the world, according to one top executive who also said the resignations at the Vernon and Kamloops hospitals are fundamentally different situations.
Dr. Peter Bosma, executive medical director for Interior Health North, spoke to The Morning Star about the resignations Friday, Oct. 24.
Interior Health told The Morning Star by email Thursday the psychiatric resignations in Vernon came due to separate and unrelated personal reasons, a claim Bosma vouched for.
“The resignations were not an entire surprise and they didn’t come all at once, they’ve been staggered over the last two to three months and we’ve been expecting some of them,” Bosma said.
He explained one of the four psychiatrists had delayed their retirement for more than a year and is now choosing to retire from acute care. Another is resigning due to a family event.
Bosma allowed that some part of the decisions behind one or more of the resignations was harder to define.
“There’s resignations that come for reasons that we don’t always understand,” he said. “We see through attrition that there’s always a cycle of people coming and going.”
“There was not anything nefarious per se in these resignations,” he added, saying the timing was such that a “cluster” of resignations happened all at once, but they were “not related at all to each other.”
Bosma said that untimely cluster puts the Vernon resignations in a different category than the OB/GYN resignations at Royal Inland Hospital. Those doctors issued a letter criticizing their working conditions on their way out the door, making it a coordinated move rather than a series of individual ones.
But Bosma didn’t skirt around the fact that workloads are heavy for health care professionals in the region, as they are elsewhere.
“Would I say that work volumes are high? Absolutely they are. Post-COVID we’ve seen admissions go up, consults go up. We’ve seen a very large increase in youth mental health consultations. And those things do put on extra demands,” he said.
“But that’s something that every physician group, I think across Canada and internationally, has been feeling.”
Bosma stressed that even if some of the resignations at Vernon Jubilee are due to the workload, all of them are still continuing to work in the community, having only resigned from acute care at the hospital.
“Our community demands are very high, and having a good, solid community base often prevents people from having to come into the hospital in the first place,” Bosma said, by way of offering a bright side to what he admitted was a situation that has few silver linings, if any. He explained that these psychiatrists can continue to work with outpatients in the community, maintaining a level of care outside the hospital, where most psychiatric consultations take place.
But what will inpatient psychiatric care will look like in light of these resignations?
One thing Bosma said Interior Health is looking at is having nurse liaisons consult patients before a physician sees them, “to ease the consult a little bit.” Another idea is to bring in family physicians to help patients once they are stable on an inpatient hospital unit but can’t yet be discharged. There are still six psychiatrists under contract to provide acute care in Vernon, but recruitment of more inpatient psychiatrists is a priority for the health authority, Bosma said, adding they’re looking at doing whatever can be done to make those positions more attractive.
Asked what a psychiatric patient in Vernon can expect going forward, Bosma said they shouldn’t have to worry about overall access to their care.
“Again, most mental health encounters are going to be as an outpatient, and all these doctors are continuing with their full caseloads, but just focusing in on the community,” he said.
‘Significant’ offer declined
Bosma expressed sympathy for the Kamloops OB/GYN doctors who felt resigning was their only viable option. He did say that it wasn’t the only option presented to them.
“I never want to downplay the difficulties that OB/GYN has had, and they’ve worked hard to provide service for us. And that group got to a point where they felt things were untenable and just represented in a way that they didn’t feel they could continue on,” he said.
Bosma confirmed that an offer “significantly higher than what was previously seen” was made to the seven OB/GYN specialists.
“The offer still is on the table,” he said. “The door open for them to continue to work with us and we want to work with them.”
Bosma agreed that money is available from the provincial treasury to support wage increases for health care specialists, but added what is really needed is more healthcare workers in order to improve the “care environments” that specialists work within.
“You need to have a good team of nursing, a good team of family physicians, a good team of specialists all working together,” he said.
But the bottom line is that health care professionals are in short supply across the board.
“It’s the reality. We do not have enough specialists, family practitioners, we’re just short supply everywhere,” Bosma said.
Bosma said Interior Health has fully filled out its recuitement team over the last year and a half, and that team is working hard to get new hires in the door while supporting their transition. International candidates are being pursued and support is being offered those candidates to expedite their licences and help them immigrate.
It’s an uphill battle made worse by two waves of resignations.
To the outgoing psychiatrists and OB/GYN specialists, Bosma offered a message of thanks. He said he’s seen them work “super hard” to provide quality care to patients.
He ended with an appeal.
“I thank them for their work and would say, please come and work with us in Interior Health. We’re actually a great place to work.”