Mark Clairmont | MuskokaTODAY.com

MUSKOKA — The long weekend, a start to summer and another busy three days at local emergency rooms.

Just another day, another weekend say, doctors at South Muskoka Memorial Hospital.

It’s also another opportunity for permanent and seasonal residents to learn more about ER wait times and the controversy around one or two hospitals in Muskoka.

Unless they’ve had their heads buried in the Leafs land or cottage capital gains talks with their financial advisor summer residents may not know how far they could have to go to get equal health care in the future.

(Lest they’ve been reading MuskokaTODAY.com  — celebrating 30 years of ‘Local Journalism’ this weekend.)

Care closer to their GTA home may one day be a better option for cottagers.

Today, the first Friday of the long weekend, SMMH is already at about “140 per cent of capacity,” said ER physician Dr. Bill Hemens speaking between patients this afternoon.

“So that’s putting a strain on all the staff.

Welcome to south Muskoka! Happy May 24!

“We’re currently in a surge capacity, which means that we have five admitted patients more than we can handle in emergency. So they had to open an outpatient department to put them in.”

Hemens was one of three ER doctors at the Muskoka Algonquin Healthcare’s south Muskoka site today. One of two back-ups docs called in for the weekend in due to a high volume of sick and in need patients.

But it’s not just about long weekends, the former GP who now only works in ER and  delivers babies at the Bracebridge hospital site.

“Since COVID — and so many people moving to Muskoka — we’re often in this position.”

Hemens said SMMH has been overcapacity at “110 to 130 per cent for three-and-a-half years. So there is no down time. Now it just becomes critical mass. It’s not that, oh, we’re gonna be busy this weekend.”

“I can’t remember the last time I saw our consensus below 100 per cent,” said Wu. “I genuinely can’t think of a single day.”

“So we’re concerned because the weekend is here and the tourists are back and we’re already past capacity today,” said Hemens.

All this as yesterday MAHC issued a release claiming “full support” for its development plan from its “medical advisory committee (MAC) in the north and south of Muskoka.”

However, Dr. Luke Wu, who was running the ICU this weekend, says that’s not true. He said “that the people listed on it, not all of them supported it, I can tell you that.”

Of the 14 MAC doctors MAHC included (below with release) more than two thirds are medical names more familiar to patients in Huntsville. Just four are known closer to home in south Muskoka.

Hemens said his “understanding” of the MAC “strong endorsement” is that “there was no vote” of the members.

MAHC’s release, he said, “reads funny. Because it makes it sound as if there was a vote and people voted on it. My understanding is there was no vote. There was a discussion at MAC and then they published the names of everybody on MAC.”

MuskokaTODAY.com’s email to MAHC asking for confirmation on that vote was not returned by publication this evening.

Hemens, however, said the south Muskoka doctors’ group did get their 43 doctors to “sign off” on all their letters to MAHC and the community after they read and agreed to what was released publicly by Dr. Rohit Gupta.

“We wanted to make sure they supported it 100 per cent and didn’t just put their name on it.  Everybody who signed, wrote saying ‘yes we support this.’”

Do patients ask about the hospitals situation?

Asked if people bring up the subject while being examined, Hemens said yes.

“The short answer is I’d love to discuss it with every patient, but we’re so busy. I tell them to please call the mayor and (MPP) Graydon Smith. And I also tell them about your website and the Save South Muskoka Hospital site.

“We’re literally running. We have no time to stop to discuss politics; and it’s not really the appropriate place when someone comes in sick. I tell them if they’re really interested go to these sites to get information.

“They ask me every day for the last three months when I’m in the emergency and I’m asked by at least five or six patients.”

He said it’s not always local people, but many others.

“I think a lot of the people who don’t know are the Snowbirds, particularly in Muskoka Lakes. A lot of them are very influential and they don’t seem to really know what’s happening. But once they’re here for the summer, I think we’ll get more support.”

Talking about last week’s virtual call between MAHC and south Muskoka credentialed medical staff, Hemens said “it was not a meeting.”

“It was a Zoom presentation with everybody muted. They only un-muted those they wanted. So you’ll be surprised to hear they didn’t un-mute me.”

When pressed, he didn’t want to talk about who spoke: “I don’t want to get into that because it was supposed to be private discussion.”

As to the more meetings MAHC touted for June 10-22, Hemens said that what he “understands” is that they are going to be “focus groups, people who are hand-picked.

“If you’re in agreement that’s great; and if you’re not — it’s more or less we can agree to disagree.”

An email to MAHC seeking details of those meetings and whether they will indeed be public as they claimed as others it hosted across Muskoka were this winter was also unreturned tonight.

“I don’t think so,” said Hemens. “Not that I’ve heard of either,” added Wu.

“These are not public meetings to come out and speak up,” said Hemens.

So where does back and forth leave patients?

MAHC told the doctors their Zoom call was their last chance to cut a final deal after previously getting a pod of 18 more beds at south Muskoka out of previous talks.

