Toronto ER doctor says patient volume at some city hospitals is 'out of control'

On a typical shift, 50 to 100 patients are waiting to be seen at some Toronto emergency rooms, says Dr. Raghu Venugopal, an emergency physician with 19 years' experience who works at three city hospitals. He says there is rarely time for breaks, and he calls overnight shifts "demoralizing."

On a Thursday morning, posted waits were nearly seven hours at Toronto General, five hours 42 minutes at Toronto Western, and three hours 47 minutes at Sunnybrook; by mid-afternoon Sunnybrook's posted wait had reached six hours 55 minutes. North York General does not publish real-time waits; its website warned of longer-than-normal waits that afternoon.

Venugopal described the situation as "insane, out-of-control, explosive, never seen before, [and] record-breaking." His central concern is that people who would otherwise be treated elsewhere are arriving at the ER. "Whether it's your five-year-old that has a fever or your 85-year-old mother that has a fever, there's no real options for those people to get medical care and to get answers for why they're ill," he said. "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."

He named shortages of doctors, radiology and support services, nurses and beds, and said that once a patient is seen, scans, tests and treatment can push total time in hospital beyond 15 hours. Hospitals can bring in more doctors, he said, but that alone cannot meet the need.

The Ontario Ministry of Health reported a median wait of 1.7 to two hours to see an ER doctor over the past year. Venugopal said a median does not reflect the full range of waits.