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Queen Elizabeth Hospital Specialists Cease Non-Urgent Referrals

Five internal medicine specialists at the Queen Elizabeth Hospital (QEH) in Charlottetown have announced a significant change in their patient referral process. Effective January 21, 2024, these doctors will no longer accept non-urgent referrals. This decision comes as wait times for their services have escalated to levels deemed "unsafe and unsustainable."

Details of the Decision

The five physicians who staff the internal medicine clinic at the QEH communicated this change to their colleagues through a memo dated December 20, which was later disclosed to CBC News. The memo elaborates on the alarming situation, stating that the clinic is grappling with "increasingly unsafe and unsustainable wait times for new consults and follow-up patient visits." It emphasizes that the choice to restrict referrals was made only after the specialists reached a critical juncture, where they could no longer offer safe and sustainable care.

Escalating Wait Times

The situation is alarming: wait times for services have surged dramatically, turning from weeks into months, and in some instances, exceeding a year. The memo highlights several disturbing trends:

• Urgent Cases: Patients flagged as urgent by emergency room (ER) doctors are now facing a wait time of three months for an initial consult, compared to less than two weeks previously.
• Semi-Urgent Cases: Those cases deemed semi-urgent from the ER must now wait over a year when the prior wait was only eight weeks.
• Primary Care Referrals: Semi-urgent cases referred by primary care providers are now languishing for 12 to 18 months, up from a mere two to three months.
• Follow-Up Appointments: Previously scheduled follow-up appointments for both medical and cardiac patients, which should have taken place within three months, now face delays of up to a year.

Implications for Patient Care

The memo, signed by the five physicians, specifies that all referral requests will at least receive an acknowledgment within 14 days, along with an estimated wait time for a consult. The doctors are also urging referring healthcare providers to actively monitor their patients for "clinical stability." A significant concern highlighted by the physicians is that approximately 2,000 of their current patients—representing one out of every four patients in the clinic—lack a primary care provider, necessitating additional support for follow-up care.

The physicians expressed an intention to gradually resume accepting new non-urgent referrals once wait times can be moderated to an "agreed-upon safe level."

Health P.E.I.’s Response

In a statement, Health P.E.I. confirmed the cessation of non-urgent referrals at the QEH internal medicine clinic, expressing awareness of the impact this decision will have on both patients and referring providers. They stated that this challenging move was necessitated by a significant surge in demand for internal medicine services, resulting in unsustainable wait times.

To bridge the gap in urgent care until the clinic can accept non-urgent references again, Health P.E.I. has suggested that healthcare professionals utilize virtual services for patient referrals. They are actively engaged in recruiting 15 new internal medicine specialists to alleviate the pressure on the clinic. This includes filling seven positions specifically for general internal medicine, aiming to restore the capacity needed for vital patient care.

Additional Context and Challenges

The situation at the QEH is compounded by recent events in the region, including the closure of the intensive-care unit at Prince County Hospital in Summerside due to a critical shortage of internal medicine specialists. The unit has now been repurposed into a progressive-care unit, which can be overseen by family physicians and nursing staff, rather than specialists. The ICU’s closure highlights the escalating challenges in the healthcare system in the province.

Growing Concerns from Community Leaders

Interim Green Party Leader Karla Bernard expressed grave concerns regarding the impact of the new referral limitations. She warned that this decision would be devastating for Islanders who are already encountering difficulties accessing care. "This is a cut to services. So we are cutting Islanders’ access to health care," she stated, emphasizing the detrimental effect on community health resources.

Bernard also criticized the lack of public communication concerning the changes, indicating that healthcare providers and patients have been caught unaware. She stated, "Who is that transparency with? The people that it impacts the most were completely blindsided."

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