A group of physicians are expressing their concern over a plan to change service levels at Muskoka’s two hospitals.
On Monday January 27, Muskoka Algonquin Healthcare (MAHC) is expected to reveal changes to the service levels at the South Muskoka Memorial Hospital in Bracebridge and the Huntsville District Memorial Hospital site. In December, Cheryl Harrison, the president and CEO of MAHC, confirmed that several confidential meetings had taken place to discuss service changes at the hospitals. Harrison declined to discuss the specifics of those changes at that time but a comprehensive breakdown is expected ahead of a series of open house meetings being hosted by MAHC beginning January 29 at 7:00 p.m. at the Dwight Community Centre.
More than 40 Muskoka physicians and healthcare professionals released an open letter on January 26 outlining their concerns with the impending changes.
Here is that letter in its entirety:
“January 26, 2024
As physicians and surgeons who practice in South Muskoka, we have significant concerns with the proposed hospital redevelopment model and its implications for healthcare delivery in our community. South Muskoka Memorial Hospital often operates at over 100% occupancy of inpatients, with our volumes being especially heavy over the past several months.
This means that many sick patients have had to wait in the Emergency Department for multiple days before a room on the inpatient unit is available. As our population ages over the coming years, it is only natural to expect that the demand for hospital services in our community will grow with time.
We had expected that our hospital redevelopment plan would respond by expanding our ability to provide care to those who need medical attention.
Instead, the new model proposed for Muskoka Algonquin Healthcare has reduced inpatient capacity at South Muskoka by almost 70%. Rather than expanding, our hospital is contracting.
This plan transitions the vast majority of inpatient and obstetrical care to the Huntsville site, leaving South Muskoka unable to provide adequate care for our population. This is especially perplexing given both the greater population and population growth1 in South Muskoka over Huntsville.
Furthermore, when we analysed admission data at Muskoka Algonquin Healthcare since 2017, we found that there is a 12% higher admission volume at South Muskoka over Huntsville. It is not rational, evidenced based, nor in the interest of patient care to allocate most of the inpatient services to Huntsville. Both sites deserve a hospital that can serve the needs of their community.
With this significant reduction of inpatient services, sick patients will need to be frequently transferred out of South Muskoka as there will be minimal capacity to care for patients locally. This will lead to poor patient outcomes and significantly worsens the quality of medical care for the citizens of South Muskoka.
There are numerous scientific articles that describe in detail the negative patient outcomes associated with hospital transfer including increased mortality2 3, longer hospital length of stay4, and delays in surgical intervention5 6.
If this redevelopment model proceeds, South Muskoka will not only be losing inpatient services, but we will be losing local physicians as well. Our obstetrical services are being closed, meaning that our family doctors who focus on obstetrics and women’s health will leave. Pregnant mothers will then need to travel for their routine prenatal care and appropriate help will be far away should they experience any urgent complication of pregnancy.
Additionally, this model makes it nearly impossible to recruit or retain specialists. Specialists such as cardiologists, internists, surgeons, or gastroenterologists will choose to leave for communities where they can work their typical practice in both inpatient and outpatient settings.
This has further implications for family doctors, who come to this community expecting to have the support of a fully functioning local hospital and its associated specialist care. In this new model, family doctors will leave and recruiting new doctors to the area will be harder than ever.
This will only worsen the current crisis of primary care availability as both family doctors and specialists will choose to work in communities that have a fully functioning acute care hospital with appropriate inpatient services.
1 Simcoe Muskoka District Health Unit, Population Data found at: https://www.simcoemuskokahealth.org/Health- Stats/HealthStatsHome/PopulationDemographics/Population
2 Schnipper et all. Interhospital Transfer: Transfer Processes and Patient Outcomes. Journal of Hospital Medicine, 2019.
3 Torner et al. Inter-hospital transfer is associated with increased mortality and costs in severe sepsis and septic shock: an instrumental variables approach. Journal of Critical Care, 2016.
4 Wen et al. Impact of interhospital transfer on emergency department timeliness of care and in-hospital outcomes of adult non-trauma patients. Heliyon, 2023.
5 Edye et al. Interhospital transfer delays emergency abdominal surgery and prolongs stay. Royal Australian College of Surgeons, 2016.
