Elective orthopedic surgery halted at Royal Alexandra Hospital due to doctor shortage

All elective orthopedic surgeries at the Royal Alexandra Hospital (RAH) in Edmonton have been suspended for three days starting Monday, due to a shortage of the doctors who care for patients after surgery.

An internal Aug. 14 Alberta Health Services (AHS) email informed surgeons the situation at the hospital has become "critical" due to minimal daytime coverage by hospitalists, also known as clinical associates. These are doctors who provide post-surgical care.

"In addition, there will be limited overnight clinical assistant coverage starting on Wednesday, leaving one single junior resident in-house to manage 120 orthopedic in-patients," wrote Dr. Paulose Paul, the chief of orthopedics for Edmonton.

"This is a situation which, I think you will all agree, is NOT safe."

Paul said in the email that the staffing problem had existed for many months.

In an attempt to fill the gaps in coverage, he said they have interviewed and identified new clinical associates who are willing to work. 

"Despite being alerted to this situation months ago, Acute Care Coverage and Medical Affairs at the RAH have been unable to fill these shifts."

Paul warned there may be more surgery disruptions throughout August if the positions are not filled.  

In a statement, an AHS spokesperson said the cancellations affected 53 patients.  

"AHS continues to experience staffing challenges as the health system recovers from the unprecedented COVID-19 pandemic," the statement said. 

"Frontline staff are taking much-needed vacation, as many have deferred vacation after 20 months of pandemic measures. This makes filling some shifts difficult."

Several new staff have been recruited, the statement said, and soon will be ready to support the surgical program. 

'Our health-care workforce is tired'

At a news conference Tuesday, Dr. Curtis Johnston, AHS deputy director for the Edmonton health zone, said the suspension of surgeries has already reduced the number of patients in hospital so that there will no longer be a single doctor for 120 overnight patients.

Johnston said surgical volumes have returned to normal levels and AHS expects to reschedule surgery for the 53 patients by the end of September.

He told reporters the surgery cancellations were not just due to staff holidays. He said there were many factors, stressing that the pandemic has stretched the province's health-care system, and its workers, to the limit.

"I think it is important to reiterate to all Albertans that our health-care workforce is tired," he said.

"They have worked extremely hard and they have done the best they can to serve Albertans and we have limits as humans.

"We need time to recover and to rest and recuperate and do our best to serve all Albertans' needs, not just the surgical patients."

NDP blame health minister

Alberta Health Minister Tyler Shandro has previously said he intends to address the waiting list for surgeries, including orthopedic surgeries, by shifting more surgeries from the public system to private surgery facilities.

The minister has actively sought proposals to build and operate chartered surgical facilities.

Critics have accused Shandro and the UCP government of reducing funding for surgeries in the public healthcare system to facilitate what they believe is an ideologically driven shift to private surgical facilities.

They also have warned it will create shortages of critical staff, such as anesthesiologists, in the public system. 

NDP health critic David Shepherd blamed Shandro for this most recent problem at the Royal Alex.

"This goes right back to Tyler Shandro, his war on doctors in the midst of a global pandemic, fighting with them, driving them out of the province, utterly exhausting them," Shepherd said, referring to an ongoing dispute between doctors and Shandro over pay.

"And now we see the implications for Albertans on the ground."

Shandro's office did not respond to a request for comment.