You can’t have an ER without MDs
Re: ERs Without Doctors?, Jan. 26.
An emergency department “without a doctor” is a cynical misrepresentation to rural Canadians. To suggest that a clinic with a nurse practitioner and/or a paramedic can replace a well-trained and adequately supported emergency physician borders on the absurd.
It is true that the percentage of life-threatening emergences presenting to an ER is often less than 5% of total patient volumes, but that is as true in downtown Toronto as it is of rural Parrsboro, N.S. Nevertheless, Canadian emergency departments are structured to provide timely intervention to the critically ill, no matter how rare the occurrence.
It is also true that things “have to change” but a more appropriate step would be an inventory of the capabilities of an individual ER, subsequent optimization and development of a regional plan. Apparently the “fix was in” when the National Council of Health Ministers requested the Canadian Medical Association to present them with three models of emergency care delivery for their consideration, of which one had to be the Nova Scotia model.
By all means let’s look at innovative ways to provide timely access to quality emergency care for rural Canadians. However, let’s not mislead them by throwing the word “emergency” into the title and suggest full capability. Call it a “rural nursing outpost”, call it an “after hours clinic” or call it a “Band-Aid station” but do not call it an ER. It isn’t.
Dr. Alan Drummond, Perth, Ont.