When her 18-month-old son’s symptoms worsened, caused by an RSV infection that had progressed to pneumonia, Tracee Moneta rushed him to the emergency department in Elk Point, only to learn there was no doctor available on site.
Moneta said this wasn’t the first time an unexpected service disruption at the Elk Point Healthcare Centre had forced her family to make the 50 km trip to Bonnyville to get medical attention, but it was “the most traumatic for us.”
With his breathing laboured, and the boy slipping “in and out of consciousness,” Moneta said she put him in his older sister’s forward facing car seat so she could monitor him and try to keep him awake until they arrived at the hospital.
“I probably drove about 140 [km/h] to Bonnyville because he was passing out in the back seat,” she said. “And when we got there, he was immediately put on oxygen and got x-rayed and everything like that.”
The Elk Point Healthcare Centre was just one of at least 25 ERs in Alberta that temporarily shut its doors in 2024, all caused by physician or staff shortages and almost exclusively in rural Alberta.
Great West Media’s analysis of service disruptions reported by Alberta Health Services found these 25 ERs were closed for more than 34,400 hours in 2024, equivalent to the province losing four ERs entirely.
This analysis doesn’t include hospitals operated by Covenant Health, which doesn’t publicly report service disruptions, or closures caused by natural disasters like the Jasper wildfires.
Service disruptions ranged from gaps in physician coverage in Ponoka lasting only a few hours to staff shortages that have kept Consort’s emergency departments offline since August 2022.
Nine ERs were closed for a month or longer.
Alberta Medical Association President Dr. Shelley Duggan said these statistics are “disappointing, and they show that Albertans are not getting served the best they can.”
“When you don't have rural [ERs] open, you're diverting people to other places. And it just puts more stress on the whole system,” Duggan said.
Duggan also said the data highlights one of the most complicated challenges in rural health care: attracting and retaining physicians.
“One of the biggest things that people forget is that you're not just recruiting a doctor to your community, you're recruiting a family. And it really does take the community to recruit a doctor and their family.”
Both Milk River and Hardisty have been successful in their strategies to attract healthcare professionals and effectively end long-term service disruptions. In fall 2023, the Hardisty Health Centre finally secured needed staff and reopened its emergency department, which was originally shut down in April 2020. Early in 2024, Milk River welcomed a new family physician, who also helped keep the ER available all but 12 days last year.
Great West’s analysis shows that while the locations of hospitals reporting prolonged closures has changed, the total amount of disruptions has not dramatically reduced.
In 2023, physician and staff shortages caused 36,000 lost service hours in Alberta ERs, compared to 34,400 in 2024.
In both years, the five longest service disruptions accounted for over 70 per cent of the total lost ER hours.
Moneta said when her family moved to Elk Point, having a small town with a good hospital was a big part of the appeal.
“If something was wrong, we were only a short drive away. As a parent, that's super reassuring,” she said.
Over the last 10 years, service disruptions have become more frequent. In 2023, the Elk Point ER was closed a combined 21 days. Last year, it was closed for a combined total of 40 days.
Last August, Moneta’s family moved from Elk Point to be closer to Bonnyville. Regaining the sense of security that comes with having a hospital nearby was top of mind when they made the decision to relocate.
“We had to make four emergency trips to Bonnyville for our children,” Moneta said.
“Now we're only a 10-minute drive from Bonnyville. If anything was to go wrong, there's no more scary drive.”
Duggan said there are smaller but substantive changes the province could make to help doctors serve rural areas and keep both family practices and ERs open.
Alberta’s new primary-care compensation model (PCCM) is expected to be in place as of April 1. The model includes pay increases and other positive changes for doctors, but the changes tend to benefit urban family medicine and specialists more than rural, Duggan said.
“Our next priority with that is, how do we put in tweaks, so to speak, for the [doctors] out in rural so that they can get as big a benefit as those in the city.”
Many doctors split their time between their clinic and the hospital, and current compensation models don’t allow for these practices to be integrated.
Duggan gave the example of a rural doctor having a patient who suddenly goes into labour at 11am, forcing the doctor to cancel appointments with the 20 other patients they would have seen that afternoon in the clinic.
While a doctor can see his regular patients in the ER, the billing rate is different than if they provide the same treatment in their own clinic.
“You don't want to be penalized for being in rural, obviously. It's something we wish to incent,” Duggan said.
“But it may actually be convenient that if you're covering the emergency department today in Boyle, that the easiest way for you to see your patients is to come to the hospital. Because you can't be in two places at once, so we've got to figure out, to really drill down to what the nuances of practicing in rural are and figure out how to remunerate those well.”
The Minister of Health’s office said in a statement it is working to address emergency department service disruptions by refocusing the health care system.
“We are also working to address physician shortages and health staffing challenges through various initiatives such as expanding opportunities for nurse practitioners, implementing a new family physician compensation model, and implementing a new compensation agreement for resident physicians,” the minister’s office said.