6 Reinke et al. Interhospital transfer for emergency general surgery: an independent predictor of mortality. The American Journal of Surgery, 2018.
This model drastically worsens access to healthcare for our population. This plan will significantly change the landscape of healthcare in South Muskoka for decades as it negatively affects the capability of our hospital and creates an undesirable environment for both specialists and family doctors.
We want to be clear that this model is not acceptable for South Muskoka. Any hospital redevelopment model that significantly reduces inpatient services should not be supported by our community.
Endorsed by:
Scott Whynot, MD, M.Sc (PT), CCFP
Luke Wu, MD, M.Sc., FRCPC (IM)
William Hemens, MD, M.Sc., CCFP
Timea Maxim, MD, CCFP, AAFP Christopher LaJeunesse, MD, DABFM, CCFP Courtney Potts, MD, CCFP
Bharti Mittal, MBBS, CCFP
Steve Rix, MB.BS, MRCS(Ed), PgDip-SEM, CCFP Adam MacLennan, MD, CCFP
Kimberley Forester, MD, CCFP
Lisa Tsugios, MD, CCFP
Cole Krensky, MD, CCFP
Jennifer Hammell, MD, CCFP
Jonathan Rhee, MD, FRCSC
Jessica Nairn, MD, CCFP
Kristen Jones, MD, CCFP
Chris Richardson, MD, CCFP (FPA)
Jessica Reid, MD, M.Sc., FRCSC
Vicki Dechert, MD, COE
Graeme Gair, MD, Past COS SMMH
Ken Hotson, MD, FCFP, BSc(Med), BA, BSc Kersti Kents, MD, CCFP (EM), PgDip (Derm) Michael Mason, MD, CCFP (EM)
Sandi Adamson, MD, MBA, CFPC
Joseph T. Gleeson, MD, CCFP, FCFP
Martin O’Shaughnessy, MD
Shannon Lees, MD, B.Sc, M.Sc., CCFP
Karen Martin, MD
Anton Deketele, MD, B.Sc., FRCPC
David Kent, MD, CCFP
Tina Kappos, MD, B.Sc(Hons), CCFP
Paulette Burns, MD, B.Sc(Hons)
Richard Daniel, MD, B.Sc, MB, CCFP
William Caughey, MD, FRCP(C)
Kent Phillips, MD, FCFP
Faizal Bawa, MD, CCFP
Ardyn Todd, MD, CCFP
Dave Hillyard, MD, CCFP
Keith Moran, MD, RCPSC, DABIM, RCS
Rohit Gupta, MD, DNB, FRCSC
Peter Maier, MD, CCFP, FCFP, AAFP”
Don’t miss out on Doppler!
Sign up here to receive our email digest with links to our most recent stories.
Local news in your inbox so you don’t miss anything!
Click here to support local news
Why are doctors ignored?
Who better to know the drastic drop in health care in Muskoka of MAHC reneging on the previous plan we were promised?
So almost a billion dollars has been committed from the province.
Surely that will pay for 2 smaller, full service hospitals of the same capacity.
Instead of 1 large one.
At least $500 million should go to Bracebridge that serves the larger and growing part of Muskoka. Refurbishing and maintaining the existing hospital.
Or adding a new wing.
Or building up.
Why are those not an option?
Or is MAHC’s plan another ridiculously expensive debacle like the arena in Bracebridge?
“the project was costing $40 million!! more than initially anticipated.”
$58 million vs $18 million.
Over 3X expected cost for local taxpayers.
For some ugly boxes.
For $10 million LESS cost for local taxpayers King township is getting over DOUBLE the facility.
King township is completing a state-of-the-art, carbon neutral, fully accessible recreation complex with TWO!! NHL-sized ice surfaces, a six-lane 25-metre lap pool, a leisure pool, a multi-purpose athletic fieldhouse, and a multi-purpose community room.
Total $86 million minus $38.7 funded from the feds and the province.
king ca/townshipwiderecreationcentre
Some areas know how to get funding and value for money.
MAHC has demonstrated they can’t be trusted.
Their costs need to be independently verified and other options costed.
How long has this been going on? Do we have a new super Hospital yet? Where’s the MRI?
Perhaps we should all go to Barrie or North Bay, whichever’s 90 min or less.
