Dr Thor Christensen, one of two family physicians to resign from practice in Montague this month, blames Health PEI’s EMR (Electronic Medical Record System) for creating extreme workload expectations.
Dr Christensen was finishing his residency in PEI and looked forward to opening his practice in Kings County in the spring of 2015. Eight years later in a candid interview he explained his decision to discontinue working with Health PEI.
“This is still my dream job,” he said. “My patients are my friends from high school who have grown up to have children, their parents, my neighbours.
“I grew up in Upton, went to Dundas School and my son will go to Cardigan. My community has always been what has mattered to me and it still is.”
Dr Christensen explained a combination of factors, not uncommon to doctors in rural areas across the country led to nearly unsustainable work-life balance. Health PEI-specific issues added to the challenge.
But he coped to one degree or another for about 7 years since taking over Dr David Hambly’s aging patient load.
It was Health PEI’s adoption of what Dr Christensen describes as a dysfunctional electronic record system that forced his work-life balance brutally over the edge. It pushed him to a point he felt was dangerous to his patients, he said.
Dr Christensen believes electronic medical record is the way to go but the system chosen by the Department of Health and Wellness has created a system that is exceptionally less efficient than a traditional paper filing system. The system has yet to achieve the lauded goal of one efficient interconnected electronic medical record on the Island which would be connected for example between hospitals and family practices.
In Christensen’s experience, it results in more errors, missed information and leaves him feeling like he is drowning in administrative work rather than spending crucial time with patients.
“I’m 39, I know how to use a computer, I learn systems quickly, that is not the issue,” he said.
Writing a prescription on paper used to take Dr Christensen 15 seconds. All issues considered, with the Telus electronic system in place, this task now takes him four to five minutes of dealing with a clumsy system.
Billing, which was written into his contract wasn’t initially his responsibility, now it falls in his hands.
These are just two of many issues Dr Christensen, who is a salaried physician and not fee-for-service, highlights.
Instead of spending time with his family, Dr Christensen found himself spending the little spare time he had between on-call duties at Souris and Montague Hospitals, emergency room shifts and his family practice at home on his laptop for hours completing administrative tasks that suddenly fell on his to-do list.
He said he raised concerns with Health PEI superiors from day-one and was open to giving the system a chance.
“It’s been 18 months and it still can’t assist with bloodwork,” he said, adding the system is intended to make doctors work more efficiently and in some applications to be more accurate. The opposite has resulted. He also suspects the burden will grow as patients’ files are recorded for decades, finding relevant information in the system will be a disastrous challenge.
When he first brought forward his formal letter of resignation Dr Christensen was open to working in a different capacity with Health PEI, somewhere he wouldn’t have to deal with the EMR system.
But Health PEI burnt the last plank of a bridge in negotiation.
He said Health PEI asked him if he could possibly work at a walk-in clinic but that would mean he wouldn’t have a day off.
Health PEI’s Chief of Medical Affairs also texted him to say he didn’t have to use the system, he said. But by that time it was too late and Dr Christensen had lost hope in accessing a workplace that would support health and happiness in Health PEI.
Dr Krista Cassell, president of the Medical Society of PEI isn’t surprised Dr Christensen cited the EMR system as a reason for his departure.
In a letter to politicians during this spring election campaign period, the Medical Society named actions that could prevent a health care system collapse as the result of worn out, frustrated health care workers leaving practice on PEI.
The letter explicitly calls on government to ensure electronic medical records do not add administrative burdens to physicians.
Since January 2022 a total of 27 physicians have left their Island practice. Fifteen of those resigned for various reasons, 12 retired and six have stayed on to work in other Health PEI positions.
Health PEI is working on gathering data from a more extensive exit survey process recently implemented, however was not able to comment about when data will be available to the public.
Dr Christensen treated approximately 1,300 patients.
Douglas family feels loss
Lyman Douglas, a retired Montague High principal and his wife Nora are two of Dr Christensen’s senior patients.
“It will make all our medical needs a little more difficult to access,” Mr Douglas said.
The couple will now have to turn to an online app for health care or wait in the ER at Kings County Memorial Hospital.
The nearest walk-in clinic is in Charlottetown and there is no guarantee of seeing a doctor since appointments fill up fast. There were 29, 546 Islanders waiting on the provincial patient registry for a doctor as of April 17.
Mr Douglas says his family is fortunate: neither he or his wife have major health issues. They mostly see Dr Christensen to renew a few regular prescriptions.
“If the reason we are losing doctors is because of the electronic record system, we have a problem we should be able to fix promptly,” Mr Douglas said.
Dr Christensen said he has no immediate plans but he hopes to stay on PEI.
Minister of Health and Wellness Mark McLane did not provide comment about who was involved in the final decision to choose Telus’s Collaborative Health Record Patient Portal as the Island’s EMR or why by press time.
By Rachel Collier, Local Journalism Initiative Reporter
Original Published on May 10, 2023 at 13:42