Open Letter to the Community: A Call to Action for Obstetrical Care
Open Letter to the Community: A Call to Action for Obstetrical Care
Dear Members of Our Community,
Today, our healthcare system narrowly avoided a crisis. We were on the brink of having no obstetrical coverage, placing expectant mothers and newborns in a precarious and potentially dangerous position. This emergency was only averted because of the extraordinary compassion of a rural physician who interrupted their family vacation to fill the gap. While we are grateful for their selflessness, we cannot continue to rely on individual heroics to sustain a critical part of our healthcare system.
The Ripple Effect on Our Community
This issue extends far beyond expectant mothers. When obstetrical care collapses, the entire community feels the strain:
Emergency Departments: Overburdened with patients they are not equipped to handle. Keeping in mind that our Emergency Department is on the brink of its own collapse!
Families: Forced to travel long distances for care, increasing risk during emergencies and most certainly increasing anxiety.
Recruitment Challenges: A crumbling obstetrical department makes our hospital less attractive to other specialists and other healthcare workers, compounding the issue.
A strong obstetrical department is foundational to a healthy healthcare system. Its stability (or lack thereof) reflects the overall health and well-being of our community.
The State of Our Obstetrical Department
Our obstetrical department is currently staffed with:
3 full-time obstetricians covering patient care and call.
1 part-time obstetrician (0.25 EFT) providing additional support.
To provide sufficient coverage for approximately 1,700 deliveries per year, it is widely recommended to have 9-12 physicians on a rotational schedule. This ensures proper coverage while allowing for necessary time off and manageable workloads for each provider.
Despite this recommendation, the January obstetrical call schedule has one physician scheduled for 24-hour in-hospital call for 6 out of 7 days in a single week. This is an extremely unsafe practice that poses significant risks to both the physician and their patients. Such situations highlight the urgent need for more robust staffing and support within the department.
It is equally important to emphasize the need for robust interdisciplinary teams. This includes highly skilled nursing staff, physicians assistance, midwives and family physicians trained in OB for low-risk deliveries and OR assistance. Collaborative teams not only provide better outcomes for patients but also distribute the workload more evenly, fostering a sustainable and supportive environment for all healthcare providers.
In comparison, just a few years ago, our department benefited from over 10 family physicians providing obstetrical care as part of a collaborative, interdisciplinary model. This diversity of care providers offered greater flexibility and support for the team, ensuring comprehensive care for all patients. As of July, following my own difficult decision to step back from obstetrical care, only 1 family physician remained. This sharp decline underscores the urgent need for rebuilding a multidisciplinary and sustainable team structure to safeguard the safety and health of mothers and newborns. This sharp decline in availability directly impacts the safety and health of mothers and newborns.
A Systemic Issue: Recruitment and Retention
This is not an isolated issue in obstetrics; it reflects a broader crisis in physician recruitment and retention. Obstetrics, however, faces unique challenges, including:
Leadership practices and departmental structures that have not adapted to modern healthcare challenges, creating inefficiencies and barriers to progress.
High demands of on-call schedules.
Increased burnout rates due to workload and stress.
Insufficient financial and systemic support to make the practice sustainable.
Strong incentives to work in Winnipeg, where physicians benefit from larger, more robust teams, well-trained residents, and extensive support staff, all for comparable pay, making rural practice less appealing.
Many physicians have been forced to step back or leave because the current model is unsustainable for their personal and professional well-being.
What Needs to Happen
Community Awareness: Our community must understand the gravity of this situation. Public pressure and advocacy are essential for systemic change.
Focused Recruitment: A dedicated strategy to recruit obstetricians and family physicians with obstetrical training must be a top priority. This includes offering:
Competitive incentives.
Flexible scheduling.
Robust support systems to make our hospital an attractive workplace.
Retention Efforts: Support the physicians already here by:
Working with Winnipeg to secure locum coverage and provide relief for existing staff.
Accepting and mentoring residents as a long-term recruitment strategy.
Strengthening departmental culture to foster collaboration, support, and a sense of belonging.
Reducing on-call burdens through a larger multidisciplinary team.
Providing mental health and wellness resources for physicians.
Government Advocacy: Push for provincial and federal policies that prioritize rural healthcare funding, particularly in Womens Health. Financial incentives for rural physicians and expanded availability and supports within residency programs for rural areas are critical.
Community Engagement: We urge every member of our community to voice their concerns to local leaders and policymakers. Let them know that this issue affects every single one of us.
The Birth of The Wellness Clinic
These massive gaps in our healthcare system, specifically within Women’s Health, are what led to the creation of The Wellness Clinic. This interdisciplinary team is dedicated to addressing all aspects of health while ensuring our community is educated and empowered. By fostering collaboration among diverse healthcare providers, The Wellness Clinic stands as an example of how we can rebuild trust, accessibility, and quality care in our healthcare system.
Gratitude and a Call to Action
To the physician who stepped in today, we are deeply grateful. Your selflessness is a testament to the spirit of rural healthcare. However, this should be a wake-up call for all of us. Heroics are not a sustainable solution.
I want to acknowledge the incredible strength and stories shared by members of our community. I have been receiving your letters and reading them with great care. They highlight the resilience and determination within our community. These letters will be brought to my upcoming meeting with the Minister of Health to ensure your voices are heard and represented.
Our healthcare system, especially our obstetrical department, is in crisis. The safety and well-being of mothers, babies, and families depend on immediate, systemic action. Our community deserves better. Let us work together to ensure that no family has to face uncertainty during one of the most vulnerable times of their lives.
Sincerely,
Dr. Alise Gaiser-Edwards MD CCFP
Co-Founder of The Wellness Clinic
Physician, Mother, Daughter, Friend & Community Member.
