Patients in B.C. waiting too long for surgery, not being counted by province: doctor
Author: sswitzer
‘Getting pretty desperate’: Waitlist for orthopaedic surgery grows in BC as pandemic continues
Thousands in Kamloops, Kelowna still waiting for postponed orthopaedic surgeries
InfoTel News Kelowna, Kamloops, Penticton, Vernon – March 22, 2022
Rob Munro
Letter from BCOA to the BC Health Minister – March 16, 2022
16 March 22
Honourable Adrian Dix, British Columbia Minister of Health
Victoria B.C.
Communicating a Realistic Picture of Orthopaedic Healthcare in B.C.
Dear Honourable Minister,
This letter is to formally request an urgent meeting or call with you to discuss the state of orthopaedic surgery in our province.
I have been approached by CTV for comment on the situation with orthopaedic healthcare in B.C. and have an interview scheduled with them for Monday March 21.
I reach out not only as the incoming President of the British Columbia Orthopaedic Association representing over 170 Orthopaedic Surgeons in the Province, but also as a practicing physician with first-hand experience of the situation we are experiencing and supported by reliable accounts from many trusted colleagues. The BCOA advocates for the tens of thousands of orthopaedic patients across our province who are waiting for their time on our surgical waitlists to be up.
Managing health care through this pandemic has been no small feat. I commend the steps that have been taken over the past two and a half years to keep British Columbians safe, and to keep health care moving forward.
I also want to thank you for your advocacy for our patients in the past.
As we enter this now new world of “recovery,” a whole new set of challenges are upon us as a province. We would like to work with you, the ministry, the hospitals and the regions to ensure steady, appropriate access to care for Orthopaedic patients across the province for the future.
The reason for this letter and our request for a meeting is also to communicate serious concerns on behalf of our association regarding comments made recently, about having caught up with 100% of postponed operations from the early pandemic. This in no way re”ects the experience for most orthopaedic patients or surgeons in the province. In fact, we continue to struggle with access to operating rooms, have not caught up, and continue to see wait lists grow. We are bringing this to your attention urgently as we nervously see these trends continuing with detrimental impact to our patients’ mobility and mental health.
In Prince George, one surgeon whose waitlist averaged 80-90 patients for the 5 years leading up to the pandemic, has seen his waitlist almost TRIPLE, currently with a waitlist of 271
patients. If he was given 1extraOR per week, it would take him an entire year to bring his list back to pre-pandemic levels.
In Kelowna there are currently over 1200 patients on the Orthopaedic surgical waitlist,over halfof them have exceeded their benchmark, many of those have now waited over 52 weeks.
In Kamloops, since the beginning of the pandemic, Orthopaedics has lost 1,803 hours of operating time. On average an orthopaedic case takes around 2 hours, that is 900 patients who have lost their chance in the operating room.
At St. Paul’s Hospital, just this week it was announced an ongoing 40% reduction in surgeries for the next 4 months, due to sta#ng shortages as a fallout of the pandemic.
Unfortunately, orthopaedic surgery is often labeled as “elective,” which implies these surgical procedures are non-urgent. As such, orthopaedics has been hit by closures at a disproportionately high rate compared to all other surgical specialties. In Kelowna, since April of 2021, orthopaedics has lost 79 OR days, the next highest level of cancelations for another specialty is 48. These trends are seen across the province; according to the Fraser Institute report, orthopaedic wait times until surgery grew by 64% from 2020 to 2021, while Neurosurgery, Gynaecology, Ophthalmology, Otolaryngology, and General Surgery all showed a net REDUCTION in wait times (ranging 6 to 34% reduction).
The reality is, Orthopaedic surgeries are life-transforming.
The patient stories that have consistently!ltered in across this pandemic, as our waitlists continue to grow, are!lled with tales of uncontrollable pain, loss of mobility, loss of independence, ultimately leading to depression, short and long-term disability, job loss, and an increasing prevalence of narcotic dependence.