“End of the road for doctors … Up to community to speak up’

Does that mean when one door is closed could another window of opportunity open for doctors?

“I think as physicians, we’ve come to the end of the road,” said Hemens. “In that we’re not being invited to any future meetings with MAHC, senior administration or the board.

“So now we feel it is up to the community to speak up for what they need. I think the physicians have been pretty clear in their letters about what the concerns and needs are.”

Hemens said the doctors had a meeting with a “planner from the Ontario government. And he talked about a seniors population in south Muskoka that will triple in the next 15 years. Which is not true everywhere else. We already have a much older population than most of the rest of the province.

“We don’t have enough beds now,” Hemens stressed.

“I think the last time I looked we had 54 acute care admissions. These are not long-term care people who don’t have a place to go. These are people who are sick. And they are offering us 36 beds (in 2032), which are not sufficient now and certainly won’t be sufficient in 15 years when the seniors population has tripled.”

The long-time physician said doctors are “speaking up for what current services we need now and for the next generation. And I think that those who are speaking up here now, we are residents who live here. We’re looking out for our families, our children, our grandchildren, our parents. We want them to have those services. We do not believe they will have those services with the current plan.”

So why such a large bed imbalance toward Huntsville?          

Hemens said the population growth around Huntsville “is not expected to be superior or even equal to south Muskoka.”

Said Wu, who’s running SMMH’s ICU this weekend: “Maybe it’s because of the stroke program up there. But that is not sufficient justification.”

“But if they say 20 beds for that,” says Hemens “that still doesn’t end up being the number that they’re projecting (in Huntsville), which I think is 119. And when they talk about 119, they don’t include 10 ICU beds. Whereas when they talk about 36 here, they include four or five in ICU and one for obstetrics.”

Even given MAHC’s argument for more beds centred around a long-standing and immoveable site for the stroke recovery centre in Huntsville, it still doesn’t make sense they say.

Not with 50,000 hospital admissions across two hospital sites now and only 20 major stroke cases in 2023.

Wu says many of those were also transferred to hospitals south of Muskoka. And so to send them up to Huntsville and then back to southern Ontario isn’t good for the patient or the environment, he said.

‘It’s not just the numbers, but the acuity. The level of health’

Talking further about the overall health of Muskokans, Hemens said of the population in the south “we have a lot of elderly and cottagers. And we have unfortunately a lot of accidents that occur.

“It’s not about just the numbers, but the acuity. It is the level of health.

“So when somebody comes to the emergency, they are triaged (assessed) as 1 to 5. So 1 means you need a doctor and a nurse at time zero — that’s someone who’s having CPR or needs life support. They’re very, very sick. And a 5 is you sprained your ankle. So 1s, 2s and 3s are really important. And that’s the high sickness, illness threshold.

“And we (SMMH) had 50 per cent more 1s than Huntsville. So we’re seeing some very, very sick people,” said Hemens.

“I just think the population is very much larger here and mentioning about this summer and thinking of this weekend people will come up and they often overdo it. They get the boat in the water and they’re not in the best shape and end up having a heart attack. Or fall off the roof as they’re trying to clean the eavestroughing.

“I’m always amazed at what I see on this weekend. There are really a lot of tragic, preventable accidents that occur and that are life-threatening.”

Hospitals are “most efficient at 85 per cent,” according to health and hospital experts, says Hemens.

“I haven’t seen those numbers since before COVID.”

And he won’t see them again.

“Everyone always says you must be so excited to be getting a new hospital. I go ‘I’d be excited if could take the capacity that we need.’”

NOTES:

Gravenhurst continues hospital support sign sweep

Oddly the Gateway to Muskoka is making it a bit difficult for cottagers to keep up to date as Gravenhurst continues to sweep the main roads where cottagers most often commute to their beloved Muskoka lakes summer abodes.

Signs supporting two equal hospitals on the busiest long weekend routes continue to end up in the back of bylaw vehicles, as municipal enforcers search and remove red sobriquets — today driving up and down Muskoka Road.

Back street supporters don’t have the same problem.

Even as illegal “incidental” garage and community sales signs popped up at the same.

Those who have had dozens of their signs removed from public rights of way were told they could retrieve them from the town. More than two dozen were by SSMH members Thursday after Wednesday’s sweep.

However, anyone who lost theirs Friday were out of luck as town hall is closed till Tuesday after Victoria Day.

And home owners were unable to replace them back away from the road for long weekend cottagers to see the wide support of citizens — if not officialdumb (sic).

The mayor and councillors (most) who have been reluctant to engage openly and transparently in the debate are least hearing about opposition to MAHC’s plan while gleaning very little information on its stance from the town.

After Save South Muskoka Hospital supporters surrounded the Gravenhurst town hall Thursday before a council meeting, Mayor Heidi Lorenz did eventually acknowledge their presence by making late mention of them albeit after the fact. (Or after reading our story?)

