As a dedicated rural emergency room physician, I feel compelled to offer a heartfelt public apology to my community.
I deeply regret that too many of you are regularly unable to receive the critical healthcare you require, whether that’s in the appropriate settings or at the moment you truly need it. I extend my apologies for the fact that many of you lack a consistent primary care provider, face unbearably long wait times, and often find me consulting you in a bustling hallway, where your privacy is compromised. This situation in our rural hospital in Kenora, Ontario, is not an isolated issue; I have witnessed similar challenges echo throughout emergency departments across the nation.
It’s crucial that you understand my colleagues and I are unable to tackle these pervasive healthcare problems alone. In fact, the relentless pursuit of solutions has driven several of us to the brink of leaving this vital profession. Ironically, our struggle to prioritize self-care might ironically exacerbate these already strained services.
My involvement in emergency room shifts has significantly decreased compared to the past, and I’m uncertain if I will ever return to my previous schedule. Currently, my shifts average around ten hours, during which I often forgo meals and bathroom breaks. I routinely stay beyond my scheduled hours, tirelessly striving to provide care.
The emergency room is filled with patients who urgently need us to exceed expectations—not just occasionally, but consistently. The complexity and severity of illnesses we encounter have reached unprecedented levels. Often, I find myself in a desperate struggle to secure transfers for critically ill patients from our modest facility to larger hospitals in Thunder Bay or Winnipeg, both of which are grappling with their staffing and bed shortages. There are moments when I find myself literally begging for essential resources on behalf of my patients.
Unfortunately, I frequently come up short in meeting these urgent needs.
In 2023, in a bid to ensure patient care while managing staffing shortages, I naively scheduled myself for every long weekend from Easter to Thanksgiving. This team effort to maintain operations that summer ultimately left me exhausted and frustrated.
I realized that many patients and their families are unaware of the toll this profession takes on its practitioners; they merely expect the emergency room to be consistently operational. While this expectation is entirely reasonable, it bears a significant personal burden for me.
The relentless pressure of burnout left me dreading each workday, as an overwhelming sense of impending doom began to shadow me in the days leading up to my shifts.
The one thing I couldn’t out-work
In an attempt to alleviate my anxiety, I began arriving at work earlier and staying late. Yet the significant demands of my role rendered me feeling powerless; I faced the harsh reality of watching patients with severe injuries wait excruciatingly long periods for necessary surgical interventions.
There were instances where I found myself utterly overwhelmed and reduced to tears, consumed by the daunting challenges within the workplace. I struggled with sleepless nights, and as I attempted to outwork the pressing issues at hand, I only found the workload becoming heavier.
Last October, I reached a breaking point and contacted my department head, urgently explaining that I needed to substantially reduce my shifts or I would have no choice but to resign.
Having once served as a humanitarian doctor in conflict-ridden areas, I am acutely aware of the dire consequences when individuals lack access to healthcare. The thought of remaining at home while a neighbor or friend suffered is an unbearable burden that weighs heavily on my conscience.
However, I came to the realization that continuing with the current state of affairs was unsustainable.
Upon reducing my shifts, I grappled with feelings of inadequacy, fearing that I was letting everyone down. Yet, the emergency room remained operational, and I discovered that I could finally take a breath and prioritize my well-being. By seeking help, I metaphorically donned my own oxygen mask, allowing me to regain focus on my health.
These days, my hospital frequently sends out weekly emails appealing for local doctors to cover extra emergency room shifts. It’s clear that hospital administration understands the extent of exhaustion felt by local physicians, many of whom serve as rural generalists, tending to both community and hospital needs.
We have all learned, often through experiencing burnout, health issues, and relationship strains, that putting in more hours does not equate to stabilizing emergency services. In fact, overextending may drive more physicians away from rural practice altogether. Despite this, I have been informed that local hospitals are under pressure from ministry mandates to prove they have exhausted every avenue before considering a closure. Hence, the emails persist.