Orthopaedic procedures have a high success rate and are e$ective at helping patients restore their mobility and function.Appropriate timely treatment allows people to ‘get their lives back’ faster so they can get back to work earlier to contribute to their own welfare and the economic welfare of the Province.
Patients have been waiting for months, sometimes years, for any indication that their pain and su$ering will end. Many have seen these recent (operations back to normal)announcements as a promise. Since this announcement our phones have been ringing o$the hook, with patients inquiring when their surgical date will be, as they saw on TV, or read online, the excellent news of the (apparent) surgical renewal and success. The reality is patients have had their expectations unrealistically raised at the same time as access to orthopaedic operating resources have been cut, again.
For orthopaedic surgeons, the shock and response to the announcement of “nearly 100% of postponed surgeries completed” – has been staggering.
On the day of the announcement, I personally received six phone calls, 12 emails, and over 30 text messages from surgeons across the province, from multiple hospitals, in every health
authority, stating their astonishment and disbelief, with the statements that were made about surgeries being back on track. It has heaped pressure on an already pressured and frustrated professional body – reinforcing perceptions of orthopaedics as the ‘low hanging fruit’ for cuts and cancellations.
It is imperative for the orthopaedic surgeons we represent to have faith in the leadership we ultimately work for. It is important too, that patients have a realistic perception of the challenges we continue to face together and realistic expectations as to the waiting times they are likely to encounter.
We share a common goal of wanting to deliver an exemplary orthopaedic healthcare service to orthopaedic patients in B.C. The challenges also present opportunities to change and I look forward with hope and optimism that we can create plans together for a true recovery for orthopaedic patients in this province.
I look forward to the opportunity to discuss this with you at your earliest convenience.
Sincerely yours,
Cassandra Lane Dielwart MD. FRCSC
President-Elect British Columbia Orthopaedic Association
BC Orthopaedic Association says Collaboration Leads to Success
Vancouver ~ the BC Orthopedic Association said today that collaboration among health care stakeholders leads to success for patients, doctors and communities.
Several examples of collaboration exist in BC with models of care that include surgeon-led multi-disciplinary clinics that utilize centralized intake and ‘first available surgeon’ strategies to reduce wait times.
Orthopaedic surgeons are working hard by providing timely access to the most appropriate and comprehensive care throughout British Columbia, according to Dr. Alastair Younger, President of the BCOA. Younger states there are programs in Victoria (Rebalance MD), Vancouver (Footbridge Clinic) , North Vancouver (Pacific Orthopaedics and Sports Medicine ), Fraser (Fraser Orthopaedic Institute), Kelowna (Kelowna Bone and Joint Health), Surrey (Surrey Comprehensive Orthopaedics), Cowichan Valley, and Prince George that have set up multidisciplinary clinics in order to see patients faster, improve the patient experience and ultimately improve patient care. More clinics care currently being developed.
We are pleased that the government is funding more hip and knee replacement surgeries, however we want to continue to work with the Ministry of Health to address the wait times for the other 85% of orthopaedic patients still waiting for surgery. Much more needs to be done to improve access to care for patients as orthopaedic surgeons need more operating room time to get people the care and surgery they require, however we are improving patient care with these surgeon led innovative programs.
Please visit http://solcreative.ca/bcoa/media/media-inquiries/ to see videos of examples of successful programs implemented by orthopaedic surgeons.
For further information, see www.bcoa.ca or all 250.588.2274.
The BCOA Annual General Meeting & UBC Orthopaedic Update
Both events will be held virtually this year. Details will be available soon.
More hip and knee surgeries may mean less access for the other 85% of orthopaedic patients
April 4, 2018
Vancouver~ The provincial government’s recent announcement of targeted funding for more hip and knee replacement surgeries may mean decreased access for the other 85% of orthopaedic patients on wait lists, according to Dr. Alastair Younger, president of the BC Orthopaedic Association.
