While Interior Health (IH) has confirmed that there is currently a neurologist shortage at Kelowna General Hospital (KGH), Dr. Pete Bosma said more neurologists are needed across the region.
Currently, KGH has six-and-a-half full-time neurologists, and coverage when it comes to strokes is not affected.
Kelowna has been a “go-to” because neurologists at KGH also provide general neurological advice that was available on a 24-hour basis, seven days a week – something not all other hospitals can provide.
Now, for the meantime, KGH can’t provide the service full-time either and is temporarily like other hospitals in major IH cities like Penticton, Vernon, Kamloops, which provide and maintain general neurology service Monday to Friday.
Bosma, the health authority’s executive medical director for the North, explained that KGH is the primary medical centre in IH and any shortage doesn’t just affect Kelowna, it affects the entirety of the health region.
“It’s really with call volume pressures and HR pressures of some of the neurologists moving work elsewhere or just finding they can’t adequately maintain a safe call balance on that one,” Bosma said. “And really at the bottom line with just a shortage of neurologists in general, there’s been a pullback of the general neurology advice service for Kelowna General Hospital, which really implies for Interior Health because they have been our main phone advice centre as such for that.”
There are neurologists at every hospital that provide general service but each is strained in terms of numbers as well.
Outside of strokes, Bosma said, there aren’t many neurologic emergencies. But he cautioned there is still a need for urgent advice and conditions that are complicated
“A patient comes into a hospital, they’re going to come in through an emergency department, they’re going to be assessed by an emergency physician and that emergency physician is going to recognize a pattern of symptoms that point to a neurologic condition,” he explained.
“Sometimes it’s hard to say exactly what the final condition is or what’s finally needed for it, but most of those become a little bit less acute. There are seizures, but emergency physicians are very capable of managing even prolonged seizures and stabilizing a patient to get them to definitive care somewhere, whether that be on-site or transferring into a higher level of care.”
Additionally, other neurological conditions like MS, Parkinsons and Guillain-Barre can have complications and patients may have questions for a emergent provider.
However, Bosma said those questions usually go to general neurology and while they can be complicated, they can usually be temporized and don’t always need advice in the moment, “even though it’s nice to be able to have advice in the moment.”
Bosma added that IH has had to “restrict the service in order to maintain the service,” but there is a collaborative effort across the region during the shortage.
While some sites might not have on-site neurologists to provide immediate advice, patients can call IH for virtual support. Additionally, while supports are limited and the exact speciality might not be provided, emergency physicians can provide advice.
“We often will talk to our colleagues to get advice in terms of how do you think we should move with this particular case,” said Bosma. “We’re working out pathways for everybody to have access as best as possible. It does in the short term put a higher burden on other services like internal medicine and even other hospitals into the Lower Mainland can feel that pressure as well. But that’s a temporary solution only as we work to maintain and provide or even start up a better general neurology call service for the region.”
On Thursday, Jan. 8, two Kelowna-region MLAs responded to the shortage at KGH, with Kelowna-Mission MLA Gavin Dew comparing the issue to the temporary closure of KGH’s pediatric unit last May.
“This is what happens when a government fails to plan, recruit, and retain specialists in an already strained health system,” said Dew in a press release. “With a neurologist shortage, 36-hour ER waiting times, and the largest concentration of B.C.’s rural seniors, the NDP government is playing with people’s lives. Just like the pediatrics situation, this didn’t happen overnight, it was flagged by doctors more than a year ago as a crisis-in-the-making.”
Kelowna-Centre Kristina Loewen MLA recognized that neurologic shortages are happening across the province.
“The loss of acute neurological coverage in the Interior is not an isolated problem,” Loewen said. “British Columbians are watching services disappear, wait times explode, and access to timely care slip further out of reach, with no clear plan from the government to reverse the damage.”
Bosma added IH has been working hard for several years to attract for neurologists to the area, namely at the main and tertiary care centres.
“There is lots of effort being put in, but there’s a shortage and there’s really an international competition… it makes for a challenging situation, clearly,” Bosma added.
KGH is in discussions with six candidates but the hospital could use even more than that and IH is looking for neurologists across the region.
Bosma believes the health authority “could easily” hire another six and still need a few more at KGH to provide a “fulsome service and make after-hours call bearable for everybody and accessible.”
He added Kamloops, Vernon, Penticton and even the Kootenays could use more.
While its unknown at this time how long the shortage will go on for, Bosma encourages patients to also go to the nearest emergency department with questions and concerns.
“If they’re worried, they will be seen and assessed and care will be arranged as appropriate, wherever we can arrange it,” said Bosma. “We continue to do the best we can and want to reassure everybody that care is still being provided. Care is always challenging because everybody is in an HR crunch but doing the best we can and we’ll continue to work hard to resolve this interim shortage and set up a better system.”
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