Association of ER doctors wants Quebecers to keep seeking care if they have health concerns

The Canadian Association of Emergency Physicians says it is “concerned” about comments made by Quebec Health Minister Christian Dubé in December suggesting that unnecessary emergency department visits significantly contribute to overcrowding.

If patients feel they need emergency health care, they shouldn’t hesitate to go to the ER, the association told The Canadian Press on Wednesday.

On Dec. 19, Dubé told reporters in Montreal that “there is a large percentage of people who consult at the emergency department who don’t have an urgent problem … I’m not saying they’re not worried, but they don’t have an urgent problem.”

He made the statement after receiving a letter from a group representing Quebec emergency department chiefs who said the situation was “out of control” due to overcrowding.

Quebec’s health department also issued a news release on Dec. 31, encouraging people to consider other health-care services instead of going to the ER.

Close up of man's face
In December, Health Minister Christian Dubé said Quebecers should avoid going to ERs if their health needs were not urgent. (Sylvain Roy Roussel/CBC)

Volumes in emergency departments are high in the midst of respiratory illness season, but the main reasons for overcrowding are systemic problems that have been flagged for years, said Dr. Michael Herman, an emergency physician at Queensway Carleton Hospital in Ottawa who was speaking on behalf of the Canadian Association of Emergency Physicians.

“The issues around emergency medicine volumes are really more to do with flow through the hospital than it is to do with individual patients presenting,” said Herman.

“When you have patients who are admitted to the hospital waiting 24, 48, sometimes 72 hours to get a bed on the ward, that in turn occupies space that can’t be used to see the next emergency patient.”

WATCH | Montreal doctor questions goverment’s plea for Quebecers to avoid ERs:

Montreal doctor questions government’s plea for Quebecers to avoid ER

Dr. Laura Sang, a Montreal family doctor, says a vulnerable person’s condition can evolve quickly and some may take time to fully present. Sang says she does not want people to get discouraged from going to the ER if ‘something feels off.’

People arriving at the ER should expect to be triaged based on the acuity of their symptoms, Herman said.

“Unfortunately we may have to anticipate that there might be a bit more of a wait than you’re used to — certainly more [of a] wait than we’re happy with. But that is the reality of the situation.”

If people have “timely access” to a family doctor, that can be a good option for those who aren’t experiencing severe symptoms, Herman said.

But “if they’re worried that there could be something more serious going on” they shouldn’t hesitate to go to the emergency department, he said.

“The patient declares their [own] emergency,” Herman said.

Government messages telling people not to go to an ER unless it’s “necessary” could deter people from accessing the care they need, he said.

“The patient is the one who has concerns about their symptoms, concerns about their well-being, so they present to an emergency department to be assessed. That’s our job, that’s our role.”

Emergency department overcrowding prompted New Brunswick’s francophone health authority on Friday to ask people to avoid two of its emergency departments unless they needed critical care.

The Vitalité Health Network said one of its ERs would be closed overnight due to nursing shortages.

It also acknowledged that the holidays were making it more difficult to access primary care services.

Emergency physicians met with health ministers from across Canada last fall to discuss the issues plaguing hospitals and emergency departments on an ongoing basis.

“The challenges that Canadian emergency departments have confronted, such as overcrowding, protracted wait times, and resource limitations, have persisted for far too long,”‘ said Michael Howlett, president of the emergency physicians association, in a statement issued on Oct. 12.

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