“While we are pleased there is a promise for more timely access to care for our hip and knee replacement patients, they only amount to 15% of all orthopaedic surgeries in the province,” he pointed out. “The other 85% still face long wait-times – from referral to consultation with a surgeon, to surgery itself takes an average of almost a full year – and that is not timely care.
“Many patients requiring orthopaedic care are unable to work,” Dr. Younger explained. “For example, half of patients with ankle arthritis cannot work. In the absence of more funding for these types of patients, the priority on hips and knees could well increase wait times for patients suffering with ankle, shoulder, foot, hand, wrist, elbow and other musculoskeletal challenges.”
Dr. Younger pointed out that more funding for hip and knee replacements does not address the increased need for access to trauma surgery because of our growing and aging population. “Orthopaedic surgeons cover both elective surgery and fractured bones,” Dr. Younger explained. “The fractures are often managed at night and over weekends, and amount to over 50% of the work performed by orthopaedic surgeons. With more hip and knee replacements being required by the government’s program, this may mean reduced access to trauma surgery and certainly puts more strain on all the doctors, nurses and ancillary staff providing orthopaedic care.
“We do laud the government’s announcement and we always want to work with the Ministry of Health towards improving timely access to care for all orthopaedic patients,” Dr. Younger said. “But we feel strongly that unequal access to care is a violation of the Accessibility Principle of the Canada Health Act and indeed, restricted access to care may be viewed as a human rights violation. We take these ethical and legal considerations seriously.
“There’s also the practical side to consider as well,” he pointed out. “Some facilities and administrators will make resource allocation decisions to prioritize hip and knee replacements and that will exacerbate wait times for other orthopaedic patients. For example, we treat many children, teens and young adults who may face lifelong disabilities or missed opportunities without appropriate and timely care.”
The British Columbia Orthopaedic Association is the professional organization that advocates for orthopaedic patients and represents the majority of orthopaedic surgeons in the province.
Kevin Wing – Patients Told To Wait
Dr. Kevin Wing, an orthopaedic surgeon operating in Vancouver, BC, remarks on how people in BC with orthopaedic foot and ankle issues have to wait an unreasonable time for surgery and suffer as they wait.
Study confirms long waits for access to orthopaedic care
August 1, 2017
Vancouver ~ A study of wait times for 4,100 BC orthopaedic patients concluded that the average journey from referral to surgery was “worrisomely long at 59.5 weeks,” according to the study’s authors Drs. Alastair Younger and Dr. Kevin Wing.
“This study confirmed what our members – orthopaedic surgeons in British Columbia – have long known: our patients wait up to one year for non-emergency access to consultation and care,” Dr. Younger said. “It’s been difficult to get accurate information about this, especially when the BC Ministry of Health’s own website seems to suggest access to surgery takes only a few weeks.”
Published this week in the BC Medical Journal (BCMJWaitTimes) and funded by the BC Orthopaedic Association, the province-wide study looked at wait times for orthopaedic care in all five health regions and examined regional variations as well. The data was collected from 49 orthopaedic surgeons between May and July of last year.
“All health authorities have long waits for consultation and surgery, with some variation by region,” Dr. Younger said. “The bright spots with lower wait times for consultation were regions in which there are surgeon-led multi-disciplinary clinics that utilize centralized intake and ‘first available surgeon’ strategies to reduce wait times.”
Drs. Younger and Wing pointed out that the province’s announcement last month of more funding for hip and knee replacements do not address the trauma surgery increases created by our growing and aging population. “Orthopaedic surgeons cover both elective surgery and fractured bones,” Dr. Younger explained. “The fractures are often managed at night and over weekends, and amount to over 50% of the work performed by orthopaedic surgeons.
“We feel strongly that unequal access to care is a violation of the Accessibility Principle of the Canada Health Act and indeed, restricted access to care may be viewed as a human rights violation. We take these ethical and legal considerations seriously,” Dr. Younger said. “In addition, we treat many children, teens and young adults who may face lifelong disabilities or missed opportunities without appropriate and timely care.”
The BCOA 2017 wait time study, will be repeated later this year.