Alberta has been facing a crisis in acute care for months and it’s only compounding. As the population increases, health care resources continue to decline or remain stagnant. In December 2023, AMA submitted the Acute Care Stabilization Proposal (member login required) to government, which provides a comprehensive framework with solutions necessary to stabilize acute care. The proposal addresses physician retention, recruitment and patient care. It should be noted that the AMA is the only group with an immediate proposal with cross-specialty solutions and measurable improvements it can provide to:
- ER waiting times
- surgical waits
- patient flow
- admissions/discharge process
- patient outcomes
- surgical recovery
- after-hours care
- specialist availability
The AMA Acute Care Concerns campaign highlights areas of the acute, hospital and community specialist world to increase awareness of parts of the health care system that many Albertans don’t see. Here are the first few issues of our campaign:
Oncology
Alberta’s cancer care system delivers some of the best treatments in Canada but is dangerously overloaded and under-resourced. As Alberta’s population grows and new treatments allow patients to live longer, there are not enough cancer care doctors to take care of these patients. Wait times for a radiologist are up to 13 weeks and many cancer surgeries are not being performed within Alberta’s target times.
We focused the oncology campaign on workforce supply not keeping pace and dangers of the delays that follow. Cancer care doctors are overstretched. For years Alberta has not had enough specialists to stabilize the current cancer patient population, making it nearly impossible to match the ongoing population increases while compensating for the doctors leaving practice. Without timely care, Alberta’s cancer patients face higher risks of complications, remissions and death. Recruitment and retention of specialists are necessary.
General surgery
General surgeons are a lifeline to the acute care system, providing a range of life-saving procedures daily. In order to perform these urgent surgeries, there needs to be an open OR, a general surgeon but most also enough Tier 1 supports, which include anesthesiologists, physician assistants, clinical assistants, nurse practitioners, in hospital family physicians and surgical residents. Without Tier 1 teams, operating rooms and other hospital services are essentially "closed” resulting in “diversions.” Without the support staff available, patients who need urgent surgery must be transferred to another hospital. Diversions are a last-resort option yet are becoming concerningly common in Alberta hospitals.
General surgery advocacy focused on the need for health human resources in the form of Tier 1 supports along with the patient and systemic dangers of diversions. Alberta’s hospitals are finding it harder and harder provide urgent emergency care and there needs to be proper teams in place to alleviate ER wait times and provide urgent care.
General internal medicine
General internal medicine specialists are in primary and acute care settings. Patients are admitted in hospital under the care of GIM range from sick to medically complex to requiring surgical support. The increasing patient volume, complexity and work hours has put unsustainable pressure on GIM specialists. GIM specialists provide a majority of after-hours care but are not given after hours compensation or supplied with enough allied health care teams to sustainably care for an increasing patient load.
Advocacy for GIM looked at the specialty’s ability to continuously fill the cracks of the acute care system, but as they reach their breaking point due ot overstretched hours, too many patients and not enough support, the acute care system is at risk of a full collapse. Compensation models must be updated along with team organizational to ensure that enough health care support staff are available to help GIM specialists provide the quality care they want to deliver.
What’s next?
Every physician, specialist and health care support staff member plays a crucial role in the acute care system. We must continue to spotlight and advocate for these professionals who work tirelessly to keep Albertans as healthy and safe as they can with the current limited capacity and resources they have. Next up in Acute Care Concerns we will be focusing on OBGYN, pediatrics and psychiatry, with more to come.