In certain high volume and high intensity emergency rooms it is not unusual to have physicians “on-call and on site”. In the majority of BC’s rural communities where the emergency room (ER) volumes are often lower than in larger towns and cities, physicians are available on a call back basis to the ER. Either way, the emergency room is covered 24/7 by skilled and well trained medical and nursing professionals.

Please do not confuse the manner in which a physician is called back to the ER with ER physician coverage – either when the doctor is called back to the ER from elsewhere in the hospital e.g. in a doctor’s lounge or sleeping quarters when the doctor on call is not seeing patients, or from elsewhere in the community if the ER is quiet and they are not immediately required to be at the hospital. As I understand this current announcement, this key issue of physician ER coverage and hours that the ER is open to the public remains unchanged.

What has not be discussed is the time in which a physician is required to respond to the hospital when called in to see a patient in the emergency room, or perhaps in another location in larger hospitals (e.g. a surgeon being called in). These are contracts held by the health authorities and referred to as MOCAP (medical on-call availability program) contracts.

Depending on the nature and urgency of the call back required, these are funded to the group of call back physicians at various levels or grades, each level requiring a physician to respond to being called in with a greater degree of urgency. The ER department as far as I know has been funded at the highest level of call back i.e MOCAP level 1.

So unless we as residents and citizens of Oliver, Osoyoos and surrounding rural districts hear otherwise from the local physicians or the health authority, there is no actual reduction in physician services at SOGH under this arrangement.

The perception that a physician is up at all hours of the night waiting for patients to present at our rural ER is not the reality. Even the on-call-on-site arrangement does not require a physician to be immediately available in the ER, but rather on site within the facility. Like most of us, when the ER quietens down, they could and should be catching up on some useful and necessary rest.

One very important piece worth considering – the vast majority of BC’s rural emergency rooms are covered by generalist physicians – the very same generalist physicians who during weekdays and business hours run their clinics and offices as general practitioners and family physicians. There are a number of GPs and FPs in Oliver and Osoyoos who still provide valuable and much needed ER department coverage at SOGH, and take on call ER shifts in addition to their family practice commitments.

This is in contrast to other physicians who focus solely on providing ER coverage and have been working at our hospital covering a number of the monthly ER shifts in an effort to support our local doctors keep our ER open and covered by a physician on call 24 hours a day, 7 days a week, and year round.

Our ER is a valuable and much needed resource for our rural communities for many valid reasons. We the public all have a responsibility to ensure that we use it wisely and for its intended purpose – primarily for the provision of urgent and emergency care when necessary. Using our ER perhaps inappropriately at times puts increased pressure on our doctors and nurses and contribute to burn-out within these professions Ideally all residents in the South Okanagan deserve to have their own family physician or nurse practitioner to participate in and support them in their primary care needs, and management of both acute and long term health care needs.

Its not enough for us to be concerned about our hospital and ER alone; we also need to give urgent attention to promoting and supporting efforts to recruit more family doctors and primary care providers to Oliver and Osoyoos where there is a pressing need for for primary care services in our communities and ideally not from our emergency room, where the sickest of the sick and the injured need to be treated appropriately and in a timely manner.”

Dr. Alan Ruddiman
Oliver, BC
Co-Chair – BC Joint Standing Committee on Rural Issues
Past President – Doctors of BC (2016 – 2017)