Rumour has it the busiest hospital emergency room in northern B.C. is at Lakes District Hospital and Medical Centre in Burns Lake.
Dr. Alan Hill believes that to be the case, and he should know. He worked there for five years, many days as the only doctor in town.
"There is probably a basis to that rumour," said Hill, 64, prior to a move back to his home in Bishop Auckland, England. "In Prince George you've got an eight-hour shift and the emergency doctor just covers emergency. In Burns Lake during the week, you've got a 24-hour shift and during the day you're covering the clinic as well as emergency, and , especially when there are fewer doctors, that is really a killing regime."
Now retired as chief of staff at the hospital, Hill says there are many reasons for the village of 3,500 to be excited about last month's announcement of a new $55 million hospital for Burns Lake. But considering the difficulty of attracting qualified medical staff to the area, he says there's also cause for concern.
The current hospital, 225 kilometres northwest of Prince George, is a catchment facility that serves a population of more than 10,000, spread over a vast area. Many of those people are involved in mining, forestry and farming operation, which makes the hospital a primary treatment centre for victims of workplace injuries and motor vehicle accidents.
"There are so many patients, and a lot of them are quite demanding," Hill said. "A lot of patients attend the emergency room in the evening and often overnight. Although we do get industrial injuries from the mills we have, Highway 16 is more of a factor and we do get a lot of road traffic accidents."
When Hill arrived in 2007, he joined a staff of five, and they divided their services between the hospital and Burns Lake Medical Clinic. After two years of relative stability, the doctor drain started to shrink the village of its medical expertise. One full-time physician (Greg Norman) retired and a part-time doctor left in April 2011. Another full-time doctor left in December 2010 and a husband-and-wife doctor team relocated in July 2009.
That left Hill and Michael Graetz as the only doctors. Graetz works two weeks on and two weeks off, while Hill was working full-time. Hill left Burns Lake for family reasons in September and came back in November, but was unable to handle the workload and returned to England. He returned to the job in March and gave his three-month notice of retirement. He had intended to stay until the end of June but was forced to go out on sick leave. He served his last day at the hospital April 8.
"I recognized last summer that I was burning out quite seriously -- Burns Lake is a young man's job," Hill said. "When I came back I quickly realized you don't get over burnout in a few months."
In that last week on the job, he was on call three days that week and in those three days got a total of four hours sleep. One of those sleeping hours came while riding back in an ambulance after escorting a patient to hospital in Prince George.
South African doctor Mambo Kibonge is coming to Burns Lake to replace Hill in June and the newly-formed Burns Lake Medical Clinic Society has recruited another doctor, scheduled to arrive in August. Since Hill left, there are now two half-time doctors and one available for three-quarters of a regular work week.
"The plan calls for six full-time physicians and we currently have three permanent part-time and regular locum coverage to help the clinic and the emergency department, so we do have short-term solutions to make sure the physician complement is there," said Northern Health Authority spokesman Steve Raper. "It is a challenge in that community to recruit physicians. We had a bit of turnover with retirements but we have some coming in and we expect to get to full complement, particularly as we are building a new facility. That tends to be very attractive to physicians."
Hill figures seven or eight doctors are needed in Burns Lake for the doctors to maintain a reasonable quality of life so they aren't on-call all the time, allowing them to take part in more recreational activities in the community. Burns Lake doctors are often called upon to diagnose a wide variety of ailments, more so than most other places, Hill says. While that pathology-related work would create an ideal training ground for medical students, he said the workload does not allow doctors enough time to teach
Hill was in England on leave from his job the night of the Babine Forest Products sawmill explosion and fire Jan. 20, which killed two men and injured 19 more. Caira Loren was the only Burns Lake doctor on duty that night.
"His training was in the emergency room in one of the busiest hospitals in Los Angeles so he was perfectly placed and trained for that emergency," Hill said.
The fire destroyed the village's largest employer, which cast a large degree of uncertainty about the future of the area. Hill says the remote location of Burns Lake, a 2 1/2 hour drive from Prince George, and its lack of amenities add to the difficulty of medical staff recruitment. To attract more people, he said the village has to continue to make facility improvements, like its new arena/curling rink and mountain bike park.
"The trouble with Burns Lake is it's got a bad reputation. You've got to overcome that, because you're out in the sticks," he said. "But once you get there, the people are very friendly and very helpful. In the five years I've been here I've developed another family, and that's something you don't get in the big cities."
The new hospital, a two-year-project to be completed by 2015, will have an anticipated capacity of 16 patients and will provide services for acute care, emergency, diagnostic imaging, as well as host a medical laboratory and a pharmacy. There will also be a procedure room large enough to be used as an operating room for emergency surgery. Construction is expected to start in the spring of 2013.
"The new hospital is of great benefit to the community and I would like to think it was coming this year even before the fire, but I'm not sure," said Hill. "We've been fighting for it for the last 10 years and it has taken a lot of effort from the people of the Lakes District. They had $2 million saved for the new hospital and ahead of the government even considering it, they put the money into an architectural design."
Hill advises Northern Health administrators planning the new hospital to act on the recommendations of patients, nurses and medical staff who will be working there, and said it's crucial to have whoever runs that hospital be someone who lives in Burns Lake to better enable them to respond quickly to local needs.
Hill also says it's time to scrap the lousy hospital food. Give patients proper nutrition and he says chances are they will spend less time recovering in hospital and will leave healthier.
"One of the national complaints about hospitals is the quality of the food. It sounds so minor but it is so important to the patient experience," said Hill. "Everything is freeze-dried and shipped from Vancouver and everybody argues that if it's centralized you save money by outsourcing it. But there was a study by the [Burns Lake] hospital a couple years ago and they found you could produce better meals cheaper using local produce, and it encourages the local industry as well. Moose or elk is better for you than beef."
