Opinion: Know Your Options: Getting the right care in the right place

I have been an ED doctor in Niagara for over 17 years — just over half of my career in medicine. In fact, there is a good chance I’ve treated you or someone you know. So, please allow me to share some inside perspectives on our challenges and how you can help us provide timely care to those who need it most.

Niagara Health’s Emergency Departments (EDs) in St. Catharines, Niagara Falls and Welland are the busiest areas of the hospital, seeing nearly 150,000 patients a year — that’s about 400 every day. Our teams work around the clock to deliver safe, quality care to anyone who needs it, no matter the severity or complexity of their condition. This commitment, however, comes under significant strain, particularly during seasonal surges of respiratory illnesses like the one we’re experiencing now.

These pressures aren’t just numbers. They represent real challenges for the dedicated doctors, nurses and staff who go above and beyond every day to provide the care our community relies on. They face long hours, complex cases, and the emotional toll of knowing patients are waiting longer than anyone would like. At the same time, we understand how frustrating long waits can be for those seeking help, and we are grateful for your patience and understanding as our teams navigate these demands.

A variety of societal factors drive the pressures on our EDs. A shortage of primary care providers has led many people to rely on hospitals for care that could otherwise be managed in the community. Staffing shortages across the healthcare system leave fewer hands to meet the growing needs of an expanding and aging population. The past few years have also brought an increase in patients requiring mental health and addiction support, as well as the unique needs of ever-growing marginalized populations. All of these factors compound the challenge of managing already stretched resources.

When these broader issues intersect with hospital-specific challenges — such as a high bed occupancy by patients waiting for community-based services — our EDs become bottlenecked. They are where the higher community demand and challenges in patient flow through the broader system come to a head, so everyone waits in the ED, be it a patient arriving by ambulance or waiting for a bed on the floor.

While we continue to address these issues through partnerships, community programs and public education, we also need your help. Knowing where to seek care can make a meaningful difference — not only for your experience but for the system as a whole.

Our EDs are places where we handle serious acute medical issues like chest pain, inability to breathe, strokes, severe burns, head injuries, broken bones or life-threatening conditions. If you’re in a critical condition, don’t hesitate — call 9-1-1 or head straight to an ED. We’re here for you, 24/7, every day. This is what EDs are built for.

However,

• If your condition is less urgent — like a minor sprain, a mild fever, or a sore throat — there are better options. These include Urgent Care Centres (UCCs), family doctors, pediatrician offices, walk-in clinics or Virtual Urgent Care.
• All EDs are busiest in the afternoons and evenings. When possible, coming to the ED early in the morning will improve your experience and satisfaction, as you are more likely to receive care faster.
• The Canadian standardized triage process ensures the most urgent cases are treated first. This means that the less urgent patients wait longer during high demand. Influenza season, expected to peak in the next few weeks, is our period of highest demand in a year.
•  Come prepared. The three things people miss most while waiting are their medications (a full list is always appreciated), entertainment (like a good book) and a phone charger.

We work daily to improve ED care and access, including reducing ambulance offload delays, improving internal ED flow, strengthening primary care with community partners, and freeing up inpatient beds to improve patient flow. But no system can function without the people at its heart.

So, to Niagara Health’s ED teams: Thank you for your dedication, skill and compassion. Every day I come to work, I am humbled by everything you do for our community. You are both the main door and the backbone of our hospital system.

To our community: Thank you for your understanding and for supporting our healthcare teams during these challenging times. Your kindness goes a long way. These challenges aren’t unique to Niagara, and by making informed choices about where to seek care, you can help ensure that our EDs continue to deliver safe, quality care to those who need it most.

I always half-joke with my patients, saying, “My private number is 911,” but it truly is. We are here at your Niagara EDs to provide lifesaving acute medical care when you need it most. That is our promise to you, and we intend to keep it.