‘Not worth the hassle’: Out-of-province doctor details bureaucratic nightmare trying to work in Vancouver Island hospital

Whereas emergency rooms and clinics throughout Vancouver Island face closures because of critical physician shortages, one Canadian pediatrician says she was buried in paperwork when she utilized for a BC license to return work at a rural hospital on the Island. 

Dr. Alexandra Dionisopoulos additionally ended up having to shorten the period of time she had supposed to work at West Coast Common Hospital in Port Alberni—down from 4 months to only one and a half—due to the best way locum doctor hours and funding are allotted.

“I don’t know if I’ll come again [to BC],” Dr. Dionisopoulos advised Capital Every day, after per week of working right here. “They only make it so exhausting for me to be right here that it’s simply not definitely worth the problem.”

Dr. Dionisopoulos has recognized since February that she needed to work in Port Alberni for one among her locums (placements filling in in understaffed rural clinics and hospitals). After finishing pediatric residencies in numerous components of the US, she had attained her Canadian license by doing a residency at McGill after which spent a couple of yr doing rural locums in Prince Edward Island, New Brunswick, and Nova Scotia. 

When she contacted the pediatrician at West Coast Common Hospital, she says he was extraordinarily useful and prepared to carry her onboard.

“Initially, Port Alberni had two pediatricians, however the different one refused to get vaccinated so he misplaced his hospital privileges,” Dr. Dionisopoulos stated. “So it is only one pediatrician serving the entire group.” A second pediatrician, obtainable over an extended time period, would have alleviated the strain on him. 

The necessity for extra healthcare employees at Vancouver Island hospitals is nicely documented. Earlier this month, an worker on the Port Alberni hospital advised CBC News that the staffing scarcity is so dire, the emergency room might should shut down for eight hours at a time. 

As Saanich Peninsula Hospital ER doctor Dr. Jeff Unger has advised us prior to now, full emergency rooms are often a results of an overflow in the remainder of the hospital: since there are too many admitted sufferers in wards, they should use ER beds, so there aren’t sufficient left for emergency sufferers. 

A protracted pandemic, delayed trip time, and diseases amongst healthcare employees have joined to create a disaster that has hit rural and remote emergency rooms in BC the hardest, with hospitals in Port Hardy and Port McNeill having to close down earlier this month. People have died ready for ambulances and closed emergency departments throughout the province. 

These closures have been the topic of a BC Inexperienced Celebration statement on July 19. Amongst different issues, the occasion referred to as on the province to “create a locum technique in order that docs can take holidays and sufferers have dependable entry to healthcare when their household physicians are away.”

Dr. Dionisopoulos says her expertise with BC’s present rural locum program has made her not need to come again. 

After going by means of a tough utility course of, she nonetheless needed to minimize her supposed work interval in half, regardless of seeing the necessity for physicians like herself and being prepared to work at West Coast Common Hospital for no less than 4 months. Her issues with the system started with the appliance course of for a BC License. 

‘A horrible and redundant course of’

Port Alberni is the primary out of a number of locum placements the place Dr. Dionisopoulos would have had private connections to individuals who reside in the identical group, so she was keen to start out the method as quickly as attainable. She began making her inquiries 5 months earlier than her supposed begin date: July 1. 

Emails to Dr. Dionisopoulos from the Faculty of Physicians and Surgeons of British Columbia (CPSBC) present she wasn’t allowed to use greater than three months earlier than her supposed begin date. Then there was the appliance course of itself. 

“While you’re making use of for the license, it is such a horrible and redundant course of,” Dr. Dionisopoulos stated. 

Her emails with the CPSBC reveal proof of the irritating quagmire of arbitrary hoops she needed to leap by means of. After already submitting a protracted checklist of required varieties, transcripts, and certificates for her BC license utility, Dr. Dionisopoulos was advised she hadn’t entered one or two bits of knowledge that she was certain she’d already despatched. Her three references confronted the identical issues, with paperwork supposedly not arriving, or with lacking data—and all the pieces needed to be despatched by references themselves, additional slowing the method.

All through this e mail chain, Dr. Dionisopoulos responded to the CPSBC consultant instantly and sometimes needed to observe up a number of instances, asking in regards to the standing of her utility, solely to attend days for a reply.

