New surgeon agreement leaves rural obstetrics behind

Allyson Beauregard

A 21-day service interruption in the Pontiac Community Hospital’s (PCH) obstetrics (OBS) department that was supposed to end January 3 was extended until January 6 due to the lack of an on-call surgeon, despite the province recently signing an agreement with the Québec Federation of Specialist Doctors (QFSD) that was supposed to remedy the problem. 

“This new service interruption is caused by the lack of a surgeon who can perform caesarean sections in an emergency,” said the Centre intégré de Santé et de Services sociaux de l’Outaouais (CISSSO) in a public notice, noting general surgery was unaffected at the PCH. The OBS interruption over the holidays was due to a shortage of nurses.

On November 28, Danielle McCann, Health Minister, announced the government signed a long-awaited agreement with the QFSD to help ensure the continuity of OBS and surgical services in rural areas by creating a “SWAT team” of physicians who will travel to different regions to cover shifts. 

The agreement has helped the PCH avoid general surgery interruptions, but the OBS unit wasn’t as lucky, given the reality of rural hospitals. “An interruption in general surgery was diverted from December 30 to January 6 thanks to the assistance of a surgeon from another region. However, this surgeon cannot perform caesareans, which caused the OBS service breakdown to continue, although nursing staff was available to resume service as planned,” said CISSSO. 

Rural hospitals offering OBS require more than just an average general surgeon. In the city, caesareans are tasked to obstetricians, as general surgeons usually don’t have the required training. Given that caesareans make up the majority of the PCH’s emergency surgeries and that the region’s small population doesn’t warrant having both a general surgeon and an obstetrician on staff, their surgeons must be able to do both.  

However, it’s unclear if anything will be done to bridge the gap. “General surgeons choose whether or not to take the training to perform caesareans. This is an individual choice that CISSSO doesn’t control,” concluded Marie-Pier Després, CISSSO communications agent.