Does this plan, more than a decade later, change the fact that 2 old tires do not make a new one.
Perhaps starting at the beginning, Canada’s ‘health services’ are in a shambles, partially due to predictive models, skewed/foreign stats, journal articles fabricating for political gain over the last 4 years. That’s just one flavour; federal politics. What about local politics? Will this be continued, will we look forward to the next episode from; let’s do a study, let’s consult, let’s change the name, let’s debate the design and location….
Meanwhile, do we, or will we have the resources/measurement tools to ‘reduce the meantime between failures’?
Donations should/will determine 1 or 2 full service hospitals in Muskoka.
A few years ago MAHC published the cost for both options.
The extra cost of 2 was not really that much.
If the southern 2/3 of Muskoka was asked to donate the difference it would likely be accomplished in no time in order to maintain a local hospital here.
But we weren’t given the chance.
On the flip side 2/3 of the expected donations for the single full service hospital model will disappear.
Donations have already plunged.
I am terribly disappointed with this news. We live in Gravenhurst and our family doctor is in Bracebridge. We have received fantastic care at the hospital and we were excited at the prospect of a new hospital with more inpatient beds and a continuation of quality care. Obviously the administration is not.
SHAME ON YOU CHERYL HARRISON!!
I am beyond shocked to even read this. The people that are behind this proposal, definitely do not have the people who live here’s best interest. In the summer time our population is even higher. This is so unfair to families who can’t even get a family Dr. now and who are on waiting lists, or cottagers or people just visiting, and to our Dr’s we have now. I I pray this proposal gets turned down……
I hope this letter gets new coverage throughout Ontario.
As Seniors, one of the BIG reasons we chose to move closer to the town of Bracebridge, was to know that we would have a hospital with an emergency department and helicopter access within easy distance of our home. From what I am reading about the new hospital model I see a proposal to reduce the services that attracted us to this area. My husband and I are part of a growing community of Seniors and quite frankly this proposal seems to be taking a massive step backward instead of dealing with the ever growing demands of health care in Muskoka, not just for seniors, but for an increasing population all across the board. My impression from reading the letter endorsed by 3 dozen of our Muskoka physicians is that this model will throw us into a major healthcare crisis. Time to rethink the plan.
Why are admin staff working the new plans? They need Doctors input. We, both hospitals are seeing.less and less beds being available. Huntsvilles one wing is mostly offices but even if it was hospital beds they dont have the staff to operate more beds. We cant do with less beds at either hospital. I know the care in huntsville emerge is 8 to 10 hour wait. I know a lot of huntsviile go to bracebridge emerge for quicker care. The health care has declined drastically. Too much overhead staff and underpaid Dr’s and nurses and environmental services. I can only see care going down. You want yo be healthy and take care not to have an accudent or heart attack because the care is just not as good as it used to be.
This “solution” can not go forward if the doctors’ delivering the care can’t support it. I’m glad they came forward to educate us on this matter. Otherwise, how would we know with all the flashy, mock-positive “Made in Muskoka” rhetoric! This sounds like a bureaucratic decision hatched up in a board room rather than a decision made by the working care providers.
If this model is adopted it will cause further unraveling of our Health Care.
The thought of less care going forward is just ridiculous.
I have lived in South Muskoka for 30 years and have felt very secure as a 82 year old in our Health care.
This would certainly make me think of moving out of the area.
It seems the MHAC has neglected to have serious discussions with the Doctors serving the two communities. I hope this wasn’t the case but, if so, its not too late to expand discussions to properly include them.
A Slippery Slope to Ford’s PRIVATE HEALTHCARE BANKRUPTCY! if Government does not provide Public beds (hospital and nursing homes locally) for the increasing population. Prevention = Early care needs more Available Dr’s, nurse-practitioners, to slow down need for the Pines, and Fairvern. Nursing resignations over shortage conditions, burnout stress is also part of Budget Cuts to move care away from public owned facilities! Not Acceptable!
That is a wonderful long list of medical professionals who support this view.
I hope politicians listen…
Thank you to the doctors for speaking up about the impossible plan for the hospitals.
We all supported a two hospital solution for Muskoka and now they decide to spring this further slow drip of information on us with no transparency. Totally irresponsible and unacceptable.