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“If I can no longer do the things we do, it will very significantly - in a negative way - impact the care patients receive on this end of the Island." - Dr. Paul Berrow
Dr Paul Berrow, one of Souris’ three family physicians, has resigned from a government appointed committee formed to oversee and implement health changes to Souris Hospital.
In a letter to Health PEI, Dr Berrow said he could not “in all conscience” help in the transition to a model of care he feels is damaging to patient care.
“I don’t know how to sit on a committee that helps us transition to stop doing a good job,” Dr Berrow, who has a practice in Souris’ Seaside Medical Center, said.
Patient care is also the primary concern of a collective group of committees in eastern Kings that called for the resignation of Health Minister Doug Currie and Deputy Minister Dr Michael Mayne on Monday.
Chairman of the Islandwide Hospital Access committee for Eastern Kings, Alan MacPhee, said patient care is their main concern and it should be the primary concern of government too.
Changes proposed include a reduction in lab and x-ray services as well as the elimination of six of its current seven acute care beds at Souris Hospital.
Although none of the changes have been confirmed or made public at this point, Mr MacPhee said there’s a “heavy smoke” indicating they are looming.
Mr MacPhee said Dr Berrow’s position on the impending changes falls in line with the mandate of the groups he represents.
“Dr Berrow is refusing to sit on the Health PEI transition team because he objects to the changes the Minister of Health is putting in place,” Mr MacPhee said. “Dr Berrow supports us and we support him.”
Mr MacPhee said the main concern is patients’ continuity of care.
“What that means is, when your doctor sees you and you get sick and go to the hospital, he still sees you in the hospital,” Mr MacPhee said.
However, under the changes, patients in need of acute care would be sent to the Queen Elizabeth Hospital emergency ward where they would then be admitted and cared for by doctors who aren’t their family doctor and who aren’t familiar with their medical history.
“In Charlottetown, only hospitalists see patients,” Mr MacPhee said. “That’s a doctor that works three days on, three days off, in the hospital. They only take a certain amount of patients, so you have to wait until they’re available. You may be seeing three to four doctors - where under the system we have now, you only see one.”
Mr MacPhee and Dr Berrow agree the patient is the centre of medical care, not the disease. And access to local and timely blood testing and lab results are key components in that patient care.
“If I see someone in the office today and think, ‘Do you have pneumonia? Do you have heart failure? I can get the chest x-ray and look at blood results in a very short time,” Dr Berrow said.
“If I can no longer do the things we do, it will very significantly - in a negative way - impact the care patients receive on this end of the Island. I don’t see how that is better access,” he said.
Dr Berrow said cutting frontline services and reducing the number of beds to try and contain costs is the wrong approach.
Mr MacPhee agrees.
“When they reduce the number of acute beds, they also reduce the number of nurses in the hospital,” he said. “When you don’t have enough nurses to look after the sick patients, then the ability to deliver health care to the patients is compromised.”
Mr MacPhee also worries about the future of Souris’ dialysis clinic, which they fought hard for last year to keep in the hospital.
“If you take the blood work out of Souris Hospital, it’s going to be all but impossible to maintain dialysis services,” he said.
Mr MacPhee said he invited Premier Robert Ghiz to come to Souris to meet with his committee and the various groups representing the interest of eastern Kings residents to discuss their concerns.
“We have a publication coming out soon. Some of the changes we’re proposing is the maintenance of community hospitals with “a focus on family medicine,” Mr MacPhee said, adding that he expects their report to be released in July and that public meetings will follow.
Dr Berrow said he will quietly offer his support to help the community realize that the proposed changes, “will fundamentally change how they experience health care.”
“The people in eastern Kings have to stand up and make a noise so they don’t have something imposed on them that will not be in their best interest,” Dr Berrow said.
This is Dr Berrow’s letter of resignation
June 24, 2013
Re: Proposed Changes to Souris Hospital
Before the next meeting of the Souris Hospital Transition Team, I wish to resign from that committee. Having read and examined all of the proposed changes, I feel that I cannot in all conscience help to transition to a model of care that I feel is damaging to patient care.
For the first time in the 10 years that I have been in Souris, we have the possibility of a stable work complement, with 3 physicians and 1 Nurse practitioner all living and working in the community.
It has been demonstrated time and time again, in many parts of the world, that access to a primary health care provider who knows the patient, improves both patient health outcomes and contains financial costs.
Similarly, in the hospital setting, it has been demonstrated that treatment by one physician with overall responsibility for clinical care who also has prior knowledge of the patient, improves outcomes and contains costs.
Access to a regular primary health care provider and the possibility of continuing care into the low acuity hospital setting, is what we now have available to us in Souris. This is heavily reliant on adequate diagnostic and nursing staff support. Remove that and we cannot continue safely to function as we now do.
The proposed changes that I have seen have the potential to destroy this model of care.
Conversely, in Charlottetown, my experience shows me that the model of care available to many patients there is dysfunctional.
In Charlottetown, many patients have difficulty accessing a regular family physician. This has led to a reliance on anonymous walk-in clinics for health care access.
Many family physicians in Charlottetown do not treat patients in hospital. This has led to the development and reliance on a model of rotating anonymous “hospitalist” care for many patients.
In other parts of the world, the lack of continuity inherent in both of these models has been shown to increase the risk of patient harm from unnecessary investigations and treatments and to increase health costs.
I have seen no evidence that the proposed changes will help to improve overall accessibility and health care for Islanders. On the contrary, I think it will lead to a reduction in service and access for the community here in Souris and an increase on an already overburdened service in Charlottetown.
Being incorporated into “Island wide care” should not disable us from continuing to provide the level of care that we now do. The obstacles that we have encountered in encouraging patients to come to Souris for hospital care have not been from Souris, but are entrenched in administrative difficulties in Charlottetown. I cannot see that effectively turning Souris Hospital into an alternate level of care facility will remove those difficulties. It will however, stop me from safely continuing to work to the full scope of my training and experience.
It is my opinion that the considered reduction to diagnostic services and nursing staff support that I have seen proposed, will mean that Souris Hospital will no longer be able to continue to safely provide the level of care that it does.
It is my opinion that the proposed withdrawal of Services to Souris Hospital will disable the Primary Health Network from functioning as safely and effectively as it does now.
This is not improved access, nor is it better care.
It feels that political decisions have already been made and I do not want to help Souris Hospital transition into oblivion. I would urge all other committee member to resign and fight the changes.
Yours Sincerely,
Dr. Paul J. Berrow
Dr. Paul J. Berrow
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