Over the past few years, many smaller community hospitals have struggled to keep their vital emergency departments (ED) adequately staffed. Across Ontario, rural communities have experienced a shortage of physicians which impacts 24-hour coverage of EDs. Quinte Health Care (QHC) is a four hospital system in south-eastern Ontario with emergency departments in Belleville, Trenton, Picton and Bancroft. They have experienced these staffing pressures before, particularly during vacation months. This past spring the organization was looking at a larger number of uncovered emergency physician shifts into the summer and early fall, particularly at Trenton Memorial Hospital and North Hastings Hospital.