ER doctors to administrators: Stop harassing us for blowing the whistle on dangerous overcrowding
Canada’s emergency doctors are demanding better protection against administrative harassment and bullying for speaking out about dangerous overcrowding and unreported deaths in the country’s emergency rooms.
Among other measures, the Canadian Association of Emergency Physicians is calling for “effective and enforced” whistleblower protection, arguing they risk personal and professional persecution for calling out unsafe conditions that are putting lives at risk.
“Advocating for better patient care, health system reform, and physician rights is a core physician competency and professional responsibility,” the association said in a new position statement .
The organization “unequivocally condemns all forms of workplace harassment, bullying and intimidation of emergency physicians by organizational and system-level administrators, colleagues, medical leadership, health system officials and politicians.”
Harassment creates “toxic work environments,” undermines patient safety and contributes to physician burnout, the organization added.
In a high-profile case , B.C. emergency doctor Kaitlin Stockton sued the Fraser Health Authority, alleging she was effectively fired after she and her colleagues posted a sign in a Port Moody ER in November 2024 warning of unacceptable wait times. Stockton was singled out, bullied and threatened when news outlets ran a story about the sign, according to the claim.
Both parties recently announced that the lawsuit had been resolved to their “mutual satisfaction.”
In her civil suit, Stockton alleged she was threatened and harassed for speaking out about critical overcrowding. She and her colleagues asked to transfer admitted patients to different areas of the hospital, cancel elective surgeries, call a “Code orange” — an emergency code that’s activated during disasters to shift all resources to respond to incoming patients — and divert ambulances to other hospitals, but the requests were denied, according to the civil claim.
“It was the perfect storm of overcrowding in the hospital and the emergency department, staff shortages, too many sick patients and too few available ER beds,” Stockton said in an interview.
“We talk about cracks in the system. But this is when the roof has fallen in. It truly has failed when we can’t treat the sickest patients in our emergency department in a timely manner.”
The statement from the Canadian Association of Emergency Physicians was driven by “the plethora and huge amount of harassment and bullying emergency physicians are experiencing across the country for shedding light on dangerous overcrowding conditions, a lack of (patient) flow and a pandemic of unreported deaths in our waiting rooms,” said first author and Prince Edward Island emergency physician Dr. Trevor Jain.
“The bullying and harassment, unfortunately, is done at all levels — by managers, by anybody in admin; it’s been done by very senior physicians who hold administrative positions, as well as administrators who hold positions of power.”
Bullying can include “administrative violence,” he said — marginalizing, intimidating, humiliating and socially isolating staff who speak out.
“Basically, they set up the conditions for constructive dismissal using everything they can,” said Jain. “It’s the slow bleed out of a care provider. They make it impossible to work. And we’ve seen that: You ask any physician who’s been around for a while. We’ve seen that.”
Emergency doctors recently warned that preventable deaths are occurring “with unsettling regularity, not randomly, not rarely, ” a function of overwhelmed emergency departments that are the only part of the health system that can’t say no, Jain said.
“The ORs can shut down at four o’clock, five o’clock, unless there’s an emergency. The (wards upstairs) can say, ‘No, we’re full,’ because they have safety concerns, and rightly so.
“The emergency, we never close our doors.”
Emergency overcrowding isn’t an emergency department problem, he said. “It just lands there. It’s a system problem. You could have 1,000 doctors in that emerg and (patients) are not going to move, because the hospital is full and we can’t get those admitted patients out of emerg to free up space and staff to see new ones.”
Staffing, equipment and infrastructure haven’t kept pace with Canada’s population growth, he said. “Not even close.”
Emergency rooms are the canaries in the coal mine, he said. “So, when you walk into the waiting room and there’s people lying on the floor, people leaning against the walls, people in distress, people who don’t have a family doctor, people with post-op complications, 84-year-olds waiting 12 hours — that should be a huge red flag that multiple canaries have died and the system is in distress.”
“We’ve become the easy button for the Canadian health-care system,” Jain said.
“You can’t access primary care? ‘Go to emerg.’ Post-op problems from the operation yesterday? Go to emerg. ‘I can’t look after my loved one anymore’? Go to emerg. A nursing home says, ‘This patient has become too difficult for us to manage’? Go to emerg.
“That is the administrative system solution to immediate problems, and then those files get put off to the side of a desk.”
There should be no retaliation against doctors who advocate for better patient care and system reform, Jain said.
“If a physician — and we report to the public — lets the public know that you are in an unsafe environment right now, that we’re doing the best we can, that overcrowding puts you at risk, that we have people dying in our waiting rooms across the nation — those are facts,” he said.
The Alberta government has ordered a fatality inquiry into the December death of a 44-year-old Edmonton father of three who died of an apparent cardiac arrest after waiting for eight hours to be treated in an emergency room.
In a post to X in February, Alberta emergency physician Dr. Paul Parks reported on a “near-miss” involving another patient with chest pain who was examined while standing up in a hallway. There were no empty stretchers. The patient ended up having a life-threatening blood clot.
In another Alberta case, a woman in her 50s arrived in emergency in a “confused/altered” state and unable to walk, Parks posted.
“She was flagged for MD assessment after a check-in found her still confused after 4 hours in a wheelchair,” Parks said. “Once in a proper treatment space, it was immediately clear something was terribly wrong. CT scan showed a bad bleed in her brain. She required emergency intubation and transfer for neurosurgery. She could have easily died waiting for care.”
Cases like these have become daily realities, emergency medicine leaders have warned. But a culture of fear keeps many doctors silent.
“Other physicians are muzzled with contracts containing non-disclosure clauses effectively burying the truth forever,” Dr. Warren Thirsk, president of the Alberta Medical Association’s section of emergency medicine, wrote last June in a letter expressing support for Stockton.
The muzzling and harassment “are eroding our ability to act as effective advocates for our patients and our system, and it really needs to stop,” said Stockton.
In her case, administrators obtained security camera footage to see who posted the sign.
“There is still a tonne of fear around physicians being retaliated against, losing their job, losing their licence. You lose your licence, you’re done. Your career is over,” Stockton said.
“But if people can’t rely on health-care providers to be their voices, especially those who can’t advocate for themselves, who is going to advocate for them?
Having whistleblower legislation isn’t enough, she said. “It needs to be visible, and it needs to be enforced.”
National Post
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