A number of reports in recent years, have highlighted the need for Central Health to move away from its reliance on locum radiologists to provide Medical Imaging services. For a long time, these temporary physicians have been the cornerstone of the service.
In recent years, the department has focused its recruitment efforts towards securing permanent, contracted, fee-for-service radiologists. While there has been incremental success in doing so, the department continues to advertise such opportunities, to fulfill that mandate.
Here is the current state of service and recruitment:
The department has four permanent, full-time radiologists, one of whom is a recent graduate from MUN, along with one permanent part-time.
Current recruitment has secured keen interest from two internationally trained radiologists, one of whom has been contributing part-time services for the past three years, increasingly extending the duration of his assignment. He loves Newfoundland, has now completed all obligations to other employers, is committed to contracting with Central Health for permanent, part time, on-site work and is looking into the process towards Canadian citizenship.
In a similar vein, since January 2019, through a recruitment firm, we have been working with another internationally trained radiologist who is scheduled to do an on-site introductory period aimed at determining whether a full-time permanent position is agreeable to both parties. Initially scheduled for the Spring, this has been delayed till September to November, and is still contingent upon the public health status of COVID.
We also have, for the past five years, an interventional radiologist who has been coming for 1-2 weeks each month to provide on-site services.
To round out the cadre of radiologists, we have three who have, for 5-6 years been providing mostly off-site image interpretation, being scheduled as and when they are available.
Among this group is Dr. Rendell, who had also been providing an average of one week a month on-site. It is important to note that we have been in facilitated dialog with Dr. Rendell to negotiate the terms and conditions of a permanent position and were working with her to schedule a time to meet immediately prior to her approaching the news media.
The locum doctors that are coming in are already established as part of the Medical Imaging team, on a temporary part-time basis and were previously scheduled to provide these services. At the time those commitments were made, Dr. Rendell was not available to be scheduled. It would be disingenuous to cancel these scheduled assignments in favor of other radiologists who are also in the same pool, and who were not available to be scheduled when these commitments were made.
As with anyone coming into the province of Newfoundland and Labrador, these doctors are subject to public health mandated screening on entry and two weeks of self-quarantine.
In addition, we do continue to seek locums who can commit to working on-site for longer periods of time to provide much needed stability. We also see these as opportunities to entice these temporary locum physicians into making commitments for permanent, on-site work in Central Health.
Central Health has long relied on locum coverage provided by a stable cadre of radiologists, Dr. Rendell included. Coverage is scheduled months in advance to secure and sustain the service across the region. During this COVID pandemic the volume of work has decreased, and in fact some pre-scheduled coverage had to be cancelled or rescheduled. From those locums, not involved in the current mediation/facilitation process, a schedule had been drawn up well in advance, given the uncertainty that unfolded after the interim solution was put forward.
It is unfortunate that, instead of committing to those contract discussions this week, Dr Rendell has chosen to bring this issue in the public domain through the news media, in violation of an agreement that binds the parties to confidentiality.
For the last several months, Central Health has been working with Dr. Rendell to facilitate her return to work and ensure she feels comfortable and well-supported to do her job. Central Health has worked to accommodate Dr. Rendell through mediation, but while progress has been made, a final resolution has not yet been reached.
Dr Rendell has been involved in a concerted effort to discredit the direction, functioning and regionalization of the diagnostic imaging department at Central Health culminating in a letter that she was signatory to that made false and damaging accusations against coworkers in the organization. This letter was sent widely outside the organization. As a result, processes were initiated inside the health authority to address this. Dr Rendell then went on leave and opted to not make herself available for locum work. Shortly thereafter, an agreement was reached to enter into a formal mediation process.
Dr. Rendell herself, chose to remove herself from serving the population in Central Newfoundland and she has remained out of service for almost a year at her election.
We have supported an active, progressive mediation process. It has taken up significant time and resources, but we were making progress. Even though formal mediation was on hold due to the pandemic, we continued to hold resources and continued conversations and mediation. We didn’t completely stop the process. We were at a point with Dr Rendell where we were about to discuss the terms of her contract to return to work at Central Health. She didn’t accept that meeting.
The mandate of the Board and Leadership team is to lead the organization in creating a culture of compassion, accountability, and respect, and ensuring that we are providing quality care and services. This transformation was reinforced from our review of the recommendations of Dr. Peter Vaughan in the External Review of Central Health from May 2018. Change isn’t easy, and it takes time, but we are working hard to build safe and respectful workplaces. And as an organization, we take all matters of fairness and claims of discrimination seriously.
Through the transformation of Central Health, we are working to ensure our workplaces reflect our values and commitment to the delivery of high-quality health and community services. There are 36 recommendations and 145 actions stemming from the Central Regional Integrated Health Authority External Review. As of December 31, 2019, 118 of these actions have been deemed completed and 24 are in progress. We are committed to continually reviewing and improving our processes and ensuring our culture is a positive one.