Surgical services at Caithness General Hospital in Wick will not be available at night or weekends from later this month, NHS Highland has said.
The health board said the staffing situation at the site had become "fragile" after one surgeon retired and another resigned.
NHS Highland said this left just one consultant general surgeon.
Raigmore Hospital in Inverness, about 100 miles away, will provide an on-call surgeon at nights and weekends.
The arrangement will begin on 15 December.
NHS Highland said it was not the beginning of a process to withdraw surgical services from Wick, and it was seeking a long-term solution.
Dr John Macleod, consultant anaesthetist and clinical lead for Caithness General, said: "Our ongoing problems with recruitment and reliance on locums won't be a surprise to anyone.
"We have tried very hard to keep everything going but it's now become so fragile that it's not reasonable to continue as we are."
He added: "We have therefore taken the decision that it is better to put in contingency arrangements on a planned basis rather than have to react to the next crisis.
"This means there will be no out-of-hours local consultant surgical cover in Caithness General, but it will allow us to protect the vast majority of our surgical services."