Saint John loses gastroenterologist and after-hours on-call specialist service

The Saint John region has lost one of its gastroenterologists and with him, the after-hours on-call service provided by digestive system specialists for emergency room and hospitalized patients, CBC News has learned.

Dr. Chad Williams recently took a position at Dartmouth General Hospital in order to be closer to family, making the around-the-clock call schedule "unsustainable" for the remaining three gastroenterologists, said Dr. David Marr, medical director for the Horizon Health Network's Saint John area.

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"For the forseeable future there will not be a GI specialist available beyond 8-5 M-F," states an internal email obtained by CBC News.

But local general internists and general surgeons, who are "comfortable in managing most of the GI problems," have stepped up to help bridge the gap until the vacancy can be filled, said Marr.

Gastroenterologists are specialists who deal with the diagnosis and treatment of a wide range of conditions related to the digestive system, such as stomach bleeds, blocked esophagus and abdominal pain, as well as inflammatory bowel diseases, such as Crohn's and diverticulitis.

If the internist or surgeon providing primary call is not able to adequately deal with a patient, which Marr contends will be "uncommon," the three local gastroenterologists will provide "secondary call."

If they are unavailable, the patient can be transferred to a gastroenterologist in Moncton or Fredericton, he said.

"So I think we have the issues covered as best we can."

'Optimistic' about candidate

Horizon is actively recruiting to replace Williams and Marr said he is "optimistic" about one candidate who has expressed interest in the fee-for-service position.

Marr is also seeking approval from Horizon and the provincial government to have a fifth gastroenterologist.

As it stands, only one of the three gastroenterologists in the Saint John area works full-time. Another works about 0.6 and the third is due back from maternity leave next month, he said.

We're just going to keep working away at it and I hope we'll have the problem solved sooner rather than later.- David Marr, medical director

Having a fifth specialist would provide the capacity to deliver the service around the clock, every day of the year, said Marr.

There are currently about 60 or 70 gastroenterologists in training programs across the country, he said. But all of the programs are west of Atlantic Canada, which makes recruitment a challenge since many people prefer to set up a practice near where they've already established roots.

"We recognize the stress on our gastroenterology colleagues when there's a shortage. I get it, and we're going to push very hard to get the complement here that meets patient needs in New Brunswick and helps our colleagues … do their work," said Marr.

"So we're just going to keep working away at it and I hope we'll have the problem solved sooner rather than later."