Cancer treatment at risk over 'exodus' of medical physicists

Physicians say Alta. cancer care at risk A shortage of medical physicists threatens cancer care say a number of Alberta physicians. Kevin Green reports.

A group of 24 doctors including the section head of radiation oncology at the Tom Baker Cancer Centre is warning patient care is at risk following an exodus of medical physicists.

"Our group as a whole has recently learned of the resignation of multiple medical physicists, including the Director of Medical Physics, primarily over remuneration and workload concerns.

"This is a devastating loss for the radiation medicine program," says the letter addressed to Dr..J. Dean Reuther, medical director of community oncology in Alberta, and Dr. Don Morris, facility medical director for the Tom Baker Cancer.

"It is not possible to run a radiation department without an adequate number of trained and experienced medical physicists. These individuals are highly trained specialists with both clinical and technical expertise. They are a highly valuable resource and not merely replaceable technicians, and are critical to the safety of radiation treatment for our patients."

The letter says several medical physicists, including the program director have left in recent months over issues of pay and working conditions.

"The most upsetting aspect of this situation is that it did not need to be this way. Concerns regarding medical physicists were raised at least three to four years ago, if not more. Had the issues been addressed properly and sooner, we would not be in this position today."

In an emailed statement Alberta Health Services Spokesperson James Wood said "quality and safe patient care is a priority for Cancer Care Alberta and the Tom Baker Cancer Centre.

"Patient care is not being affected at this time."

Wood also went on to say  "We do not anticipate issues with services as we plan the move to the new cancer centre in 2023."

SHORTAGE WILL HAVE IMPACT

The president of the Canadian Organization of Medical Physicists (COMP), disputes that statement, saying a shortage of physicists will definitely impact Alberta Health’s ability to open and staff the new cancer centre.

In an email to CTV, Wayne Beckham wrote "This exodus of medical physicists has potential to impact the large amount of highly specialized work needed to get the new cancer centre in Calgary up and running with radiotherapy treatments.

"Any time you see a reduction in staffing such as has occurred in Calgary, there is reason to be concerned that this has potential to impact patient access to quality cancer care in this case radiotherapy. Furthermore MPs (Medical Physicists) are also solely responsible for testing new equipment to be sure that it performs according to specifications and that it is safely commissioned to allow it to be used to treat patients."

Beckham said the physicists' pay concerns are not simply about wages but also about progression along the pay scale, writing  "with frozen salaries since about 2014, there are people who have grown into senior and leadership roles that are stuck at essentially entry-level reimbursement. It's tough for them when former trainees are now making as much as their mentors. Now they are seeing physicists leaving and taking their skills to where they will get market value commensurate with their experience."

Alberta medical physicists are currently the second lowest paid in Canada with a median salary of $143,000 per year in 2021, behind only those in Quebec.

AHS spokesperson Wood admits there are staffing issues but says they are being addressed;

"We are experiencing some staffing and recruitment challenges at the TBCC (Tom Baker Cancer Centre) in the specialized medical physicist role, as with many other specialized roles that are in high demand across North America.  An interim director is in place, and AHS is aggressively recruiting to fill all vacancies. AHS is providing medical physicists with a one-time salary increase next month, and we are optimistic that will help with our recruitment and retention efforts, in partnership with the University of Calgary.”

None of the 24 doctors who signed the letter are speaking publicly after being advised to refer any questions to AHS. That raises some serious issues according to University of Calgary law professor and health policy expert Lorian Hardcastle.

"I think by encouraging staff not to speak up, it suggests that there is something more going on. And I think that AHS should, instead of trying to silence critics should be addressing the root of those criticisms," said Hardcastle.

"The doctors here are merely fulfilling that advocacy role," she added, "and bringing about concerns with staffing that they believe will affect patient care, and teaching and other important aspects of the health care system, and so if they think those are concerns, then I think silencing that is problematic because the public wouldn't otherwise know that these concerns exist."

AHS claims it did not muzzle the physicians.

"AHS has not asked physicians to avoid speaking to media about this issue," said an AHS spokesperson in an email to CTV News Tuesday.