Physicians feeling the strain

Management measures introduced at Lewisporte Family Medical Clinic

Karen Wells
Published on January 30, 2013

LEWISPORTE & AREA — Physicians at the Lewisporte Family Medical Clinic are coping as best they can in light of the current staffing situation.
While there are normally five full-time physicians at the clinic, a series of events has resulted in a staffing shortage. Dr. Kadhem voluntarily resigned from practice when legal charges were brought against him. Another two doctors have since delivered their resignations.

In spite of the difficult situation, Dr. Wayne Collins and Dr. Brenda Penney are working to keep the doors to the clinic open. The Pilot spoke with Dr. Collins and Dr. Penney last Friday to get an update on the status of physician recruitment efforts and steps being taken to manage the situation.

To date one physician has been recruited to take over Dr. Amin’s patient files. He is expected to be at the clinic on March 1, coinciding with when Dr. Amin will be leaving.

Dr. Taher will be leaving the Lewisporte Family Medical Clinic the end of March.  

Dr. Collins has had discussions with another physician. There is some interest from this doctor in coming to Lewisporte to join the practice, but nothing definite yet. If that physician were to decide to come to Lewisporte it would still leave one position to be filled.

“Whether we are five doctors or three, the same number of people present to this clinic,” said Dr. Penney. “If there are five doctors you can handle it, but you can’t with three.

“If in March we get one – possibly two (doctors to join the practice), we are still down a doctor and it is still a strain. We really need five full-time doctors.”

That strain on the current staff of physicians was compounded with one physician being on holidays, leaving only three doctors for the better part of last week and just two doctors available to see patients one particular day.

Management measures

Dr. Collins and Dr. Penney have been in consultation with Central Health and Freake’s Ambulance, and discussed the matter with the Newfoundland and Labrador Medical Association.

“We’ve decided that because of the staffing issues with a shortage of staff here (at the Lewisporte Family Medical Clinic) that the ambulance will be deferred directly to the Grand Falls-Windsor emergency facility,” Dr. Penney explained. “We are not an emergency facility, we are a clinic and at the present time we are not equipped to deal with emergencies. We have significant staffing issues and we cannot take on emergencies at this time (effective Jan. 28).”

The physicians will be in consultation with Freake’s Ambulance if there are any particular concerns that arise. The ambulance will still be accepted as per normal policy at the After Hours Clinic. In addition, there is no change to the hours of operation at the After Hours Clinic.

The other significant management measure that is being put in place has to do with the patients that were seen by Dr. Kadhem. Dr. Penney said they do not have the staffing capacity to assume his patient load.

“Patients should feel free to speak to a general practitioner elsewhere in the region as we will not be able to take on his patients for ongoing medical problems,” she said.

Dr. Penney said, “We are not doing this because we are the bad guys.”

Dr. Collins said they feel bad for patients who are without a family doctor.

“I’ve opened up my practice to see drop-ins and I follow up on these patients, but there’s only so much I can offer. We try our best to accommodate what we can.”


Maxed out

In addition to the appointments scheduled for their own practices, Dr. Penney said they have seen up to an additional 105 walk-in patients in a day.

Dr. Collins said, “We’ve been coming in earlier, not taking lunch, leaving a lot later and coming in at night to do paperwork because there is no time to get that done during the day.”

If March comes and there is only one replacement physician, the doctors say just the three of them cannot accommodate everyone who requires a family physician, so people impacted should seek a physician elsewhere in the region.

The Pilot posed the question to Dr. Penney and Dr. Collins that’s been on the minds of patients of the Family Medical Clinic. Will they be resigning?

While Dr. Penney did not want to comment on that specifically at this point, she did say the workload is not acceptable.

“No one is going to stay and work this hard forever,” she said.

Dr. Collins said he doesn’t want to retire right now, but “I don’t want to work myself to death.”

“Right now we are coping with things. We had an overwhelming number of patients come down with influenza and it looks like that has peaked,” said Dr. Collins.

He is hopeful that will result in a decrease in the number of walk-in patients, noting that even if it does slow down the Lewisporte Family Medical Clinic is still a very busy clinic at the best of times.


Closing the doors to the clinic is not an option. Dr. Collins said that would be unethical. He is hopeful recruitment efforts will be successful.

“We are trying our best under very difficult and unusual circumstances,” he said. “This is the worst I’ve ever seen.”

Dr. Penney said they’ve never had a problem recruiting doctors in the past. A certain amount of physician turnover is to be expected, but they have always been able to keep pace with it, with no issues in replacing a physician who resigns in short order. Dr. Collins said facing the need to replace three physicians at once is a challenge when there are clinics and hospitals across the country who are also actively recruiting doctors.

Both Dr. Penney and Dr. Collins have received numerous letters trying to recruit them to provinces such as Alberta with “astronomical incentives”.

“We choose to stay here,” said Dr. Penney.


Second clinic

As the Pilot reported last week, the Concerned Citizens Committee is working with a private developer to try and have a second privately operated medical clinic opened in Lewisporte.

Dr. Penney and Dr. Collins say they have not been consulted about such a venture, and only found out about it by reading the newspaper. They agree that while a second clinic is a good concept, they wonder if it is feasible when there aren’t even enough doctors to staff one clinic.

Add to that the overhead cost doctors incur in a private clinic setting and whether or not there are enough patients to support a second clinic and these physicians have their doubts about it working.


Looking ahead

Dr. Collins said while they have had to have patience with the current situation, they understand people are frustrated. They feel most people understand the circumstances and are trying to be patient as well.

“We want to thank the public for their understanding,” said Dr. Penney.

Appreciation was also extended to Central Health “for their cooperation in working with us to help get through this crisis.”

Dr. Penney said further updates on service changes would be provided through public service announcements.