DOCTOR SHOWN THE LOVE SAYS MAHC PLAN ‘REAL CONCERN’ FOR HIS SOUTH MUSKOKA PATIENTS
Mark Clairmont | MuskokaTODAY.com
MUSKOKA — Doctors don’t usually get hugs, handshakes and high-fives.
Least not in public at a park.
Dr. Stephen Rix had all three Saturday morning.
Taking time out to attend the rally supporting fellow physicians was nice way to spend an hour or so with his young son.
Better than digging deep in to a stack of paperwork for his job, which he said can consume “at least 40 per cent of my work day … looking at results, reading and responding to reports (and dealing with government red tape) rather than seeing patients.”
Jokingly a provincial press release last week said it was “axing the fax” as part of a plan to reduce the bureaucratic backlog that’s weighting down MDs and GPs.
The U.K.-born doctor laughed about how odd it is that fax machines are still an integral part of our healthcare.
Rix looked relaxed at the weekend while wearing a white t-shirt and looking fitter than most Muskokans. As was his colleague Dr. Rohit Gupta, an equally svelte example of healthy eating and probably exercise.
They were exercising their right to participate in a public exercise in democratic freedom of expression by contending proposed hospital changes in Muskoka.
The doctors, too, have been rivalling Muskoka Algonquin Healthcare’s division of services due in under a decade from now.
Rix, Gupta and other south Muskoka doctors are questioning the planning and rationale of divided north-south service deliveries.
Both will be online tonight with MAHC pushing for as many as “72” equivalent acute care beds at South Muskoka Memorial Hospital.
That’s almost an equal split of 147 beds whence they open in 2032 — if not the full services for all that advocates like Save South Muskoka Hospital say Premier Doug Ford, MPP Graydon Smith and MP Scott Aitchison had promised.
Going in to Wednesday’s virtual meeting (which MAHC cancelled rather than favouring a face-to-face in Utterson with the doctors) the stakes are high with the hospital board appearing to be sitting firmly at 36 beds for the Bracebridge site.
Rix said: “I suspect there may have been some pressure behind the scenes, I don’t know,” when MAHC doubled its original offer from 14 or 18 beds.
“And they said that’s it.”
He suspects Smith may have influenced the board.
“It’s still a one-sided model with most of the care in Huntsville,” Rix replied when asked. “And we still feel with what they are proposing we will still struggle even to meet the current demand within south Muskoka — let alone what that demand will look like in 10 to 15 years out.
“That’s the real concern that we’re building something that probably isn’t going to cope with local demand.”
Rix, who is MAHC accredited, has hospital privileges and sees his own patients admitted to SMMH, says: “I think it’s very difficult to see how this is going to work in the long-term for our community.”
As for keeping the status quo of two separate hospitals as some have suggested, he doubts that’s possible at this stage.
“The only way to operate as two separate entities would be to dissolve MAHC and go back to being two separate hospitals, which I can’t see that happening. I think politically, organizationally, structurally, I can’t see there being any role to do that.”
Rix seems convinced of a need for an overall redevelopment.
“I haven’t seen the assessments — and they haven’t released any of the data — but our current hospital infrastructure is struggling. It’s however many years old — 60-70 years? But it’s struggling. Things like fire safety, it certainly isn’t to current fire code. And over time, certainly as we’re hearing it from the board, the maintenance costs are going to be very substantial to keep the hospital running.”
Does Rix feel unsafe in the hospital?
“I don’t think I feel unsafe. I’m conscious there are limitations. I think the argument from the board is that to actually bring our current facilities up to modern standards would actually be more expensive than building two new facilities.”
He said “it’s difficult to compare yourself to Toronto” where even older hospitals spend their maintenance money to keep them in up to date repair and use. “Downtown Toronto is definitely a different kettle of fish” with the amounts of money flowing in to them. “And with bigger facilities they can cope with closing part of them to upgrade them.
“Whereas we’re a small building and closing most of the hospital to try and upgrade it, yeah, I think it would be logistically challenging.”
Rix said the “overwhelming majority” of his medical colleagues “are very concerned.
“I think we’re very concerned that the proposals at the moment do not adequately meet the long-term care needs for south Muskoka — and the patients. That’s the main concern.”
A crowd SSMH estimates at 300+ showed support for the ‘Care Close to Home’ Saturday.
He’s also worried about staff “recruitment to Bracebridge and Gravenhurst being very challenging. Both for specialties such as general surgery and internal medicine. But also for family medicine physicians. Particularly for anyone (like him) who wants to do some hospitalist work as well as you have some office practice.”
Rix made sure to note that three new internationally-trained graduate doctors due in south Muskoka later this summer and fall “have nothing to do with the hospital….”
“They’re on a government program where they will get licensed and then there’s a three-year return of service. That’s completely independent of the hospital. They will probably have hospital privileges once they are fully licensed, because that’s generally what happens.
“No! The hospital has not been part of that recruitment.”
“But when you look 10-15 years down the line, the inpatient general surgery and inpatient internal medicine call is mostly going to be up in Huntsville.
“So typically physicians need to be relatively close to the hospital so they can be there in short notice for their patients. And ultimately, if Huntsville’s where all the patients are then that’s where the physicians are going to locate to. Because they will need to be close to that facility to provide on-call services.”
Rix admitted he’s unlikely to follow them.
“In 2032 I will be approaching 60, so the likelihood I’m going to relocate at that stage is low. But I would probably consider whether I can continue with hospital care at that point. Because whether it would be worth my while to be on-call 24 hours a day — Monday through Friday — and cover weekends in between. Whether that level of commitment is worth it for the number patients I have to look after. I’m very doubtful at the moment.
“The board seems to think that all the Bracebridge and Gravenhurst docs would be happy to just go and provide inpatient care in Huntsville, which seems completely impractical. As it adds an hour-and-10-or-15 minutes to my working day travelling up and down the highway. I can’t get there quickly in an emergency.
“My work days are already pretty long. It’s not unusual for me to do 12-hour-plus work days with all the admins (required) these days.”
Rix laughed about the “axing the fax,” saying “that’s a separate issue. The fact the Canadian health system is still so heavily dependent on faxing is a concern.
“There’s a huge amount of admin I have to do. In recent years it has increased dramatically. To the point that I would probably suggest that at least 40 per cent my working day is admin rather than seeing patients.”
Isn’t that just part of the job and can’t you offload that to staff?
“It totally is. But it’s increasing. So the more of that there is the less time I have to actually see patients face-to-face. It’s not unusual for me to spend a couple of nights now up until 11 o’clock doing paperwork. It’s got to be done. As you say, it’s part of the job.
“And that’s independent of the hospital situation.”
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