NO TO 18! NO TO 36! NO TO 54! DOCTORS WANT 72 BEDS IN SOUTH MUSKOKA
Mark Clairmont | MuskokaTODAY.com
MUSKOKA — Yesterday’s surprise announcement that talks between doctors and the MAHC board tomorrow will be virtual has caught a lot of people off guard.
Oh, to have been a fly on that wall had it remained at the Utterson Town Hall as planned until Monday.
Alas the fate of hospitals health care remains in the hands of a couple dozen doctors and Muskoka Algonquin Healthcare board members.
The MAHC board has said May 8 is south Muskoka’s last chance to plead its case for ‘Care Close to Home.’
Then its onward with MAHC’s proposal going forward to the Ministry of Health anytime reportedly between September and December.
But they may — or may not — be surprised by what the physicians have up their sleeves in the high stakes poker game.
Dr. Rohit Gupta, who is the face of the physicians, said Saturday — at a rally in support of their position — that they’re not stopping at 18, 36 or even the 54 beds they have now.
They want 72 — as in seven two — acute care beds for south Muskoka’s South Muskoka Memorial Hospital.
He told me so Saturday — not so hestistantly as is his nature when speaking and addressing an issue simple to him and seemingly to most south Muskokans; and as it could appear to be to their northern neighbours.
Doctors are doubling down on the latest bone MAHC has tossed them.
That is the 36 beds announced last month.
Dr. Stephen Rix suspects that was the result of the last meeting — in person, in Utterson — attended by MPP Graydon Smith who may have upped the MAHC/province/health ministry ante tilting it toward his hometown.
Lacking any clarity and transparency on MAHC’s behalf, the physicians’ position seems to makes perfect sense.
Amid a steady cacophony of honking horns on Manitoba Street, Gupta began with me at the rally by saying he’s “cautiously optimistic — still” about getting what doctors and south Muskoka want.
So you got 18 new beds? I asked him.
“They say that,” Gupta replied.
And why do you say “they say?”
“We don’t know what the plan is, because “we still don’t think 36 beds is enough to take care of our population. Right now we have 54 beds. We’re still struggling every single day. Every day were are 110, 120 or 130 per cent (over capacity) even with 54 acute care beds.
“If we’re talking 10 years from now, the population is more and older. And how are we going to take carry on with 36 beds?”
Huntsville today has 42 acute care beds, he said.
The province has already committed to increase acute care beds in Muskoka to 147.
“Absolutely,” said Gupta.
So by that simple math: 147 minus 36 in south Muskoka would leave Huntsville with 111 beds — or so it would appear.
But if SMMH were to keep their 54 beds, Huntsville looks to up with 93 beds.
Gupta said those “93 beds are what they call acute care beds.
“But in reality they are way more than that. Because they have 14 stroke beds, which actually are acute beds. And then they also have 10 ICU beds, which they are not counting in that. And our 36 beds they are counting our 4 ICU beds. So in reality they (will) have more than 120 acute care beds. And we are getting only 36 as part of their new proposal.”
Rix reiterated that “it’s still a very one-sided model, with most of the inpatient care still in Huntsville. We still feel that with what they’re proposing we’ll still struggle to even to meet current demand in south Muskoka, let alone what demand that might look like in 10 to 15 years.
“The real concern is that we’re building something that’s probably isn’t keeping with local demand. It’s very difficult to see how this is going to work in the long term for our community.
“We just don’t believe that what’s on the table is good for the patients of south Muskoka. “We’re worried that it’s going to make recruitment to Bracebridge and Gravenhurst very challenging. Both for specialities such as general surgery, internal medicine. But also for family physicians. Particularly for anyone who wants to do some hospitalist work, as well as have an office practice.”
Speaking of past meetings with MAHC, Gupta said “they were not very heated. They were polite, but at the same time it seemed they were not willing to listen to us when we are saying with Care Closer to Home what beds we need.”
