Doctors Manitoba warns only 1 in 5 rural ERs will be open 24/7 this summer

Manitoba's rural emergency rooms are bracing for another summer of instability, with Doctors Manitoba warning that only about one in five rural ERs will be reliably open around the clock.

The organization representing physicians in the province says staffing shortages and growing burnout among front-line workers are pushing more emergency rooms toward reduced hours, periodic shutdowns, or full closures. Doctors Manitoba president Dr. Nichelle Desilets says it's a longstanding issue that's expected to worsen as travel increases and resources are stretched thin during the summer months.

"This isn't a new problem. It's been building for many years," Desilets said. "The prolonged uncertainty and short staffing is taking a toll."

According to Doctors Manitoba's forecast, based on schedule reviews and feedback from physicians, just 20 of the province's 95 rural emergency departments are expected to be reliably open 24/7 this summer. Another 24 are predicted to face reduced hours or periodic closures, 28 are slated to close completely and 23 remain under long-term closure.

The group has launched a resource website, offering region-specific ER schedules. It also outlines what to do in an emergency and how to plan ahead for medical needs in remote areas.

This marks the fourth consecutive summer that Doctors Manitoba has issued warnings about the state of rural emergency care. Desilets says this year carries added risks.

"We are expecting more travel within the province this summer as Manitobans avoid travelling south of the border," she said. "We physicians want to ensure that Manitobans are prepared to access emergency medical help across rural Manitoba, no matter where they are."

'One problem after another'

Robert Misko, the head of council in Roblin, says his community has grown accustomed to the strain of unpredictable emergency access after years of persistent doctor shortages.

Roblin's ER catchment covers a wide area, stretching from the Duck Mountains to the Saskatchewan border. Travel times to another functioning ER can be 30 to 45 minutes or more, depending on the emergency.

"It's one problem after another," Misko said, adding that while local efforts to work with the regional health authority are ongoing, bureaucratic roadblocks are slowing progress. "They put up as many roadblocks as they possibly can to try to get people through the system."

Ed Bedford, the deputy mayor of Glenboro-South Cypress, says his area has seen improved stability, thanks to a shared ER coverage arrangement between Glenboro and Carberry, each with two doctors and alternating service days. They also have 24/7 paramedics in town.

Still, Bedford says he hopes Doctors Manitoba's summer forecast won't impact coverage.

"It's kind of the reality of how things are nowadays," Bedford said. "I don't think you're ever going to see 24-hour ER service in the smaller places anymore."

The closest full-time ERs for Glenboro-area residents are typically in Brandon or Killarney. Bedford says people have adjusted to checking schedules and managing expectations.

"I think we've just got used to it," he said. "We'd like to see more nurses and doctors too. But yeah, that's a long ways away."

Staffing shortages create strain

Jason Linklater, president of the Manitoba Association of Health Care Professionals, says many ERs remain closed because of severe staffing shortages in diagnostic services. These roles — such as lab and X-ray technologists — are essential to keeping emergency rooms operational.

There are 45 posted positions in lab and X-ray — 75 per cent of which are outside of Winnipeg — and that is also likely undercounted, Linklater said.

"They're having a ton of trouble filling them, and the reason is there are simply not enough people to fill those positions."

Shared Health should offer incentives to attract temporary help in rural areas, including covering travel and accommodations, Linklater says.

Some relief is on the way through a new contract for allied health professionals, which includes rural and northern wage increases, he says. But it hasn't been fully implemented yet.

Desilets, who works in Neepawa, says she sees the consequences first-hand. 

 A recent Doctors Manitoba survey of ER physicians found high levels of burnout and distress, with nearly a third saying they're considering cutting hours or stepping away from ER work entirely unless conditions improve.

"It's a really unique work environment," Desilets said. "There's low resources, and sometimes there's no one else in town to call and help. It's hard work for ... the one doctor town who is on overnight with only two nurses for the entire hospital, including their in-patients."