The Interlake-Eastern Regional Health Authority is proposing a temporary solution to concerns over nurse managed care in their emergency rooms. Over the summer CEO Ron Van Denakker has been meeting with physicians, local health networks, and other stakeholders to come up with a way to move away from nurse managed care, which was originally supposed to be a temporary solution to the doctor shortage. Van Denakker presented what he describes as a 'band-aid solution' to the issue yesterday afternoon.

Under the current system, nurses at some emergency rooms need to work with a doctor in another location over the phone. However, a new method would see doctors providing their schedules at least a month in advance to the RHA, so the health authority can put together a schedule of which emergency rooms will have doctors and be accepting new patients, and which won't. The schedules will be available online and through a 1-800 number that has yet to be determined, while bright green signs will be placed outside hospitals that currently don't have a doctor scheduled. While those emergency rooms won't technically be accepting patients, Van Denakker emphasizes they're not going to be turning anyone away.

"It was adamant from our nursing staff that the doors remain open. There will be a sign that says something to the effect of 'No doctor, not accepting patients here. However, please come in and speak with staff.' What we don't want to do is have somebody who's not well who didn't know not to show up, show up. That person will then attend to the individual, depending on what the needs are."

When asked why the IERHA is the facing the most challenges for doctor recruitment, Van Denakker says there are a few reasons. He says historically the RHA has been one of the lowest funded in the province, collecting $2,000 per head, compared to the average of $6,000. What's more, is that it's the only RHA without a residency teaching program in place. Van Denakker says the situation should improve with new doctors coming in the near future, but says without that program, it could be a while before they're able to move away from the new system which includes disruptions.

"You can't just give us the four (doctors) and hope that solves the issue for us. They're lovely people and they're wonderful doctors, but that's not the solution because they don't stay. I need a bit of time. I'm talking about the clinical teaching unit. Without that, we will not solve the problem."

The plan was created with the assistance of the doctors in the region, who had previously threatened to pull out had the RHA not ceased the practice of nurse-managed care. Van Denakker says it was surprising just how willing they were to have their schedules ready a month or two in advance, to allow more predictability, and prevent the unexpected diversion of ambulances in an emergency situation. However, it's only a temporary solution that Van Denakker hopes the new provincial government can help them move past.

"We're doing this in the interest of patient safety, but we'll continue to work incredibly hard with the new government and with Manitoba Health around strategies to try and really deal with these physician shortages."

On top of a residency program, Van Denakker says they also need many more beds. He says at times their hospitals can be over capacity by up to 30 per cent, something that can really disrupt the flow of the health care system.

In the meantime, Van Denakker says they're currently short about 20 to 25 doctors, but if you include the number of specialists they should have that number increases to more than 40. He says they're continuing to focus on overseas recruitment drives, including a provincial drive to recruit physicians from the United Kingdom.