Exodus begins

Young doctors leaving the County due to cuts to Picton hospital

It was not unexpected. Most knew this was coming—that faced with declining services and resources at Prince Edward County Memorial Hospital, doctors would leave this community. Still the news that two young and energetic physicians have concluded that their future isn’t in The County and will pursue their careers elsewhere, is hitting hard in a community still reeling from yet another devastating array of cuts to the local hospital.

Last week Drs. Lisa Forster and Darren Lett advised their patients they will close their Picton practices at the end of August “due to recent changes at the hospital.”

Dr. Forster provides primary care along with obstetric and maternity care. Quinte Health Care has said it will end maternity care in Picton because too few babies are delivered in this hospital to retain the nurses in Picton who provide this care.

Along with his primary care practice Dr. Lett is the lead physician in the Picton emergency department, and indeed, heads the emergency department for all of QHC.

Losing these two young and energetic doctors is a severe blow—not only to their patients who are now anxiously learning they are losing their family doctors—but also for a community seeking to grapple with the increasing demands for health care.

health care. “They are extraordinarily good and caring physicians,” said Dr. Elizabeth Christie, president of the Prince Edward Family Health Team. “Their decision, though sad for us and disappointing for County residents, is not surprising. When I spoke at County council earlier this year I made the point that as a result of the cuts then proposed we would lose physicians.”

Dr. Christie draws a straight line between QHC’s cuts to services and resources at PECMH to the departure of these two physicians.

“I know a large part of their decision was because obstetrics is being pulled from Picton,” said Christie. “She wants to continue to offer obstetrics care—and that is no longer available in Picton.

“It’s a big loss for us. It is unnerving. One can’t guess whether others are considering the same decision.”

It is a worry shared by Councillor Barb Proctor.

“I hope it’s not the beginning of a long exodus of physicians,” said Proctor, chair of the municipality’s health care advisory committee. “Dr Forster and Lett are looking to grow their practices. It is disappointing we don’t seem able offer them that opportunity.”

QHC chief Mary Clare Egberts took a more sanguine approach, saying that doctors come and go. But when it was noted that Drs. Lett and Forster were leaving, in part, due the recent changes to the Picton hospital, Egberts pivoted her response, suggesting that the doctors’ departure was an inevitable part of the cost of health care change.

“The real world is that the changes happening at Prince Edward County Memorial are part of a province-wide transformation,” said Egberts. “ I recognize the community is having difficulty with where their services will be received. But this is all about ensuring that services will be there in the long run for the community.

“It is a major change taking place. And yes, some physicians may choose their current working situation is not one they want to continue working in.”

Egberts offered her thanks to the departing physicians.

“I want to thank Dr. Lett for the leadership he showed in the organization as chief of emergency for all of our four hospitals. They certainly will be missed and we wish them well in the future. “

WHO WILL CARE FOR ME?
It is, of course, the patients of Drs. Lett and Forster who face the most anxious days ahead. Many of these are seniors and some are clearly worried about who will care for them.

One south County resident frets that Belleville is too far to go for health care. But Belleville offers no welcoming physician arms—where more than 400 residents are currently on a waiting list seeking a primary care physician according to Dr. Christie.

But Mary Clare Egberts say she expects County family health team doctors and nurse practicioners will pick up the departing doctors’ patients. “I would imagine the remaining Picton physicians would be more than happy to pick up the services that were previously provided by Drs. Forster and Lett,” said Egberts. “ My understanding is that that Family Health Team prides itself in providing coverage to everyone who lives in the County. I would assume they will live by that.”

Dr. Christie offers assurances the Family Health Team will do its best to offer interim support and coverage to these orphaned patients if replacement physicians aren’t recruited before the end of the summer.

“In the longer term this isn’t sustainable,” said Christie. “Everybody is currently operating at full capacity and there are likely some retirements on the horizon. This is going to require an effort that will require community involvement.”

STEPPING UP RECRUITMENT EFFORTS
Part of this effort is in the form of hosting training physicians in this community. Last week, two first-year medical students spent a few days in the hospital and clinic. On Wednesday they were squired around the County on a tour of its finer features.

Proctor traveled with these aspiring physicians to extol the virtues of the community. Mayor Peter Mertens joined them for lunch. He says this level of recruitment was all that was needed in the past—because this community offered a beautiful, friendly place to live and a comprehensive array of health care offered in an innovative way by a dedicated and collaborative group of health practitioners.

“It has to be an increased priority,” said Mertens, “both in keeping docs here and keeping Prince Edward County on the radar for new physicians looking to set up practice.”

Egberts says that QHC can play a role in helping to recruit new physicians to the County.

“We have a physician recruiter on staff who works with physicians seeking to gain privileges at the hospital at QHC,” said Egberts. “ They offer tours, explain what is available in the area, work with real estate agents. That is a service we will offer if asked by the family health team—we would be happy work alongside them to entice further physicians to come.”

But Mertens, Christie and Proctor each fear recruiting doctors to Prince Edward County has become a great deal more difficult in context of QHC at the local hospital.

“One of the reasons Queen’s puts its students here is because they get to work in a small rural hospital that offers a wide range of services,” said Mertens.

Dr. Christie says the trend of declining services at the local hospital will be a deterrent to some.

“I’ve said for five months we are going  to lose physicians and recruitment is going to be more difficult. On the one hand we have less of the broad range of medicine to offer here—on the other hand we have no idea what we will be able to offer down the road from the hospitals point of view.”

Barb Proctor worries County residents will now have to compete with Quinte West and Belleville with financial incentives for doctors—something this community has never done before—never had to do.

“In Quinte West they commit about $100,000 a year to attract physicians to their clinics,” said Proctor. “ Belleville does the same. Our municipality hasn’t been put in that position. If we have to do that it will be another pressure on the taxpayer. The effects of cuts to our hospital are rippling through the community.”

Despite the turmoil and anxiety Christie feels the County still has a compelling proposition for young physicians.

“I am fully confident in saying we have a fantastic family health team which is a microcosm of remarkable medical services available to the people of Prince Edward County,” said Christie. “That in and of itself is an extremely appealing feature for a new physician. We have visiting psychiatrists, a strong group of social workers providing psychotherapy, expertise in diabetes, congestive heart failure, visiting internal medicine specialists—the list goes on and on.

“I am confident that we will be successful in recruiting doctors to replace them because the County is such wonderful place to live and work.”