Health officials won’t publicly admit the scale of ‘crisis’ at Surrey Memorial Hospital ER, doctors’ letter says

Dozens of physicians working inside the busiest emergency room in British Columbia have released a scathing letter describing an unrelenting “crisis” at the department, claiming the local health authority has “repeatedly” asked them to keep details of the situation from the public.

The medical professionals at Surrey Memorial Hospital said it’s become necessary to speak out in violation of communications protocol because health-care leaders have not been transparent about the dire reality of overcrowding and inadequate staffing in the facility.

More than 35 emergency physicians at the hospital backed the page-long letter that said patients were suffering and, in some cases, dying in hallways as a result of “steadily worsening” problems.

“We have been repeatedly sounding the alarm to our regional and provincial leaders; these alarms have been ignored,” read the letter dated Friday and obtained by CBC News.

“Additionally, these conditions have been poorly and incompletely communicated to the public. We feel that patients and the public deserve honesty. Fraser Health has repeatedly told ER physicians to not openly discuss our ‘challenges’ with the public.”

CBC News is withholding the physicians’ identities as they fear professional repercussions for releasing the letter.

“It’s scary, and we know we’re going to get blowback on this. All we want to do is go to work and look after our patients in a reasonable way — and we feel like there’s an incomplete truth that’s been told,” one physician said in an interview.

“When a patient comes into the emergency department, and they see how busy it is, they see patients in hallways and corridors, there’s a natural feeling that the emergency department is failing — and, truly, the emergency department is failing,” they added .

“But the failure is not because of your frontline emergency physicians, nurses, affiliated staff … It’s actually the system that’s failing your emergency providers, and we don’t have the resources to provide safe and appropriate care for all patients.”

3 key issues, letter says

The letter said three critical issues are contributing to the problem.

First, a lack of acute care beds means patients who have already been admitted are taking up rooms usually reserved for incoming emergencies.

“This bed-block forces us to routinely treat strokes, heart attacks, traumas, miscarriages and palliative patients in the hallway,” the letter read.

Second, the physicians said there are not enough hospitalists to admit patients from the emergency room to other wards, meaning patients linger in the emergency department for days. Doctors said some die while waiting.

Third, the letter said elected leaders have failed to provide any “meaningful solutions” to the problem.

The physician who spoke in an interview said the doctors decided to release the statement Monday after previous letters sent “all the way up the food chain,” including to the BC Ministry of Health did not result in accountability or transparency.

“We feel like we’ve exhausted all other options… Even though our group is feeling threatened and intimidated to release this, we feel that it’s important to get this information out despite our own anxieties,” they said.

“We don’t like using the media to communicate this message. We want to work with our internal partners, but unfortunately, those relationships are failing.”

Asked about the letter on Monday, Health Minister Adrian Dix said the province was “actively” working to get more hospitalists in facilities across the province and said the government had had success dealing with pressure on other sectors of the health-care system in recent months.

“I understand the frustration that health-care professionals feel and the remarkable job they’ve done during COVID-19, and we’re working with them to resolve these questions,” he said during a news conference.

“We’re going to deal with it the same way we dealt with primary care, the same way we made progress dealing with nursing — we’re going to do it by working with hospitalists [and] working with emergency room doctors.”

Fraser Health says it regularly meets with emergency department physicians and hospital leadership.

“There have been challenges with human health resources. There have been some challenges with waiting times, and I think it’s also important to note there has been a significant number of solutions put forward,” said Dr. Victoria Lee, Fraser Health president and CEO.

In an interview with CBC News, Lee said she appreciated doctors advocating for their patients.

“In the emergency department, in our current scenario, of course, we are stretched. There are times that people are waiting longer, but patients are always prioritized depending on their severity,” Lee said.

The physician interviewed said patients are “truly stacked on top of each other” on a day-to-day basis in the emergency room. They said vulnerable patients are affected more than others, including older adults and people who might be experiencing a mental health crisis.