A plan to stay healthy
I have come to understand that maintaining my health is the most effective way I can contribute to alleviating the staffing crisis. By adhering to my assigned shifts and occasionally picking up vacant slots, I’ve accepted that, regrettably, our emergency room—like many others—will likely face periods of closure in the near future. With just 11 local doctors currently available in our ER, down from 22 four years ago, it’s clear that no single individual can resolve the crisis we face.
Therefore, I am reaching out for both forgiveness and understanding from the public.
In September 2023, local MPP Greg Rickford announced over $1 million in funding for much-needed infrastructure enhancements at the Lake of the Woods District Hospital. Despite these efforts, patients frequently must be transferred to larger facilities for emergency surgeries or referrals—a process that can be disheartening for the healthcare professionals advocating for them, as I have witnessed firsthand.
However, I must emphasize the urgent need for systemic changes that shift the responsibility of maintaining rural healthcare services back onto the politicians and civil servants whose roles are tied to the healthcare system.
I sincerely apologize that our healthcare system currently falls short of meeting every one of your needs. Despite my efforts to improve the situation, I have often come up short, but I can assure you that by balancing my work hours, I am much more likely to continue serving this community in the emergency room for the long haul.
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What motivated Dr. James Thompson to issue a public apology regarding healthcare in Kenora?
**Interview with Dr. James Thompson, Rural Emergency Room Physician in Kenora, Ontario**
**Editor:** Thank you for joining us today, Dr. Thompson. You recently issued a public apology to your community regarding the state of healthcare in Kenora. Can you elaborate on what prompted that decision?
**Dr. Thompson:** Thank you for having me. The apology stemmed from a deep sense of responsibility towards my patients. I’ve witnessed firsthand how the lack of consistent healthcare access affects our community. Many individuals are struggling to find primary care providers, facing long wait times, and receiving care in less-than-ideal circumstances. I felt it was essential to acknowledge these shortcomings and communicate my regrets.
**Editor:** You’ve highlighted the systemic issues that are impacting rural emergency departments across the nation. Can you describe some of the specific challenges that you and your colleagues face daily?
**Dr. Thompson:** Absolutely. The challenges are numerous: we are dealing with critically ill patients who often have to wait too long for necessary transfers to larger facilities. Our hospital, just like many others, is grappling with staff shortages, which means that the few of us still here are stretched incredibly thin. I often find myself working ten-hour shifts without taking breaks, struggling to provide the care that each patient deserves.
**Editor:** You mentioned the toll that the profession is having on you personally. How has burnout affected your ability to work and provide care?
**Dr. Thompson:** Burnout has been a significant issue—not just for me, but for many of my colleagues. The expectation from the community is that the emergency room will always be operational, but that’s a heavy burden to carry. I reached a breaking point last October, where I realized that I needed to cut back significantly on my hours or risk leaving the profession entirely. It was a tough decision—feeling like I was letting the community down—but it was necessary for my mental and physical health.
**Editor:** What steps are you taking now to ensure both your well-being and continued care for your patients?
**Dr. Thompson:** I’ve learned that prioritizing my health is crucial for my ability to serve my patients. By reducing my shifts, I’ve been able to breathe and regain some clarity. It’s a balance—I need to be healthy to care for others effectively. Additionally, I’ve been actively advocating for support and better working conditions for all healthcare providers in our area.
**Editor:** What do you believe needs to change at a systemic level to improve rural healthcare?
**Dr. Thompson:** There needs to be a more robust support system for rural hospitals to ensure they can attract and retain physicians. This includes better funding, improved staffing models, and a focus on mental health resources for practitioners. Our high burnout rates indicate that we can’t keep expecting providers to just work harder. We need to recognize the unsustainable nature of the current demands and find a path that promotes both patient and provider well-being.
**Editor:** Thank you for sharing your insights and experiences with us, Dr. Thompson. Your dedication to your patients and your own well-being is commendable.
**Dr. Thompson:** Thank you for the opportunity to speak about these critical issues. I hope that our conversation can help raise awareness and drive meaningful change in the healthcare system.
