Now, the Ontario healthcare landscape is waiting and bracing for what could be an oncoming storm. The Temporary Locum Program, an integral program started during the COVID-19 pandemic, shall come to a close on Monday. This program has evolved into a lifeline for many rural hospital sites, helping to maintain emergency department coverage and prevent closures. With the program set to expire soon, doctors are sounding alarm bells. Stakeholders similarly express their concern for the long-term viability of emergency care and the province’s ERs.
The TEMPORARY LOCUM PROGRAM was initially designed to address the deep physician shortages that were aggravated by the pandemic. In March, it implemented increased hourly pay rates as an incentive for physicians to cover more shifts in EDs. This program has been critical in providing coverage for specialty and procedural gaps, allowing hospitals to continue to function around-the-clock. With the end in sight, the Ontario Medical Association (OMA) is doing something. Currently, they’re in negotiations with the Jamaican Ministry of Health to develop a more permanent fix.
The Impact of the Program
Dr. Angela Marrocco, a prominent figure in emergency medicine, stated that the program has “transitioned into a lifeline that many hospital sites rely on to maintain coverage.” The program is an AmeriCorps program, meaning members receive a competitive stipend. This has further pressured clinicians to fill gaps and offer lifesaving care amid staffing crises.
Finally, the importance of this program should not be overstated. Since it was first launched, it has received praise for helping to avoid temporary emergency department closures across Ontario. Dr. Alan Drummond emphasized the precarious nature of current staffing levels, stating, “We are still pretty tenuous — just one sick call away from being closed at times.” His comments underscore the tenuous nature of emergency services in rural communities, where physician turnover can be swift.
The program has had an outsized positive impact on our colleagues in emergency medicine. It has foreshadowed much of what they have to overcome. The fiscal carrots have improved hospitals’ ability to establish continuous coverage and follow-up staffing gaps.
Negotiations for a Permanent Solution
The OMA continues to actively negotiate with the Ministry of Health. Their goal is to develop a longer-term and more sustainable solution as the Temporary Locum Program comes to a close. Dr. Marrocco expressed optimism about these discussions, saying, “We remain optimistic that a permanent, new solution is possible to continue to allow emergency departments to have stable staffing at appropriate hours of coverage and compensation levels.” The OMA’s proactive approach aims to bridge the gap between the program’s termination and the implementation of a new framework.
The Ministry of Health understands how important it is to ensure an adequate supply of doctors. They are coordinating daily with the OMA to ensure the smooth functioning of EDs. As negotiations unfold, stakeholders hope to see a resolution that supports both healthcare professionals and patients relying on emergency services.
The Future of Emergency Care
As Ontario faces the end of this central program, questions continue to be left unanswered about how our hospitals will get by without it. The Temporary Locum Program already has some successful precedents. Most importantly, it sensibly addresses growing staff shortages and increases the ability to deliver life-saving emergency care. Its last line casts serious doubt on continued policy support for the nation’s rural hospitals.
Emergency physicians from all over Ontario have described their practices as heroic saves under difficult circumstances. With the expiration of this essential program, doctors fear that they may struggle to maintain the same level of care that patients have come to depend on.