Lorenz did take time to address her councillors, staff and those in the council chamber at the end of her meeting — about what she called the “Elephant in the room ….

According to a town release, she said: “As we drove in today, we did see the … you know, some people out, you know, with their hospital signs.

“And it is my understanding that the Muskoka Algonquin Healthcare is dedicated to maintaining an open and transparent process with staff, including the doctors, community organizations and the public. There are public sessions that are going to be scheduled for mid-June, so I encourage the public to, you know, attend and provide feedback. And, you know, listen as well. I mean it should be a two-way conversation. And I believe that.

“The details will be out there soon. I don’t know where and when they’re going to be. And we look forward to seeing where the plan lands as a result of this … this further collaboration.”

Meanwhile … keep on smiling cookie lovers

In another irony, South Muskoka Memorial Hospital’s coffers are more than $20-grand sweeter thanks to hospital supporters, many of whom were invited to buy cookies to help the hospital during a rally in support of SMMH last week.

That oughta put a smile on chair Dan Brooks’ face.

The two Hortons in Bracebridge raised $20,405.85 in this year’s Smile Cookie Campaign. The annual week-long total was one of the largest amounts the two locations have raised, said a release.

“It was so incredible to see the community come together to support such an important cause,” Foundation development officer Kathryn Devlin said. “We are so grateful to store owners Kevin and Laura Francis, to our volunteer cookie decorators, and to everyone who bought a cookie.”

Funds raised will improve patient care through the purchase of new technology, equipment and facility renovations, all of which are not funded by the province.

MAC ‘fully supports’ MAHC plan — or do they?

MUSKKA — In a release from MAHC Thursday, they claim their Medical Advisory Committee, consisting of department chiefs, clinical committee chairs, medical directors, and physician leads from both North and South Muskoka, has provided its “strong endorsement” through a consensus statement in support of the proposed health system plan designed to transform regional healthcare delivery.

As above doctors are in doubt of that.

It reads:

“As trusted advisors the MAC is the leading medical committee that oversees the quality of medical care and provides council to the board of directors on all medical matters. The MAC operates within a decision framework that prioritizes quality of care while recognizing budget constraints, government regulations, and the current deterioration of facilities. The committee’s endorsement comes after rigorous assessment and comprehensive feedback from care-providers and community stakeholders and is based on the potential of the plan to maintain and enhance healthcare quality across Muskoka and surrounding areas.

“We, the members of the MAC, fully support the updated plan for our regional healthcare system as presented by the Project Team. This plan, improved through valuable community feedback, serves as a strong foundation for enhancing healthcare across Muskoka and surrounding areas. It aims to effectively expand our system and ensure each community sees improvements.

“The strategy is carefully designed to maintain fiscal responsibility, reflecting our commitment to responsible use of public funds. This financial stewardship is apparent in managing initial construction costs and ensuring sustainable operational expenses.

We are committed to actively collaborating with the Project Team to address any issues that arise as we implement this plan. Together, we aim to develop a forward-thinking healthcare system that meets current demands and is prepared for future healthcare challenges. Our support for this plan shows our belief in its potential to improve healthcare delivery in our region.

“The MAC calls on the medical community and local politicians to support this vital project, which represents a significant investment from the province in healthcare development for the region. The collaboration of all stakeholders is essential, particularly considering the tight timeline and existing financial and governmental constraints.

“The endorsed plan signifies a strategic transition from operating two independent small hospitals to adopting a cohesive regional healthcare approach, where two interdependent hospital sites complement each other and the broader local health system.

“This strategy aims to improve and expand services, benefiting each community in the region. It includes thorough risk mitigation strategies and a commitment to ongoing collaboration with healthcare providers to effectively adapt and respond to operational needs.”

Members of the MAC:

1. Chief of Staff, Dr. Khaled Abdel-Razek (both sites)
2. Chief & Director of Emergency Medicine, Dr. John Simpson (both sites)
3. Chief & Director of Diagnostic Imaging, Dr. Jason Blaichman (both sites)
4. Chief of Obstetrical Services, Dr. Sheena Branigan (both sites)
5. Chief of Surgical Services, Dr. Hector Roldan (both sites)
6. Chief of Internal Medicine, Dr. Khaled Salem (both sites) (SMMH)
7. Chief of Family Medicine, Dr. Kristen Jones (SMMH)
8. Chief of Family Medicine, Dr. Melanie Mar (HDMH)
9. Quality Lead Physician, Dr. Keith Cross (SMMH)
10. Quality Lead Physician, Dr. Caroline Correia (HDMH)
11. Chief Medical Information Officer, Dr. Nick Biasutti (both sites)
12. Chair of Pharmacy & Therapeutics, Dr. David Johnstone (both sites)
13. President of Credentialed Staff Association, Dr. Allison Small
14. Vice President of Credentialed Staff Association, Dr. Joseph Gleeson

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