An emergency room physician at the Whitehorse General Hospital and former Yukon Medical Association president has publicly stated that health care in the territory is on the “down slide and crashing.”
In a post on X, formerly Twitter, Dr. Rao Tadepalli links to the News’ previous story on the flailing trial hospitalist program at the Whitehorse hospital. He cites “no takers” on the program, which affects inpatient care and the intensive care unit, as well as a lack of beds, cancelled operations, “no hope” for a walk-in clinic and the rising number of family doctors wanting to quit.
Yukon doctors have expressed concerns that none of the physicians currently covering the Whitehorse hospital’s trial hospitalist program will sign up to stay on. The territorial health minister indicated no doctors are lined up to cover the soon-to-be formalized hospitalist program given the job posting hasn’t gone live.
Doctors currently providing inpatient care at the hospital are having issues fully covering the schedule and have indicated that they won’t have full coverage starting Jan. 3, 2024, according to the Yukon Hospital Corporation.
A spokesperson for the corporation recently told the News its physician leadership is working on a solution that could see all actively privileged hospital physicians temporarily contribute to provide inpatient care.
Health and Social Services Minister Tracy-Anne McPhee told reporters in the cabinet office Nov. 7 that an expression of interest will go live in the next few days or by next week to employ hospitalist doctors.
McPhee said the government has been working “diligently” to make the program successful. If doctors don’t take up the offer or if the program is not fully staffed, then “adjustments” will be made to determine how to move forward.
“If it’s not ready to go, then we will continue the current process, which does still provide care for inpatients who are not attached to their own family physician, until the program is up and running,” she said. “It’s not ideal, which is why we hope that people come forward […] we expect it to be successful as it moves forward.”
Health critic Brad Cathers of the Yukon Party told the News he has heard from a couple of physicians who said there’s a lack of clarity about what will happen and that they hadn’t signed on to provide hospitalist services.
The Whitehorse hospital has been changing the way it provides inpatient services to bring it up to par with major hospitals across Canada that run hospitalist programs.
The News spoke with a doctor who is part of a small team that has been caring for people admitted to hospital beds over the past few years as part of the trial hospitalist program. The News agreed to withhold the physician’s name given the small size of the local medical community.
The unnamed physician said the doctors providing the trial gave notice that it’s no longer viable in its current form, which triggered the hospital to strike up a back-up plan. The doctor said the contingency plan involves mandating physicians outside of the hospital — and potentially outside of their comfort zones — to work in the hospital.
READ MORE: Yukon doctor fears for hospital inpatients amid physician shortage
In the Yukon Legislative Assembly on Nov. 6, the Yukon NDP described a hospitalist program as the “backbone” of a well-functioning primary care system. It fears family doctors will be taken out of programs like the cancer clinic, the Kwanlin Dün First Nation clinic, the Yukon Sexual Health Clinic, community visits and the non-existent walk-in clinic that the government has promised for 2024.
Yukon NDP Leader Kate White suggested the government is effectively offering a pay cut of 10 to 15 per cent. The News hasn’t seen the offer.
“The hospitalist program at Whitehorse General Hospital has done a world of good for family doctors since the program first started in 2020. Before this program existed, any patients admitted to the hospital fell under the care of their family doctors, leaving family doctors to do hospital rounds in-between seeing patients at their clinics. It made for long days and zero work-life balance,” she said.
“The hospitalist program changed that by creating a roster of dedicated doctors taking charge of patients at Whitehorse General [Hospital]. It has proven to be better for patients, doctors and hospital staff — everyone agrees that it should continue — but now the program is heading toward collapse in January.”
White asked if the Yukon government will reconsider what it’s offering to pay hospitalist physicians “instead of trying to force them to either quit or accept a pay cut.”
The hospitalist program will be moving away from a fee-for-service model, which means physicians are paid per patient and doesn’t consider influx, time spent and health complexities. McPhee told reporters the expression of interest, which was developed with insight from the local medical association and physicians, will move to a daily rate as well as additional payment depending on duties. She said she didn’t know the exact figure.
“We compensate physicians very well here compared to other jurisdictions in Canada, and certainly one of the highest, and that will be maintained,” she said.
Dr. Alex Kmet, president of the Yukon Medical Association, previously said he hasn’t formally heard from physicians who won’t be providing hospital services come the new year, but there’s lots of talk about how evolving care in the hospital has led to challenges in ensuring consistent service. He told the News the Yukon government has committed to working with the medical association and the hospital corporation to ensure that a hospitalist system is properly resourced and doesn’t create gaps in care.
The unnamed doctor the News spoke with is taking on flexible work outside the territory. They said the amount of money the Yukon government is pitching falls short of what doctors were trying to negotiate and what they could make elsewhere or “down South” plus that Outside work comes with less responsibilities. They wonder if other physicians will follow suit.
McPhee shrugged it off as a “personal business decision.”
“I don’t have any expectation that that’s everyone […] people will see when the expression of interest goes out. I fully expect that we’ll have individuals who are interested,” she said. “We are not doing anything that will make that less enticing, or, more importantly, will reduce care for Yukoners because that’s the ultimate goal here is to improve patient care.”
While details are slim, the minister is more than hopeful for the territory’s only walk-in clinic to open in the new year at 9010 Quartz Rd. as a temporary location to start. Opening a new walk-in clinic in Whitehorse by January 2024 is a stipulation in the confidence and supply agreement between the governing Yukon Liberal Party and Yukon NDP caucuses.
“I don’t sit around and hope. We’re working extremely hard to make sure this happens with our partners at the Yukon Medical Association and with physicians from across the territory,” she said.
This week, the Centre de Santé Constellation Health Centre celebrated its first year since opening. McPhee has described it as the Yukon’s “first of its kind” bilingual health centre. The News recently reported the centre has no doctors.
A government statement marking the one-year anniversary on Nov. 7 notes a “team of interdisciplinary health professionals has provided exceptional care to over 816 Yukoners” but doesn’t indicate any physicians have been hired.
Contact Dana Hatherly at dana.hatherly@yukon-news.com