Personal care treatments

Cancer treatments in Alberta could suffer from exodus of key staff, doctors warn

A group of two dozen Calgary doctors are warning that the safety of cancer care and the ability to continue to provide some treatments could be jeopardized by the resignation of a number of highly qualified medical physicists from the radiation therapy program of the Tom Baker Cancer Center.

Doctors call the exodus of staff a “devastating loss”.

Although the radiation oncologists have written a letter outlining their concerns, Alberta Health Services says patient care is not affected and it is working to address the staffing shortage.

The letter, signed by 24 doctors, says several medical physicists, including the program director, resigned in a short time, mainly due to pay and workload issues.

Medical physicists play a key role in cancer treatment by ensuring the safety of complex radiation therapy devices, creating treatment plans and developing new techniques.

Their expertise is also needed to commission the state-of-the-art machinery at the $1.4 billion Calgary Cancer Centre, slated to open in 2023.

“We are concerned that we will not be able to provide our current level of care, or any treatment at all. The safety of our daily cancer treatments is put at risk by an understaffed, overburdened and inexperienced medical physics department,” said the indicated letter.

Radiation oncologists said they were particularly concerned about the ability to provide total body irradiation (used before stem cell transplants to treat leukemia and lymphoma) and brachytherapy (internal radiation therapy treatments for gyneological cancers, breast and prostate) and that this exodus jeopardizes the vision for a “world class” program once the new Calgary Cancer Center opens its doors.

They noted that Calgary is the only site in Alberta to offer some of these treatments, including total body irradiation, and receives referrals from Saskatchewan and British Columbia.

Doctors said these concerns had already been raised and they wondered if the program would be ready to move into the long-awaited new cancer center next year.

The new Calgary Cancer Center is expected to open in 2023. (Rebecca Kelly/CBC)

A quarter of the staff has disappeared

AHS urged the doctors involved not to speak to reporters – and to redirect any inquiries to the media relations department – ​​after the letter leaked on social networks. Consequently, none of them agreed to be interviewed.

In an emailed statement to CBC News, AHS acknowledged it was having staffing and recruiting issues and said three medical physicists had resigned since last fall.

According to the health authority, four of the 22 positions are vacant, including that of director. He wouldn’t say whether temporary positions are included in his full contingent.

Additionally, sources connected to the program tell CBC News that two other full-time medical physicists have accepted positions elsewhere but have not yet left.

With these departures (based on AHS’s definition of its normal staffing levels), the program will have lost more than a quarter of its full contingent of physicists.

Sources told CBC News that other support staff have also left.

AHS said an interim director is now in place and is actively recruiting to fill vacancies.

“The team … prioritizes activities and monitors workload and processes. Safe, quality care remains our goal for patients and staff,” spokesperson Kerry Williamson said in the email.

“Patient care is unaffected at this time, and we do not anticipate any issues with services as we plan to move to the new cancer center in 2023.”

In order to stem the bleeding, the health authority is giving medical physicists a one-time pay rise next month.

“We believe that the steps we are taking will allow us to meet the recruitment challenge we are facing … and ensure that we have the qualified people we need in the future, to maintain the full range of care for people. from Calgary and southern Alberta,” Williamson said, adding that work at the Calgary Cancer Center continues.

“It’s worrying”

“This is really bad news for the province,” Wayne Beckham, president of the Canadian Organization of Medical Physicists, said in an interview.

According to Beckham, medical physicists work alongside radiation oncologists, playing a central role in the treatment process, and rebuilding the program could take years.

“It’s not possible to provide cancer treatment safely unless these two groups of staff actually work together,” he said.

“The Calgary center has all the elements of a world-class medical physics program. They teach graduate students. They train their own residents. So they potentially have a pipeline to populate the workforce. But if that workforce is being depleted… this is concerning. And this is really going to cause significant issues for cancer treatment.”

The group conducts an annual salary survey of its members. Self-reported data shows medical physicists in Alberta are the second lowest paid, compared to their counterparts in other provinces, with a median salary of $143,000 per year in 2021.

“I understand from my colleagues in Alberta that one of the main concerns is not just the level of compensation, it is also the progression of salary over time,” he said in an email.

“With salaries frozen since about 2014, there are people who have moved into management and leadership positions who are basically stuck at the level of entry reimbursement. It’s difficult for them when former students.. “Now they’re earning as much as their mentors. Now they’re seeing physicists leaving and bringing their skills to where they’ll get market value commensurate with their experience.”

Lorian Hardcastle teaches in the Departments of Law and Medicine at the University of Calgary. (Colin Hall/CBC)

A University of Calgary health policy expert said the implications of this staffing shortage could be severe.

“When you have multiple departures in a small department, that represents a large enough magnitude of departures to affect patient care and affect the ability of the program to continue as it unfolds,” said Lorian Hardcastle, associate professor at the law schools. and Medicine from the University of Calgary.

“I think this is a question that will deeply concern the public.”

According to Hardcastle, the AHS directive against talking to journalists underscores the seriousness of the situation.

“If there was nothing to see and everything was fine, I don’t know if AHS would ask people not to talk.”

In the Legislature on Monday, NDP Health Critic David Shepherd pressed Health Minister Jason Copping on the staffing shortage. And Copping tried to reassure Albertans that cancer care is not in danger.

“I have spoken with AHS. They have a plan to be able to fill these vacancies and will work with the University of Calgary to be able to hire more. But let me be clear…it will not impact about treating cancer patients now or in the future. We’re going to fix that,” Copping said during Question Period.

“We understand how important these positions are. We are working to fill them.”