Emergency room closures at Cape Breton community hospitals are getting worse, in part because doctors from those hospitals are needed to keep the regional hospital open in Sydney.

The Glace Bay hospital emergency department has been closed for more than five weeks since Jan. 1. It's open this week, but only during the daytime, and on Thursday evening, it will close again for two more weeks.

The New Waterford hospital and the Northside hospital in North Sydney have also been hit with temporary closures due to a lack of physicians, but the Nova Scotia Health Authority admits the Glace Bay ER has been closed more often and for longer periods lately.

Chris Milburn, chief of emergency medicine for the health authority's eastern zone, said a national shortage of ER doctors is affecting most hospitals.

Now, it's starting to affect the regional hospital, which he said cannot close because it's a designated trauma centre.

The ER at the Sydney hospital, the largest one on Cape Breton Island, has been operating at a razor-thin staffing level and has been short an ER doctor a couple of times recently, Milburn said.

"We're barely able to open the Northside or Glace Bay at this point, and as we go forward, if we lose more people, we get to the point where it becomes very hard to fully staff the regional," he said.

Chris Milburn, an emergency doctor and ER chief for the health authority's eastern zone, says the regional hospital in Sydney can't close, but being short-staffed puts extra pressure on remaining doctors. (CBC)

Milburn and other health officials say some ER doctors have retired or moved away, while family physicians with ER privileges have been declining emergency shifts because they are busy with their own practices.

The health authority has been recruiting doctors, but the number of emergency physicians continues to dwindle, said Milburn.

The solution has been to move doctors from community hospitals to cover emergency shifts at the regional hospital. But Milburn said being short-staffed makes it harder on the remaining doctors.

"Would the [regional] emerg close? No," he said.

"That's what I don't want [is] the public to panic. No. We would keep it open. We would keep it going, whatever it takes, but it's going to put a lot of pressure on the people who are left, and it's not a good situation that we'd want to see."

Community ER closures can hurt patients

Dr. Bernice Dias, a retired family doctor who runs a part-time walk-in clinic in Glace Bay, said ER closures at community hospitals can threaten people's health.

Some of her patients won't travel to the regional hospital in Sydney when their community hospital is closed, she said. That's especially true of the elderly, people with young children, or those without a vehicle.

"Many of them don't have access to transportation," Dias said. "Secondly, because many of them don't want to go to Sydney and sit in the emergency for several hours, sometimes going into eight or 10 hours."

Dias said that could lead to worsening health conditions.

"Most days, I send one or two people up to the hospital to get either an inhalation or an injection — something that I cannot do in my clinic, so I send them with a written prescription and they get it there," she said.

If they were in the emergency, they would have stayed there and got the appropriate medication or attention overnight, and they would have been sent home in a more stable condition. - Dr. Bernice Dias

But with the local ER closed, Dias ends up working longer hours.

"There were a couple of people that basically I followed them every day for the next, I think a week or a week and a half. If they were in the emergency, they would have stayed there and got the appropriate medication or attention overnight, and they would have been sent home in a more stable condition."

Milburn said often people misunderstand what the ER is for, with emergency departments becoming relief valves for people without a family doctor.

Opening more walk-in clinics won't solve the problem, he said. The only solution is to recruit more doctors.

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