Alberta cancer treatments could suffer with exodus of key staff, doctors warn

A group of two dozen Calgary physicians is warning the safety of cancer care and the ability to keep providing some treatments could be jeopardized with the resignation of a number of highly trained medical physicists in the radiation program at the Tom Baker Cancer Centre.

The doctors call the staff exodus "a devastating loss."

While the radiation oncologists have written a letter outlining their concerns, Alberta Health Services says patient care is not impacted and it is working to address the staffing shortage.

The letter, signed by 24 physicians, said multiple medical physicists, including the program director, have resigned in a short period of time primarily over pay and workload concerns.

Medical physicists play a key role in cancer treatment by ensuring the safety of complex radiation treatment machines, creating treatment plans and developing new techniques.

Their expertise is also needed to commission the state-of-the-art machines for the $1.4-billion Calgary Cancer Centre, set to open in 2023.

"We are concerned that we will be unable to provide our current standard of care, or indeed any treatment. The safety of our routine, daily cancer treatments are put at risk by a medical physics department that is understaffed, overworked and inexperienced," the letter stated.

The radiation oncologists said they're especially concerned about the ability to provide total body irradiation (used before stem cell transplants to treat leukemia and lymphoma) and brachytherapy (internal radiation treatments for gyneological, breast and prostate cancers) and that this exodus jeopardizes the vision for a "world class" program once the new Calgary Cancer Centre opens.

They noted Calgary is the only site in Alberta offering some of these treatments, including total body irradiation, and it receives referrals from Saskatchewan and British Columbia.

The doctors said these concerns have been raised before and they questioned whether the program will be ready to move into the long-awaited new cancer centre next year.

One-quarter of staff gone

AHS urged the doctors involved not to talk to journalists — and to re-direct any requests to the media relations department — after the letter was leaked on social media. As a result, none of them agreed to an interview.

In a statement emailed to CBC News, AHS acknowledged it is experiencing staffing and recruitment challenges and said three medical physicists have resigned since last fall.

According to the health authority, four of 22 positions are vacant, including the director's job. It wouldn't say if temporary positions are included as part of its full contingent.

In addition, sources connected to the program tell CBC News two more full-time medical physicists have accepted positions elsewhere but have yet to leave.

With those departures (based on AHS's definition of its normal staffing levels) the program will be down more than one-quarter of its full contingent of physicists.

Sources tell CBC News other support staff have also left. 

AHS said an interim director is now in place and it is aggressively recruiting to fill the vacancies.

"The team … is prioritizing activities and monitoring workload and processes. Safe, quality care remains our focus for patients and staff," spokesperson Kerry Williamson said in the email.

"Patient care is not being affected at this time, and we do not anticipate issues with services as we plan the move to the new cancer centre in 2023."

In an effort to stem the bleeding, the health authority is providing medical physicists with a one-time pay increase next month.

"We believe the steps we're taking will enable us to deal with the recruitment challenge we're having …and ensure we have the skilled people we need there going forward, to maintain the full range of care for people in Calgary and southern Alberta," Williamson said, adding work at the Calgary Cancer Centre continues.

'That is concerning'

"It's really bad news for the province," Wayne Beckham, president of the Canadian Organization of Medical Physicists, said in an interview.

According to Beckham, medical physicists work alongside radiation oncologists, playing a pivotal role in the treatment process, and it could take years to rebuild the program.

"It's not possible to deliver safe cancer treatment unless you have both those staff groups actually working together," he said.

"The Calgary centre has all the elements of a world class medical physics program. They teach graduate students. They train their own residents. So they've potentially got a pipeline going to populate the workforce. But if that workforce is being depleted … that is concerning. And it really is going to cause some significant problems for cancer treatment."

The group conducts an annual salary survey of its members. The self-reported data shows Alberta's medical physicists are the second lowest paid, compared with their counterparts in other provinces, with a median salary of $143,000 per year in 2021.

"I understand from colleagues in Alberta that one of the major concerns is not simply the level of compensation, it is also about salary progression over time," he said in an email.

"With frozen salaries since about 2014, there are people who have grown into senior and leadership roles that are stuck at essentially entry level reimbursement. It's tough for them when former students … are now making as much as their mentors. Now they are seeing physicists leaving and taking their skills to where they will get market value commensurate with their experience."

A University of Calgary health policy expert said the implications of this staffing shortage could be serious.

"When you have several departures in a small department, that is a significant enough magnitude of people leaving to affect patient care and to affect the ability of the program to continue as it has been going," said Lorian Hardcastle, an associate professor in the faculties of law and medicine at the University of Calgary.

"I think this is an issue the public will be deeply concerned with."

According to Hardcastle, the AHS direction against talking to journalists underscores the seriousness of the situation.

"If there was nothing to see and everything was fine, I don't know that AHS would be directing people not to speak."

On Monday at the legislature, David Shepherd, the NDP health critic, pressed Health Minister Jason Copping on the staffing shortage. And Copping tried to reassure Albertans that cancer care is not in jeopardy.

"I've been speaking with AHS. They have a plan to be able to fill those vacancies and work with the University of Calgary to be able to hire more. But let me be clear...this will not impact treatment for cancer patients now nor in the future. We will get this solved," Copping said during question period.

"We understand how important these positions are. We're working to fill that."