“The entire [application] course of itself took three and a half months,” she stated. Her begin date was pushed again by two weeks. 

The CPSBC wouldn’t reply Capital Every day’s questions in regards to the delays with Dr. Dionisopoulos’ utility, citing privateness legal guidelines. 

“Typically talking, the method for fast-tracking physicians who maintain licensure in one other Canadian jurisdiction is simple and delays could also be the results of easy issues similar to not receiving applicable paperwork or fee in a well timed matter [sic],” they stated in an emailed assertion. 

The appliance course of additionally entails a large number of charges: $1,152 for the appliance itself, $640 school registration payment, plus charges to get certifications like transcripts mailed to the faculty. All of those are the accountability of the doctor making use of for the license. 

“Every time I’ve to request a certificates {of professional} conduct…it’s $125,” Dr. Dionisopoulos stated. “For all of my American exams, I believe it price $75 for me to ship simply my transcripts.”

The BC license, like others throughout Canada, can be solely legitimate till the tip of the calendar yr, after which physicians must undergo a separate re-application course of. 

No incentives in BC

There are not any variations within the medical necessities for physicians from province-to-province, Dr. Dionisopoulos stated. However every time a doctor applies to work in a rural locum in a distinct province, they should submit the entire similar transcripts, references, and documentation to numerous schools and well being authorities. 

The Globe and Mail published an overview  in 2019 of the cumbersome and costly licensing course of for physicians, a lot of whom echoed Dr. Dionisopoulos’s expertise. They reported {that a} rising group of medical associations have been pushing for nationwide licensing, to make it simpler for physicians like Dr. Dionisopoulos to assist fill the gaps in rural and distant components of the nation. 

As of late, nevertheless, some provinces have taken steps to incentivize physicians to tackle rural locums of their communities, to attempt to alleviate the impacts of employees shortages on their healthcare methods. Prince Edward Island, for instance, paid for all of Dr. Dionisopoulos’s licensing charges. 

When she discovered herself with out work for the primary two weeks of July, after her BC license course of was delayed, hospitals in New Brunswick labored with their well being leaders to carry her there. 

“They supplied to arrange and pay for and assist expedite the New Brunswick license and I acquired it in lower than 24 hours,” Dr. Dionisopoulos stated. 

BC has no applications in place to pay for out-of-province physicians’ licenses as an incentive for them to return work right here.

Dr. Dionisopoulos was advised as a lot in an e mail from the doctor lead of locum companies on the Rural Coordination Centre of BC. “My hope is that with nationwide licensure, this may turn into a factor of the previous, however we aren’t there but and don’t have something in place within the meantime,” the doctor wrote. 

Even after Dr. Dionisopoulos had paid for this BC license, in each time and money, and had it in hand, she was advised there was no allotted time (or funding) for her to remain in Port Alberni longer than the tip of August. 

“It’s Island Well being’s job to cowl [the costs of] my lodging and rental automobile,” Dr. Dionisopoulos stated. “It is Rural Locum BC’s job to pay for the price of [traveling] to the locum. So it is only a bunch of locations I’ve to ship totally different paperwork and fear about what’s lined and what’s not.”

With out Island Well being funding her lodging for the 4 months she had supposed to remain, Dr. Dionisopoulos has no alternative however to return to Montreal on the finish of August and reevaluate her plans.

Longer rural locum placements haven’t been a difficulty in different provinces, she stated. Prince Edward Island, for instance, was simply in a position to accommodate her bills for a four-month locum. 

“I discover this ridiculous…there’s such an enormous want,” she stated. “Each time I am going into the [West Coast General] hospital, each healthcare employee I work together with [says], ‘We’re in determined want of a pediatrician. Please, please come.’ After which they simply make it so exhausting for me to be right here.”

After she leaves on the finish of August, Dr. Dionisopoulos says there could also be room for her to return again and work in Port Alberni for just a few days in September and October. However the dates are so disparate and the method so disorganized, she is not going to be returning to Vancouver Island. 

“It does not actually make sense for me to return all the best way right here to do this,” she stated.

Island Well being didn’t reply to Capital Every day’s questions in time for publication.