A newborn baby in an incubator. The BC Anesthesiologists' Society, saying hospitals in the province are falling short of safety recommentations for high-risk pregnancies, is urging B.C. to create a long-term plan to recruit and train anesthetists through a mix of better pay and shorter hours.Rubberball Productions
The B.C. Anesthesiologists' Society warns that three out of four hospitals in the province charged with caring for high-risk expectant mothers are not meeting safety recommendations amid a critical shortage of anesthetists.
The dilemma already forced Victoria General Hospital to send women with complicated pregnancies to the mainland and prompted a hospital in Surrey to end its care for high-risk premature babies.
It will take more than just funding to fix the problem, according to the society, which claims the province must create a long-term plan to recruit and train doctors through a mix of better pay and shorter hours.
"The safest thing for moms is, undoubtedly, to have someone dedicated to anesthesiology," said society president James Helliwell. "Nobody is willing to do that job."
The Public Health Agency of Canada recommends that all hospitals dealing with high-risk pregnancies, also called Level 3, have obstetric anesthesia services available immediately when asked.
To meet this requirement, B.C.'s Perinatal Health Program recommends that all four Level 3 hospitals have a full-time, on-call anesthetist dedicated for obstetrics.
These hospitals include B.C Women's in Vancouver, Surrey Memorial, New Westminster's Royal Columbian Hospital and Victoria General.
Currently, only the Vancouver facility has a 24-hour dedicated obstetrical anesthetists.
Juggling duties with obstetrics and other emergency services is a daily safety risk, Dr. Helliwell said.
Meeting the recommendations would require each hospital to hire at least five anesthetists, Dr. Helliwell said.
On top of obstetrics, there are already 25 other anesthetist positions that need to be filled provincewide, but that's been difficult to do because of low pay and long hours, he said. Attracting an obstetrical anesthetist, he added, is a greater challenge because of even more erratic hours and historically lower fees in that specific specialty.
When his own wife needed an anesthetist during a delivery at St. Paul's Hospital, where Dr. Helliwell works, he relieved another anesthetist so the doctor could do his wife's epidural.
The province recognizes that 24/7 coverage is necessary to manage additional demand from high-risk obstetrics according to statement provided by the Ministry of Health. Minister Kevin Falcon was on vacation and unavailable to comment.
In 2009, the provincial government, the B.C. Medical Association and the B.C. Anesthesiologists' Society negotiated $18-million in funding to allow anesthetists to bill for supervising epidurals.
"The fee compensates obstetrical anesthesiology at an equivalent amount to what an anesthesiologist would make in an operating room, making obstetrical anesthesia an equally attractive service," the statement read.
That money has improved obstetrical care in hospitals across B.C., but it hasn't delivered dedicated anesthetists to the high-risk maternity centres, Dr. Helliwell said.
Plus, it's going to take more than just money. Facing some of the lowest pay and highest hours in Canada, anesthetists have been fleeing the province for decades, said Dr. Helliwell.
David Kent, originally from Vancouver, took a job in Alberta after he finished training at the University of Calgary.
Any thoughts of a homecoming have been quashed by a rate of pay that is up to 50-per-cent higher in Alberta.
Dr. Kent said he would move back to British Columbia if the province offered "a reasonable work environment where you don't have to work until you are haggard."
The anesthetists society wants to sit down with the government to make that a reality, Dr. Helliwell said.
Training more residents, providing more physicians with support staff, and funding innovations that would allow more surgeries in less time would go a long way to solving the problem, he said.
"We've done too much juggling for too many years and it's time that we got the anesthesiologists to come to British Columbia to do this work so that women can feel confident that they can get all the care they need when they need it."