Fredericton doctors call for action to replace vascular surgeon

New Brunswick's health minister and Fredericton doctors agree that something has to be done about the recent loss of a surgical specialty at the local hospital.

The only remaining vascular surgeon at the Dr. Everett Chalmers Regional Hospital, Dr. Claus Schaus, closed his practice last month after almost 30 years.

"The medical community is concerned about what the future of care here is going to look like," Dr. Chris Goodyear, a general surgeon, said.

"We're losing services in spite of the fact that we have a growing population. We're being asked to provide more care to more people with less."

Patients in need of vascular care now have to be referred to doctors in Saint John and Moncton, said Dr. Elna Hauman, an emergency room doctor and president of the physicians' association at the Chalmers.

Wait times will increase and patients will have to travel farther, she said.

WATCH | DECH staff explain why it's hard to recruit specialized physicians: 

Vascular surgeons specialize in all diseased blood vessels other than in the brain or heart, Hauman said.

When a vascular surgeon is available in-house, a patient with an infection or circulation problem and a foot wound, for example, can be assessed and treated directly and quickly by a specialized team whose members know and trust each other, she said.

A wound on the foot of a person with diabetes. (Tim Devlin/CBC)

When there's no vascular surgeon at the hospital, she — as an emergency doctor — may have to spend a lot of time on the phone trying to secure a referral or manage care with a specialist in another city.

If any surgeon runs into problems in the operating room with bleeding, it's nice to have a vascular specialist around, added Goodyear.

When Goodyear moved to Fredericton 23 years ago, there were two vascular surgeons, a thoracic surgeon and four plastic surgeons. Now, out of each of those specialties, all that remains is one plastic surgeon, he said.

"I know that every hospital in the province can't provide every service, but … we feel that we have the population base here to carry on with this service that has been here for 50 years."

Hauman, too, has witnessed a decline in health services during her time in Fredericton.

"When my husband and I came here almost 25 years ago, we picked this community over other communities because we felt that we could offer full-service family practice here while being supported by a wide range of specialty colleagues."

The Chalmers had every kind of specialist except neurosurgery and cardiac surgery, and the presence of specialists remains an important factor for new doctors choosing where to practice, she said.

It's no coincidence that Fredericton has the highest number patients that don't have a primary care provider in the province, said Goodyear.

Health Minister John Dornan says the main problem is a short supply of specialists along with high demand for services. (Jacques Poitras/CBC)

Health Minister Dr. John Dornan describes the absence of vascular surgery in Fredericton as "a short-term gap."

He acknowledged the situation posed a significant challenge and suggested that to re-establish the service would require doubling down on resources.

"We need to have vascular surgeons in Fredericton and we need to buckle down to make that happen," he said, speaking to Information Morning Fredericton.

The main problem is a short supply of these specialists along with high demand, said Dornan, pledging to work with Horizon Health CEO Margaret Melanson to explore recruitment measures such as surgeon pay.

"We need to think about different ways of managing our surgical resources, such as people working in an alternate funding program like we do with thoracic surgery in Saint John and Moncton. That will allow us to recruit two instead of just the one," Dornan said.

The minister was also supportive of involving the broader community in recruitment measures, such as helping to bring in a physician's family or other resources.

"We need to show a better foot forward, a better environment here and that will be our challenge," he said.

Dornan rejected the notion that services at the Fredericton hospital were intentionally being downgraded.

"Nothing is further from the truth," he said, noting recent renovations.

However, he did not diverge from the previous government's plan to hold off on allowing the hospital to open a hybrid operating room — a state-of-the-art facility designed for multiple types of surgery.

The Saint John Regional Hospital will get the first because it does the most surgeries, said Dornan, and others will be considered after the province has a better understanding of the resources required to support its operation.