Doctors want competitive wage

For doctors like Shawn Tiller, chief of the emergency department for James Paton Memorial Regional Health Centre, the current dispute with government is a matter of putting Newfoundland and Labrador on equal footing with the rest of Canada.

That's one of many issues at play in the ongoing dispute between the provincial government and the Newfoundland and Labrador Medical Association (NLMA), whose members have been working without a contract since September 2009.

Negotiations between both groups have hit an impasse, with no agreement reached as of The Beacon's Monday deadline.

According to the NLMA, doctors in this province make 87 cents for every dollar earned by physicians in other Atlantic provinces.

"It's an impossibility to recruit physicians to this province, or get new physicians to stay in the province, if you can't offer a competitive wage," said Dr. Tiller. "Physician salaries and salaries of professionals are all relative. They may be higher than someone who works in a skilled-labour force, or someone in a department store, but we're talking relativism. We need to be compensated at a level that's at least equivalent to the rest of Atlantic Canada in order to recruit and retain physicians."

While Dr. Tiller understands pay levels cannot match those of Alberta, where the oil boom has allowed doctors in the same position as himself to receive a salary three-times his own, he said the province can at least stay competitive with regional counterparts.

He remains confident an arrangement can be found that will please both sides, and hopes it can happen through congenial dialogue.

"I think the tone has changed in the past little while, and that's good, because we don't want to get into a war of words with anybody."

The association is also looking for help in emergency rooms, like the one Dr. Tiller works in, by requesting a review of emergency medicine as part of its most recent proposal to government.

"It's all in a process to better improve care," said Dr. Tiller, who has worked out of the Gander hospital since 2006. "We want them to review the system to see if different types of care would be appropriate."

He cited several possible issues that could be looked at in a review, such as the use of nurse practitioners, the use of more than one physician in a department at one time, and an examination of which facilities are able to provide 24-hour care.

Category A facilities have a physician physically on set 24 hours a day, seven days a week, while category B sites offer emergency care through a physician who is on call.

"We'd like the government to review the entire system to see what's the most efficient way to deliver care," said Dr. Tiller.

Within his own work setting, overcrowding is an issue that carries with it a trickle-down effect.

Dr. Tiller said a lack of long-term care facilities and rehabilitation facilities means more beds are taken within a hospital.

"Because they are there and in the hospital for long periods of time, the beds that are allotted for acute care aren't available, and so patients that should be admitted to hospital, they're not able to be there, so there's overcrowding."

Thus, patients are held over in the emergency room section for long periods of time.

"That holds up emergency beds, so then we are not able to get the people from our waiting rooms in to lie down on a bed and assess them, because the bed's aren't available."

This creates stress for both physicians and nursing staff, said Dr. Tiller.

"(Nurses) have to juggle providing daily care for patients, administering medications to patients, and then having to turn around and take care of patients with heart attacks, strokes, and broken bones, having to assist me, and then having to assist a patient with toilet duties. The emergency department is not staffed to do that."

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