OTTAWA - Canada's nuclear medicine community is worried there will be layoffs if the isotope crisis drags on much longer.

Health-care providers sometimes find themselves idle at the end of the week because they don't have enough isotopes to do diagnostic scans, say two nuclear medicine groups.

But hospitals still have to pay staff to be there all week because they don't always know what their shipments will look like.

The Canadian Association of Nuclear Medicine and the Ontario Association of Nuclear Medicine are warning that hospitals may soon cut staff to cut costs.

"Hospitals cannot keep paying people to do nothing," said Dr. Jean-Luc Urbain, head of the Canadian Association of Nuclear Medicine.

Doctors and their staff are at the mercy of a shaky isotope supply. Sometimes there are enough isotopes for the week. Other times there aren't.

Shipments typically arrive over the weekend and, if there are enough, again mid-week. But isotopes have a shelf life of mere days and cannot be stockpiled, so staff scramble to book patients for tests before the particles decay.

But by the week's end there aren't always enough isotopes left to do scans - leaving staff with little to do some weeks but wait for the next shipment.

"Last Friday, during the entire day, I did four bone scans and I could do 12 a day," said Urbain, who is also chief of nuclear medicine at the London Health Sciences Centre.

"For the staff, technologists, it's very difficult. A fair amount of them are fearful that they're going to lose their jobs."

Clinics are already coping with higher costs. Some are paying two to three times more for medical isotopes after suppliers and distributors hiked their prices recently.

It's also costing more to keep clinics open evenings and weekends to do patient scans before the isotopes decay. That has forced hospitals to go into debt or cut from other departments to pay for the procedures.

There haven't yet been reports of pink slips making the rounds at clinics but doctors warn that could change.

"There may be notices for potential intermittent layoffs, not outright firings" said Dr. Christopher O'Brien, head of the Ontario Association of Nuclear Medicine.

"The ability of hospitals to maintain staff during this crisis situation will become more and more critical as we're facing these greater and greater degrees of intermittent shortages. ...

"Hospitals are beginning to look at, 'Do we need all the staff that we need?"'

O'Brien, who is also the medical director of nuclear medicine at the Brantford General Hospital, predicts smaller, rural hospitals will likely be the first to lay off staff.

A prolonged shortage will further strain clinics.

Atomic Energy of Canada Ltd.'s downed reactor at Chalk River, Ont. - which used to make about a third of the world's medical isotopes - won't be back until at least the year's end.

Other reactors around the world are filling in but clinics still face uncertainty over their isotope supplies.

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