Asked directly if he thought MAHC’s references to “misrepresentation” by doctors was akin to calling them liars, Gupta sidestepping politely saying: “Yeah, they’re just being very adamant and not looking at the data.
“We have time and again sent all the data and all the numbers, which they’re not paying any attention to and just keep coming with their own numbers, which basically do not give justice to what we’re seeing nowadays. I don’t think with this current number this (SMMH) will be an adequate hospital for us. So that’s what we’re fighting.”
Population and patients
So what’s it boil down to?
“Population, care close to home, not many transfers,” Gupta said.
“If we could take care of the population locally that would be the best. So looking at the numbers I think 36 is not gong to cut that.”
That’s his message going in to tomorrow night.
“They know it loud and clear,” notably coming out of Saturday.
He doesn’t think MAHC has a leg to stand on.
“We don’t know what’s going on. They’re not very transparent. They don’t tell us anything, they don’t discuss anything. They don’t engage in any conversation.”
No justification?
“No, nothing.”
“They’re only rationale is money. ‘Oh, we don’t have money for this, no money for that ….’ Which I’m not sure I can compare quality of care, quality of life.”
“I don’t what to say. I’ve said it many times,” Gupta said sounding frank but frustrated.
The doctor said he didn’t speak Saturday because he wasn’t “allowed to because of hospital bylaws.
“If you’re part of the hospital privilege group, because if we have privileges in the hospital you’re not supposed to publicly speak against administration. It’s a very thin line.”
Asked if he signed anything to that effect, he said “I think we did.”
But “their definition of rules is very different. So in the meetings when were speaking against the plan, we were all reprimanded.”
Gupta said the doctors haven’t spoken to the Ontario Medical Association (OMA) seeking any kind of support statistically or financially.
“Because we didn’t want politics to creep in to that. We just wanted to keep it local. Maybe we will have to involve them.
“At the end of the day we don’t want it to be a fight between north and south. Because the northern doctors are also part of the OMA. We don’t want to create that divide. Because we’re not saying we need a hospital in Bracebridge and not in Huntsville.”
Has Gupta’s group consulted physicians in Huntsville or received any empathy from them.
“I haven’t seen any official support for us to be honest. So whether they empathize with us or not — maybe they do, maybe they understand what we’re fighting for.”
He said he wasn’t aware if doctors in Huntsville have galvanized themselves as an official group around HDMH’s expansion.
He said of the reportedly 17 accredited doctors at SMMH “ours are a bit smaller than Huntsville” — with some he said working in walk-in clinics, but not in the hospital. “So there are many of us.
“At the same time most of our doctors are fulltime, whereas Huntsville they are part-timers.”
Gupta dismissed any references by MAHC’s chief of staff that the future of strictly “hospitalist” doctors taking over in Muskoka.
“I don’t think there’s any truth to it. In major cities yes that is they way the trend is. But not in our hospitals. Our doctors want to take care of our patients. That is why we are unique in that way. So I’m not sure I will agree with his statement.”
And as far as Wednesday night’s meeting, “all credentialed staff (with hospital privileges) are suppose to be in there.”
Or online now tomorrow.
He said the majority of the board have been at the two other meetings.
So will doctors come out with more beds? Is there room for movement from MAHC?
“I don’t think so,” said Gupta. “I think there is room. But I don’t think they are engaging with us. Because when the board is there they don’t even speak. They have hired these agencies (facilitators), which are outside agencies. And those are the people who do most of the talking. So we don’t get to see what they are thinking.
“All we are hearing is from all these hirees, which are not even Muskokans — these PR agencies.”
Still, Gupta says “I think we are cautiously optimistic — still. And we hope the board hears us loud and clear. That we are OK to have some services go as long as we have a good functioning acute care hospital as a compromise. Because we are willing to compromise — and cooperate. But at the same time we don’t want to have sub-optimal hospital where we can’t meet the needs of the community.
“Thirty-six is not a number we want. We want at least 70 beds.
“Seventy or 72 — that’s what we want for a future hospital.”
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