Muskoka’s depleting medical resources, including the potential loss of its in-hospital lab services, has helped prompt the departure of another one of the area’s valued health-care professionals.

Dr. Marc Bibeau recently resigned from Muskoka Algonquin Healthcare (MAHC) after almost two years as the region’s only general internist specializing in respirology, the study of lung diseases and other related conditions such as asthma.

Bibeau, who practised out of Bracebridge, had his last day with the organization Dec. 6.

He accepted a new position as a respirologist in Edmonton.

Prior to his departure, Bibeau had accumulated more than 500 patients from around Muskoka. He was contacted by this newspaper last week to discuss his resignation. During an interview prompted in part by his patients, he told how the area’s diminishing medical resources played a large part in his decision to leave.

“One of the biggest things for me is the lack of resources required to provide the level of care I have been trained to provide,” said Bibeau. He noted that while MAHC outfits its hospitals with specialized equipment including CT scanners, the area’s lack of trained specialists, such as radiologists, coupled with the potential loss of lab services, has made it difficult to provide a high level of care to patients.

“For me the practice of medicine is more than just the physician and his or her equipment,” Bibeau said. “It’s co-ordinating with nursing staff, radiologists, technicians, the laboratory . . . I need these resources to provide the level of care that I want to provide.”

During his tenure in Muskoka, Bibeau said he witnessed many of these resources “slipping away.”

“If I can’t provide (patients) the care they deserve . . . then my services and training is probably better served in a centre where I can do that.”

Bibeau is not the first doctor at MAHC to voice frustration over the growing lack of resources available to local physicians.

Earlier this year, MAHC lost one of its most skilled radiologists, Dr. Giovanni Bruno, after the organization implemented a new on-call funding structure that reportedly paid him approximately one-tenth of what on-call surgeons and internists make.

Before he left, Bruno too, expressed concern that depleting medical resources and budgetary constraints at MAHC are stretching local heath-care services beyond their limits.

“I urge citizens to take charge of their health care, because it may not be here at the level it always was,” Bruno said to this newspaper in May.

Bruno left MAHC two months later. The organization has yet to recruit another radiologist to replace him.

Losses like these, Bibeau noted, have a widespread impact that ultimately trickles down to patient care.

“Having a radiologist in Toronto . . . is great, (but) it’s not the same,” said Bibeau. “It works, but it’s not how I want to work.”

The ongoing possibility of losing MAHC’s community-based lab program, which tests blood and other swab samples in Bracebridge and Huntsville hospitals, is another worrisome issue, he said. The program is currently under review by the province and MAHC is expected to announce a decision on its status in March.

Bibeau, however, said he could not envision working in Muskoka without the lab.

“I need a lab and I need access to it 24 hours a day,” he said. “I don’t feel I can stay knowing that there’s still a very real potential that we may not have a lab. . . .I’ve seen enough instability that it worries me.”

Bibeau, who was hired by MAHC to act as a general internist, admitted his desire to focus solely on respirology further factored into his decision to leave. He said he hopes health-care organizations can ultimately find a way to better support the work of sub-specialists in small, rural communities.

“The reality of the (health-care) system these days is we’re graduating more sub-specialists than we are general internists,” said Bibeau. “So we may have to re-evaluate our recruitment and retention procedures.”

Dr. David Mathies, chief of staff for MAHC, acknowledged the recruitment quandary, but noted that locally, a general internist can serve more of the public’s overall needs.

“In Muskoka we need to provide the more core, generalist services,” said Mathies. “We can’t expect to be covering sub-specialist services. But we should expect that we cover our general services.”

Mathies said MAHC “regrets” Bibeau’s departure, but is actively recruiting another general internist to replace him.

In response to Bibeau’s others concerns, Mathies noted that Muskoka is not alone in its challenge to provide a high level of service with a limited budget.

“I think his concerns are real, but not realized,” said Mathies, adding MAHC is still able to provide “excellent” care.

The organization, he added, is continuing to actively recruit more radiologists, as well as other health-care professionals. Overall, Mathies said he believes Muskoka is seeing a trend toward more medical resources, not less.

“It’s always sort of one step back, and two forward,” he said. “Short term, does it look like there are threats? Always have been, always will be. Long term has always been good, though.”

According to Mathies, those requiring the services of a respirologist can travel to either Orillia or Barrie for treatment.