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Letter to Sault Area Hospital ER Physicians & Ministry of Health

This is a letter in response to the open letter from SAH ER physicians dated June 28th, 2025.

As rural ER physicians and NPs whose primary referral site is Sault Area Hospital (SAH), we are deeply concerned by the recent decision by the Ministry of Health to reduce funding to the SAH Emergency Department—cuts that will reportedly result in a 15% reduction in physician coverage.

While the impact on the local community is immediately apparent—increased emergency room wait times in an already overburdened system—the repercussions for surrounding rural communities are equally serious, though perhaps less visible.

Rural hospitals operate with fewer resources than their urban counterparts and rely on the ability to transfer patients to a higher level of care when they are too complex or critically ill to be managed in their local rural hospital. When patients from our rural hospitals are transferred to SAH, most of these patients are first assessed by ER physicians at SAH upon transfer. These assessments often determine the need for urgent advanced imaging such as CT scans, MRIs or specialist consultation—services not available in smaller rural hospitals.

Cuts to ER staffing at SAH will delay the care that our patients need. As a result, sick rural patients may face prolonged stays in their home facility that is unequipped to manage their needs, or worse, may not be transferred at all due to capacity constraints.  It’s hard to believe that this will not have significant negative impacts on patient outcomes.

There will also be increased pressure on both air (ORNGE) and land transfer services if patients need to be transported out of the region to access advanced imaging or specialized care.  This will likely result in unnecessary additional downstream costs to the system.

Rural patients already experience barriers in accessing higher levels of care, have worse health outcomes than their urban counterparts and are generally more medically complex.  The cuts to SAH ER funding will further disadvantage our patients and add to the equity gap that already exists.  Should SAH become unable to accept patients from rural sites due to the reduced funding and resulting increased wait times, the consequences for our communities will be both unacceptable and avoidable.

We strongly urge the Ministry of Health to reconsider this decision and reinstate full funding for physician services in the SAH Emergency Department. A strong regional referral hospital is essential to equitable care for all patients in Northern Ontario.

Sincerely,

Dr. Anjali Oberai (Wawa)
Dr. Mike Cotterill (Wawa)
Ms. Tricia Provost (ER NP, Wawa)
Dr. Amy Vine (Bruce Mines and Thessalon)
Dr. Eric Haapala (Bruce Mines and Thessalon)
Dr. Dannica Switzer (Rural Locum, Northern Ontario)

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