Doctors lament overnight closure of Montreal hospital ER, dig into pockets to end it

MONTREAL -

Dr. Fahimy Saoud spent a recent shift in a west-Montreal emergency room idly sitting and waiting for patients she knew would never come.

The urgent care area of the Lachine Hospital, where she's spent the last 12 years of her career, used to be packed with patients in need of her attention.

But those patients have been sent elsewhere as of Nov. 7, when the hospital opted to close its emergency room overnight until further notice.

The move, Saoud says, has left her feeling both worried and useless on the job.

"Sitting down and doing nothing from 7:30 p.m. to midnight, knowing that nearby hospitals, who are now getting an extra charge from patients we send them, are overflowing… Our teams are here but we can't work," Saoud said.

The Lachine Hospital says the closure became necessary due to what it describes as a critical shortage of key medical staff, particularly respiratory therapists.

From 7:30 p.m., until 7:30 a.m., all ambulances are being redirected to the McGill University Health Centre and the Montreal General Hospital.

Saoud says she fears the ER closure will put patients at risk, as some of them might be unwilling to travel further distances to seek treatment.

She's already seen a decrease in consultations over the past few days, she adds.

"Were all the options taken into consideration?" she said. "It's like if we were treating an illness with measures that can actually kill the patient."

Dr. Paul Saba, president of the Lachine Hospital's council of physicians, says the current shortage of respiratory therapists is caused by pay inequity among Montreal health care facilities.

"Four have left in the past year and ... they explained that the reason they did was, primarily, the pay difference between taking care of patients at Lachine [Hospital] and the same patients downtown," he said.

Saba says therapists are "incentivized" to work downtown because of "critical care bonuses paid by the Quebec government."

Those incentives, he added, have not been offered to workers at Lachine Hospital.

The McGill University Health Centre did not immediately respond to requests for comment.

The Quebec Health Department issued a statement saying "workers at the Lachine Hospital are eligible for the same premiums as workers at all establishments in the network."

Spokesperson Robert Maranda says the department is working toward finding solutions instead of keeping the ER shut down at night.

Saba, however, calls the government's current response "cheap, easy and a lazy approach to managing health care."

"And also dangerous on top of it because you are depriving people of the service they deserve," he said. "It's not a snack bar. You don't close an emergency room for 12 hours."

Saba says physicians at the Lachine Hospital are willing to put up their own money to ensure the emergency room returns to full-service as quickly as possible.

He announced on Friday that doctors will offer incentives of $15,000 per year for two years, out of their own pockets, for the first three respiratory therapists who step up to work at the hospital.

The Health Department says it doesn't support the doctors' initiative to pool their own resources because it is "not governed by a collective agreement or ministerial decree."

"We cannot condone the practice, which creates an inequality between establishments," Maranda said in a statement.

For Dr. François Plante, who's been practising at Lachine Hospital for more than 40 years, offering bonuses from his own pocket is not normal practice, but he said it's better to give than to close doors.

"We want to do what we can to attract and keep staff with us," Plante said. "What can we do? Not say a word, stay closed and let the population have no access to services in our health care establishment?"

Plante says he is willing to personally contribute up to $3,000 if that means reopening service.

Saoud, for her part, says the initiative to keep the hospital alive is both necessary and "heroic."

"An emergency room is the heart of a hospital," she said. "It feeds into the hospitalizations, the intensive care, the surgeries. So how can you expect to close its heart and expect the rest to survive?"

-- This report by The Canadian Press was first published Nov. 15, 2021.