'Keep the doors open': As ERs close, doctor speaks out on the challenges of practising in rural Sask.

The senior lead physician of a Saskatchewan Medical Association program that provides help for rural doctors is speaking out on the challenges they face, after a number of temporary rural emergency room closures forced by a shortage of medical professionals in the province. 

"We tend to get the feeling that from an emergency perspective … the importance is placed on just keeping the door open, not necessarily, you know, keeping the door open when we are adequately staffed," Dr. Francois Reitz said in an interview Tuesday, as he was coming off a 24-hour emergency room shift.

Reitz works with the medical association's rural relief program, which provides short-term locum relief to general and family doctors working in rural communities with fewer than five practising physicians. 

The workload for health-care workers in rural areas has increased from when he first started with the program 20 years ago, he said, including greater demand from patients as health conditions have become more complex.

At the same time, there is a shortage of health-care workers in rural areas.

"It's not just physician shortages that we're seeing," Reitz said. "My nursing colleagues, my pharmacy colleagues, my lab techs, etc. — there's a shortage of everybody."

That's resulted in many rural health-care workers who are on call "every single day," he said, which means they struggle with work-life balance or may have to reduce services.

When somebody calls in sick, there's often nobody to replace them, Reitz said.

"I need certain things to be able to deal with the heart attack or if there's a motor vehicle accident," he said. 

"If I don't have those resources available to me, I cannot do the best that I can from a rural perspective. And rural, classically, we deal with fewer resources that we have to juggle."

The expectation to "keep the doors open" for health services like emergency rooms can compromise the quality of care for patients, which is top of mind for doctors, said Reitz.

"Our concerns are more about not being able to provide that quality of care," he said. "When one hasn't had sleep or [doesn't] have enough staff, what is slipping through the cracks?"

Reitz said the current doctor shortage is not a complete surprise. 

He said by 2018-19, it was known the field would run into a "mass retiring of doctors," due to the number of baby boomers working at that time.