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Petition may drive final nail in coffin for ob/gyn


Editor's note: This letter was originally written in response to a news story in the May 20 edition of the Beacon (Gander) entitled Moms upset with obstetrics closures (see page 8A of today's Advertiser). Dear Editor: I wish to comment on the situation regarding obstetrical coverage in central Newfoundland this summer. Given my position as the chief of obstetrics gynecology at the Central Newfoundland Regional Health Centre and also as a native of Gambo, I feel my opinion may have some value.

Letters to the Editor - Editor's note: This letter was originally written in response to a news story in the May 20 edition of the Beacon (Gander) entitled Moms upset with obstetrics closures (see page 8A of today'sAdvertiser).

Dear Editor:

I wish to comment on the situation regarding obstetrical coverage in central Newfoundland this summer. Given my position as the chief of obstetrics gynecology at the Central Newfoundland Regional Health Centre and also as a native of Gambo, I feel my opinion may have some value.

Obviously I care about the outcome of all patients in central Newfoundland. When people ask why I work here (where conditions are less favourable and income is far lower than the rest of Canada), I usually say, "If I don't look after my friends and family, then who will?" I consider everyone in this region to be friend or family and I will accept nothing but the best health care for my people.

In July 2005, as a new graduate with full certification of the Royal College of the Physicians Surgeons of Canada, I could have gone anywhere in the world to practice my chosen specialty. This is a fact. Canadian training is recognized the world over as superior to most jurisdictions. I chose to come back to my home and ultimately settled in Grand Falls-Windsor.

My initial contract was for two years at a rate of on call of one-in-three. This was in return for a modest signing bonus. Before I arrived, there was a crisis in ob/gyn in central Newfoundland as many may remember. When I started work on July 19, I was one of two (not three, as agreed). I placed no pressure on the health authority at that time and I pulled more than my fair share of the load at a one-in-two pace, but made officials aware that a third specialist was required if we were to build a sustainable service.

My practice started to grow and over the past year I have seen my waitlist as long as two years for some benign issues (urgent care was provided continuously and without pause).

My reputation grew and as a gynecologist with an interest in minimally invasive surgery, I have seen referrals from all over central Newfoundland, including Glovertown/Eastport, Twillingate, Fogo and Wesleyville. I have seen women from Clarenville, the Northern Peninsula, Stephenville and even Labrador. I have taken calls from colleagues on the Burin Peninsula.

One might say a waitlist might represent an individual that works at a slow pace. I am currently one of the few private physicians in the province who pays (out of my own pocket) a full-time registered nurse and a part-time LPN to work in my private (outside of the hospital) office. As a result of this staff and some efficiencies we have created with our team approach to patient care, the actual volume of patients we see per week is staggering.

Over the past year I had been working toward recruitment of one of the graduating group of ob/gyns at Memorial. We have four new specialists in the class of 2008, expected to finish at the end of June. My view, and others feel the same way, is that to build a sustainable service in rural and remote areas we have to recruit Newfoundlanders - people who are born here, live here and are trained here.

I have all respect for my internationally trained colleagues. My current partner who will soon be leaving for greener pastures is from overseas. He is kind, knowledgeable, a proficient surgeon and always is a gentleman. At this time he has decided to move on and I must accept this.

As for my potential recruits, they have accepted positions in a bigger city where conditions are better, pay scales are better and the lifestyle and on-call requirement (less than one in 10) cannot be matched by us in these rural areas.

When I describe having to be on call, I am not sure that most understand this commitment. When I am on call, I have to be near a phone or carry a beeper and have to be able to get to the hospital within minutes. It is difficult to have a social drink with friends. Family commitments always come second to this work.

As a physician, I understand what this means and I did realize this when I chose this field many years ago (prior to my 12 years of training after high school). Having to provide this service for half of the time, however, is difficult. One-hundred-and-eighty-three days of every year I have to be immediately available to the hospital, night and day.

Now that my work partner is leaving next week, I will be expected to provide this service alone for 365 days per year, or at least that is what I understand to be the context of this petition that has been started in Gander. Locum ob/gyns will not fix this problem. There are very few locum physicians available, as we all have regular practices. If someone does come for a weekend, they cannot follow up on patients they admit to the hospital - that is left to me, the regular guy. Locums only cover on-call emergencies and do nothing to shorten my ever expanding wait list for outpatient appointments and surgery. A

After two years of one-in-two on call, I am tired. I cannot imagine how I (or the remaining solo ob/gyn in Gander after July 31) will be expected to function in this manner. It is impossible in the current context to recruit new grads from the mainland to come to rural Newfoundland. I have tried. As I mentioned above, I feel defeated in my failed efforts to recruit one of this year's Memorial University grads to come to central Newfoundland.

The one thing that has kept me going these past three years is that I am providing a good service to my family and friends. I enjoy my work and actually do look forward to it every day, but like anyone, if I do a couple of weeks straight (when my colleague is away - remember, there really are no locums) I get very irritable and it definitely showed last year when I covered all of April and May while my partner had a prolonged leave.

My fear is this petition may drive the final nail in my coffin. If the work conditions are poor, the money is not great and my family is unhappy that I am never around, then all I have left is the satisfaction of helping the patients.

If they turn on me, what do I have left?

Dr. Steven Parsons

Chief of ob/gyn

Central Newfoundland Regional Health Centre

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