Toronto emergency doctor describes record-breaking patient volumes as 'demoralizing'

TORONTO · An emergency room physician who works at three Toronto hospitals is raising alarm over the capacity of some emergency departments, calling the volume of patients "insane, out-of-control, explosive, never seen before, [and] record-breaking." Dr. Raghu Venugopal, who has worked in emergency rooms for 19 years, said the current situation is concerning for any ER doctor. He said the primary issue is that people lack other access to treatment, whether for a child with a fever or an elderly parent. "For some of the patients that we're seeing, it's not that they're orphaned with no family doctor. It's just that they can't get an appointment for three weeks," Venugopal told CityNews.

When describing what it's like to walk into work on an overnight shift, Venugopal said the one word he would use is "demoralizing." "When nurses and doctors arrive in the emergency room and the number of patients is 50 to 100 to be seen. You sort of have a sinking feeling like, 'How am I going to make an impact on that?'" he said. He added there is rarely time to take a break, and staff must focus on being fast, friendly and right while seeing as many patients as possible. The hospitals have the capability to bring more doctors in, Venugopal said, but that alone cannot meet the need.

Official data from the Ontario Ministry of Health reports the median wait to see an ER doctor in Ontario is 1.7 to two hours. Venugopal said that figure does not reflect the full reality. On Thursday morning, data posted by Toronto hospitals showed wait times at nearly seven hours for Toronto General Hospital, five hours and 42 minutes at Toronto Western Hospital and three hours and 47 minutes for Sunnybrook Health Sciences Centre. By the afternoon, Sunnybrook's wait time had ballooned to six hours and 55 minutes, while Toronto General and Toronto Western were around three-and-a-half hours.

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"I will easily see on my ER shift patients waiting four hours, seven hours, eight hours. In Toronto, we have patients waiting 10 hours, and that's just to see the doctor," Venugopal said. He added that wait is only the beginning, as many patients then require scans, tests and treatment, leading to their total time in hospital exceeding 15 or more hours. North York General Hospital does not provide real-time wait times, but an alert on its website Thursday afternoon said it was seeing a high volume of patients in the ER and warned of longer-than-normal waits.

Venugopal said the system lacks sufficient doctors, support services like radiology, nurses and beds. "One of the real underlying problems in Toronto and Ontario is our hospitals are full ... it's really problematic that our hospitals are full before respiratory season because we know it's only going to get worse," he said. He noted the fundamentals of the health-care system are strong with well-trained physicians, but they have not scaled up enough to meet population needs. "We need more hospital capacity and long-term health care capacity that can help make space in the ER to see new patients," Venugopal said.

He advocated for surge funding specifically for Toronto to get more staffed doctors and nurses on the ground. Venugopal gave credit to the current provincial government and Premier Doug Ford for introducing 3,000 beds and plans to build another 3,000. "But we're so far behind the needs that our efforts are not keeping up," he said. He cited far more medical complexity, serious social problems, an aging population and a bigger population as reasons the system has not kept up. The Ontario Hospital Association has advocated for $2.7-billion worth of funding to stabilize the system, Venugopal said. Representatives for the organization declined an on-camera interview.

"We have the money. What we need is the political will to allocate that money to hospitals," Venugopal said. He added he would never tell someone not to go to the ER and does not blame patients for the current crisis. "Doctors don't define emergencies. Politicians, premiers, and nurses don't define an emergency. A patient and their family define an emergency. And we rely on the public's good judgment to define when they need emergency care," he said. The best advice he can give right now is to get flu and COVID-19 vaccines to reduce the chances of severe illness when respiratory conditions peak in Ontario.

With files from CityNews