A group of physicians in Swan River is calling on the province to address changes they say are having "profound and dangerous effects" on the community's air ambulance service.

"We are writing out of concern for our patients," the doctors wrote in a letter to Health Minister Cameron Friesen this week.

"While the government and Lifeflight sort out their funding and resource issues, rural communities like ours are suffering the consequences of not having a vital provincial program fully operational," the letter said.

In the last two months, there have been increasing gaps in availability for Lifeflight planes in Swan River caused by staffing shortages, says Rafiq Andani, a part-time physician in the rural community about 380 kilometres northwest of Winnipeg. The travel distance by road to the community is roughly 490 kilometres, according to Google Maps.

"When we're talking about Lifeflight, we're talking about critically ill patients," said Andani.

"Delays in transport can have a profound impact on patients' outcomes and the overall quality of the care they're receiving."

Lifeflight's staffing issues began last July, when the province issued a request for proposals to explore privatizing its air ambulance and general transport services.

In October, 16 Lifeflight physicians signed a letter to Friesen, threatening to quit their jobs over concerns about how privatization could compromise patient safety.

Vacant positions 'difficult to fill': health minister

In an email to CBC News, Friesen said while the process of looking into privatization is underway, the province has hired pilots, paid for maintenance of two Lifeflight jets and worked to fill two empty nursing positions.

"Those positions are proving more difficult to fill than originally anticipated," said Friesen.

Andani said there have been times where critically ill patients are transported by ambulance from Swan River to other communities that are more accessible for STARS air ambulances. (CBC)

In the meantime, there is a contingency plan in place that sees other healthcare professionals — including a STARS physician, nurse and paramedic, and a Shared Health advanced practice respiratory therapist — cover the shifts not staffed by a Lifeflight nurse, he said.

"Manitobans, including those living in Swan River, can be assured that the Lifeflight Air Ambulance service can continue to be relied upon to provide consistent care of a high quality," Friesen said.

He says the triage process for Lifeflight takes into account a patient's condition and the availability of resources which may also be tasked with other critical care transports.

"The Lifeflight team continues to work with local providers to assess patient needs on a case-by-case basis and respond appropriately. This can include Lifeflight completing a trip to Swan River, as it did on Monday, but it can also include a STARS intercept or ground transport."

Friesen says the request for proposals process is continuing, and that the province is only interested in opportunities that will improve service quality and reduce wait times.

'It's scary for us'

Andani says there have been times this month where doctors have needed to transport critically ill patients by ambulance from Swan River to other communities that are more accessible for STARS air ambulances. From there, patients are often transferred to Winnipeg by helicopter, he says .

Andani says these patients would usually be transferred directly by Lifeflight if it were available and staffed appropriately.

"We've relied heavily on the Lifeflight program, and it's been such a strong and good resource … so to all of a sudden have it not operational at its full capacity is scary for us," he said.

Andani says timely transport is an important part of care when a patient's needs are beyond what Swan River's doctors can provide.

"Having to sit on critically ill patients for prolonged periods of time in our environment with the resources we have is less than ideal," he said.

Geographic 'grey area' for air ambulance service

Andani says Swan River's geographic location puts the community in a precarious position to access air ambulance services.

It's too far south to have the same services as some more northern Manitoba communities, he says, but it's too far north to reliably access STARS air ambulances without delays caused by jets needing to refuel or doctors needing to transfer patients to more southern air fields.

"Occasionally, what we've had to do is transport patients from Swan River to Dauphin," Andani says, about a two-hour drive.

"Thankfully, there haven't been any negative outcomes from this, but I'm sure that if there were to be a negative outcome, this would become an even bigger issue," Andani said.

"We're trying to address it, or at least bring it up sooner, before things potentially get out of hand."