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On the eve of the summer vacation, hospital emergencies in the province are already starting to overflow. Some establishments in Greater Montreal had occupancy rates well above 100% on Tuesday.
This is particularly the case of the Royal Victoria Hospital (170%), the Pierre-Boucher hospital in Longueuil (191%), the Saint-Jérôme hospital (172%), the Suroît hospital (175%), Maisonneuve-Rosemont hospital (148%) and Pierre-Le Gardeur hospital (147%). Regional hospitals are also under pressure, particularly in Sept-Îles (210%), Hôtel-Dieu de Lévis (149%), Center hospitalier régional de Lanaudière (167%) and Hull hospital ( 144%).
While the months of May and June are normally among the least busy for emergencies in the province, the waiting rooms are not going anywhere, says the president of the Association of Specialists in Emergency Medicine of Quebec, Dr.r Gilbert Boucher.
Our waiting rooms for two weeks are really full. When patients seek help, they come to the emergency room.
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The Dr Gilbert Boucher, President of the Association of Specialists in Emergency Medicine of Quebec
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At the CISSS de la Montérégie-Est, to which the Pierre-Boucher hospital is affiliated, it is said to have received “more than 195 visits” since Monday, including sick elderly waiting for a hospital bed.
A “complex” problem
But even more serious, hospitals are far from having regained their cruising speed even if the pandemic is gradually fading. And that has repercussions on emergencies. The number of patients arriving by ambulance is not higher than usual. But hospitals have less capacity to treat these cases, says Dre Judy Morris, President of the Quebec Association of Emergency Physicians. She notes that several hospitals are still working with small teams in several departments.
The Dr Boucher also notices that staff are lacking everywhere. “The system is stretched. The slightest jolt we have, we have a hard time getting out of it, ”he said.
All this at a time when we are trying to make up for delays in surgery. And that care protocols are still weighed down by protective measures against COVID-19. For example, we always avoid grouping too many patients in the same room, notes the Dre Morris.
She stresses that the summer vacation, which will be well deserved, has not yet started in hospitals and that the situation in emergencies could therefore become more complex in the coming weeks. “Hospitals are going to have to operate according to their capacity. Otherwise, it is always emergencies that suffer, ”she said.
May and June are usually the least busy months in emergencies. We don’t want to cry wolf. But it is sure that we are stretched.
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The Dr Gilbert Boucher
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The latter nonetheless emphasizes that preventive measures related to COVID-19 are being eased in hospitals as the pandemic situation improves. “We continue to be extremely vigilant. But that could help us, ”he says.
More outpatients
To amplify the problem, many people show up to the emergency room. The Dre Morris says more ambulatory patients (who present on their own) have been coming to hospital in the past few weeks, including several who have been reluctant to see a doctor for a long time. “Our waiting rooms are full”.
Several emergency physicians report seeing more and more patients presenting with severe symptoms ignored for too long by people who did not want to go to hospital during a pandemic.
PHOTO OLIVIER JEAN, ARCHIVES THE PRESS
While the months of May and June are normally among the least busy for emergencies in the province, the waiting rooms are constantly on the move, notes the Association of Emergency Medicine Specialists of Quebec.
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Some of these patients also present because they are having difficulty accessing their family doctor, according to Dr.re Morris. The Dr Gilbert Boucher confirms that there are “still several clinics that do not work 100%” and where face-to-face visits are limited, which pushes patients to turn to emergencies.
Last Thursday, the Assistant Deputy Minister of Health, the Dre Lucie Opatrny, sent a directive limiting the use of telemedicine for family physicians in the province. This directive, first reported by The duty, “Aims for a return to face-to-face consultations, a reduction in the use of teleconsultation to allow a resumption of clinical activities deemed non-essential face-to-face”. Family physicians must therefore limit teleconsultations to their registered patients “whose health problem is known and not complex”. “No teleconsultation is authorized for orphaned patients or those not known to the doctor”, indicates the directive.
The president of the Federation of general practitioners of Quebec (FMOQ), Dr Louis Godin, assures that family doctors want beacons for teleconsultations. But he believes that this directive arrives “quickly, while we still have issues related to the pandemic”, and that the doctors’ offices “have not returned to their normal functioning”. The Dr Godin gives as an example several clinics where the waiting rooms are not large enough to ensure the two-meter distance between patients.
For the Dr Godin, several patients appreciate the teleconsultations, which must remain, but be supervised “according to a normal reality”. The Dr Godin says that the fact that patients come to the emergency room saying they have been unable to see their family doctor is mainly caused by the fact that some practices are still limited in their operation because of the measures related to COVID-19, well more than abuse of telemedicine.
Recent data from the Régie de l’assurance maladie du Québec (RAMQ) obtained by Press show that the use of teleconsultations by family physicians has been declining slowly, but steadily in Quebec since January. For the Dre Morris, the reality of emergencies is “complex”. And the significant use of telemedicine alone could not explain the high occupancy rates in emergencies currently observed.
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At the height of the pandemic, in April 2020, 60% of consultations by family doctors were done by teleconsultation. This proportion was 37% a year later. Among medical specialists, the teleconsultation rate fell from 32% in April 2020 to 12% in April 2021.
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