SHAWVILLE – For the second time in about a month, the Pontiac Community Hospital (PCH) experienced a temporary general surgery interruption from April 13-15 because an on-call surgeon wasn’t available. This time around, the obstetrics department also experienced an interruption extending from April 12-15. The Centre intégré de santé et de services sociaux de l’Outaouais (CISSSO) announced the breach shortly after 7 am on April 12, less than hour before the interruption in obstetrics began.
For both departments, emergencies were to be redirected to the nearest hospitals (Pembroke, Hull, Gatineau). “Surgeons from the Gatineau and Hull hospitals are working together to ensure the clinical conditions of patients are monitored,” said CISSSO in a press release before the breach. “We [stress] that all surgery positions in the Pontiac are filled and that the absence of an on-duty surgeon is
temporary and exceptional,” they continued. Specialized surgeries wereunaffected.
The lack of obstetric care was due to the absence of a general surgeon. “Obstetrics is unpredictable. Should the baby become distressed or the mother run into problems, you may have to act promptly, [possibly] with surgical intervention. The distance to Gatineau is too far if [intervention is needed], so patients are transferred in early labor for the safety of the mother and the infant,” said Shawville’s Dr. O’Neill, who is also head of Anesthesiology. “You need the ability to do cesareans locally if you are offering obstetrics,” he continued.
Local citizens group Pontiac Voice said they are concerned about the lack of representation from Pontiac MNA André Fortin concerning the matter. “We elected him to represent us and expect him to work with the government in the defense of our interests. He is our MP Persona non-grata to the minister because of his role as the opposition’s critic to health,” said the organization in a press release.
“We do not want to wait for a major crisis like in Maniwaki before our concerns are taken seriously. All the players involved in health and social services are in waiting mode and hope the Pontiac will not be put aside when changes are said to be coming. Pontiacers are not second class citizens. The Health Minister has made announcements in several corners of the Outaouais, but nothing in the Pontiac,” said Josey Bouchard, spokes person.
More to come, warns surgeon
Following the interruption at the beginning of March, Dr. Freydoun Homayounfar, one of the PCH’s two on-call general surgeons, warned the problem will worsen if something isn’t done soon. He and Dr. Nicholas Sperduto work alternating shifts at the PCH with a rotation of seven days on, seven days off, which means each of them is on call fourteen days a month, while surgeons in the city generally don’t work more than five. Dr. Homayounfar said this schedule is demanding, mentally and physically taxing, and reduces their ability to cover each other’s shifts due to burnout and legal requirements.
Despite the seriousness of the problem, CISSSO has not developed permanent solutions. “When one of us is absent and the other is unavailable, the only solution we’re offered is an interruption of service. We’re both getting older so the interruptions will only get worse [unless better solutions are found],” said Dr. Homayounfar.
A lack of replacements with the required training is a major contributor to the problem. The PCH offers obstetric care, so it means on-call surgeons must be able to perform caesareans, a skill many general surgeons are not equipped with. “About 80% of emergency surgical interventions at the PCH are c-sections,” said Dr. O’Neill.
The solution is not complicated, noted both Dr. Homayounfar and Dr. O’Neill; other regional general surgeons could complete the short training required to
perform c-sections and then offer their services to the PCH, or new doctors could be hired who have or are willing to take the training. However, this would require concerted effort on behalf of all parties: the province, CISSSO, the community (to make new doctors feel welcome), and other general surgeons in the region.
Prior to this year’s interruptions at the PCH, the last one was experienced in August 2018. CISSSO did not respond to the Journal’s inquiries about whether any transfers were needed during the most recent interruptions.