Emergency physicians at 19 B.C. hospitals say they need more help to deal with a 25 per cent increase in ER traffic in some areas. The physicians are on salary through an agreement between the medical association and the government. The two sides have tried without success the last two years to agree on a formula to determine how many emergency physicians are needed in a given ER. Talks were abandoned last December and even negotiations between the medical association and individual health regions have failed. (Victoria Times Colonist, May 7; Globe and Mail, May 13)

The federal government is providing funding to expand the Northern and Remote Family Medicine Residency Program at the University of Manitoba. It will provide $6.9 million to train an additional 15 family medicine residents over the next four years to practice in rural and isolated regions of Manitoba, Nunavut and the Northwest Territories. News release at www.hc-sc.gc.ca/ahc-asc/media/nr-cp/_2010/2010_72-eng.php.

Ontario is calling for applications for 14 new Nurse Practitioner-led Clinics. The new clinics will be awarded in the summer of 2010, and are part of the government’s commitment to have 25 NP-led clinics in operation by 2012. There are currently 11 in various stages of implementation with the first due to open some time this month. News release at www.health.gov.on.ca/en/news/release/2010/may/nr_20100510.aspx.

The Ontario Hospital Association has been accused of trying to “muzzle’ physicians in new prototype bylaws it has drafted for use or adaptation by individual hospitals.

The bylaws say hospital professionals cannot engage in any conduct that would adversely affect the hospital’s “reputation or standing in the community” and any concerns they have must be conveyed through proper channels.

The president of the Ontario Medical Association told the Globe and Mail this week that the new rules will minimize physician influence at a time when hospitals are under severe budgetary pressure and need physician input.

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The Health Council of Canada has published a report of the McMaster Health Forum on primary care reform held last January. Recommendations from the session include: re-affirming primary health care as the foundation of Canada’s health system; ensuring appropriate management structures are in place between health ministries and primary health care providers; linking funding agreements with physicians and others to public policy goals for primary health care; and, finally, paying attention to change management so that physicians and primary health care teams are supported in their efforts to strengthen primary health care across Canada. The report can be found at www.healthcouncilcanada.ca.

Ontario’s health minister is open to some of the ideas in last week’s report from TD Economics calling for “urgent” reforms to health care. The report said rising health care costs are unsustainable.

In an interview with reporters last Thursday, Health and Long-Term Minister Deb Matthews said the report’s recommendation of limiting drug plan coverage for wealthier seniors was “something we can look at.” She was similarly interested in another recommendation to shift more physicians from fee-for-service to salary-based compensation.

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Crowded emergency departments at Montreal hospitals are endangering the health of the population, the head of the Association of Quebec Emergency Physicians says. “We are in constant overflow,” Dr. Bernard Mathieu told La Presse. ED volumes are at levels that have not been seen for some time. Also this week, nurses on the evening and night shifts at the intensive care unit at the Maisonneuve-Rosemont Hospital in Montreal refused overtime which would have seen them put in an 18-hour shift. Obligatory overtime is an ongoing issue in hospitals. (La Presse, Feb. 24,25)