Service interruptions continue – New surgeon agreement a hoax?

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Allyson Beauregard

SHAWVILLE – The lack of a surgeon extended the 21-day service interruption in the Pontiac Community Hospital’s (PCH) obstetrics (OBS) department from January 3 to January 6 despite the province announcing in November that they signed an agreement with the Québec Federation of Specialist Doctors (QFSD) to remedy the problem.

Allyson Beauregard

SHAWVILLE – The lack of a surgeon extended the 21-day service interruption in the Pontiac Community Hospital’s (PCH) obstetrics (OBS) department from January 3 to January 6 despite the province announcing in November that they signed an agreement with the Québec Federation of Specialist Doctors (QFSD) to remedy the problem.
“This new interruption is caused by the lack of a surgeon who can perform cesareans in an emergency,” said the Centre intégré de Santé et de Services sociaux de l’Outaouais (CISSSO), noting general surgery was unaffected. The OBS interruption over the holidays was due to a nurse shortage. 
On November 28, Danielle McCann, Health Minister, announced the government signed an agreement with the QFSD to help ensure the continuity of OBS and surgical services in rural areas by creating a “SWAT team” of physicians to travel to different regions to cover shifts, effective December 1.
It appeared as though the agreement had partially helped the PCH avoid an interruption. “An interruption in general surgery was diverted from December 30 to January 6 thanks to the assistance of a surgeon from another region, but because they couldn’t perform cesareans, the OBS breakdown was prolonged,” said CISSSO. However, another interruption affecting both general surgery and OBS was planned for January 9-13, but was lifted for general surgery on January 10 when CISSSO found a replacement surgeon; it continued until January 13 for OBS because the surgeon couldn’t perform cesareans. 
According to information Pontiac MNA Andre Fortin’s office obtained on December 20 through an access to information request, the agreement with the QFSD still hadn’t been signed.
“The Minister wasn’t honest with the population … Pontiac patients thought this problem was behind them. When we saw the replacement surgeon during the holidays, we believed the agreement had finally taken effect, but the January
9 interruption proved it hadn’t,” said Fortin.
After multiple calls, Fortin discovered the truth: “The QFSD’s obligation to provide a replacement surgeon who can cover both surgical and obstetrics needs only takes effect on April 1.” Marie-Pier Després, CISSSO communications agent, confirmed the agreement will only be “rolled out gradually over the next few months.”
Rural hospitals offering OBS require more than just an average general surgeon. In the city, cesareans are tasked to obstetricians, so general surgeons often don’t have the required training. Given that cesareans make up the majority of the PCH’s emergency surgeries and the region’s small population doesn’t warrant having both a general surgeon and an obstetrician to perform cesareans on staff, their surgeons must be able to do both. 
However, it’s unclear if anything will be done to bridge the gap. “General surgeons choose whether or not to take the training to perform cesareans. This is an individual choice CISSSO doesn’t control,” concluded Després.