By Breanne Massey
The shock of roughly 50 per cent of baby boomers retiring from Interior Health lab services over the next five years could change the way clinics offer service to their patients, according to Dr. Michael Moss, who serves as Interior Healths medical director for laboratory services in Kelowna.
On Tuesday, October 6th, Dr. Moss and Interior Healths project team met with three dignitaries, nine doctors and five lab staff from the Columbia Valley at the Invermere and District Hospital and the Invermere Health Centre to discuss options for a different business model, while collecting information about the best solution for the community during the consultation process.
While there have not been any decisions made that are set in stone, there have been discussions about the challenges of offering complex testing by lab services in light of problems related to staffing retention and recruitment, budget and tools, as well as service equity.
This is driven by the realization that our baby boomers are retiring and this means that were facing a huge, unprecedented loss of staff through retirement, said Dr. Moss. Its not about us cost-cutting or choosing to downsize. Its simply that the number of people who are becoming eligible for retirement is going to outstrip our ability to replace them so were continuing to recruit and we will continue to recruit. But the reality is were going to have difficulty replacing every position thats going to become vacant and thats going to be more of an issue in our smaller sites in many locations.
However, there will not be a cookie-cutter solution for every community, according to Marty Woods, Interior Health lab services regional manager.
In many locations, were depending on a number of staff some who are already of age (to retire), but who have chosen to continue to work for now, explained Dr. Moss.
Its going to become more and more difficult for us to staff certain shifts. Weve already had instances in New Denver and Barriere where weve lost all of our staff, so weve had to choose to use a different model.
But establishing the best approach is expected to be a long and involved process.
This is very early in the process, so were engaging and this (Columbia Valley) is only our second site for consultation (out of 35 locations in the East Kootenay region), said Dr. Moss. What were doing now is developing a better understanding of the clinical activity at every site so that we can be sure that we have a good understanding of what lab services are needed to support them, and only after that do we know what options we could propose.
When asked what a different business model could look like, Dr. Moss replied, Theres a form of testing called Point of Care, which may have a role in some places. In some places a small role and in other places, a larger role. The benefit of Point of Care testing is that people other than lab technologists can actually do
Point of Care Technology is a portable, hand-held device that can provide the result right beside the patient. However, the vision thats being proposed could mean that a patients test results will be sent to Kelowna General Hospital for analysis in the future.
Interior Health is well aware of our concerns about the possible diminishment of laboratory services at the Invermere hospital, said Regional District of East Kootenay (RDEK) Area G director Gerry Wilkie. We expect further consultation as their plans evolve.
A sentiment that District of Invermere mayor Gerry Taft agrees with.
The meeting was useful in that Interior Health Authority seems to be doing meaningful consultation, said Mr. Taft. There are concerns from our end about the level of service, potential long-term loss of skilled positions locally and the general trend towards centralization of health care services.
RDEK Area F director Wendy Booth was surprised to learn about the nature of lab services that are currently in place in the Columbia Valley.
I did learn that currently some of the testing is already completed elsewhere, which is common amongst labs, she explained.
Dr. Moss believes offering Point of Care Technology could have a role for health care providers in Canada in the future, as there is a nation-wide shortage of lab technologists.
This is an opportunity for us to take stock of what were doing today, other services that the physicians need today that were not providing that we need to take into account in considering a sustainable service in the future and (lastly) in any new model, we need to be sure that we will allow the clinical services being delivered here to be sustained, concluded Dr. Moss, adding there is no prediction at this time that patients will be required to commute for lab services.
Tests that arent urgent may be moved to another site, the specimen itself may be sent somewhere for results, but thats already happening today.
He added the Kelowna General Hospital also sends samples out for specialty testing.
Thats not new, but people might not realize it yet, said Dr. Moss. Our goal is to preserve the necessary services here in a way thats sustainable.
The Interior Health project team will be travelling to 35 sites in the East Kootenay region over the next 10 weeks to offer consultations to physicians, lab and administrative staff. Afterwards, the information will be reviewed to evaluate what changes might be possible to sustain the services.
Dr. Moss added that the American Society of Clinical Pathology estimates there will be 75,000 vacant positions in lab technology over the next five years.
Thats a huge number and at Interior Health, we know that many of our staff will be eligible to retire in the future, said Dr. Moss. Ive been a physician for 40 years and I have not encountered anything like this before
I think that it would be irresponsible of us not to do something and look at the possibilities because, otherwise, we run the risk, if our lab closes for a shift, imagine what the impact will be so we absolutely have to find a way to ensure that we can continue to provide the service and support the techs that we have, while continuing to recruit more.
The Interior Health project team expects the consultation process to last for roughly several months before returning to the Columbia Valley to discuss possible options to change the way lab services are offered to patients.