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Specialists join forces to push B.C. for same recognition as family doctors

Specialists ranging from cardiologists to pediatricians and orthopedic surgeons are pushing the British Columbia government to alleviate backlogs that have worsened wait times.
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The trauma bay is photographed during simulation training at St. Michael's Hospital in Toronto on Tuesday, August 13, 2019. In B.C. Specialists ranging from cardiologists, pediatricians and orthopedic surgeons are pushing the British Columbia government to alleviate backlogs that have exacerbated wait times. It comes as the head of the Canadian Medical Association says it's time for innovative solutions to address the same problem across the country.THE CANADIAN PRESS/ Tijana Martin

Specialists ranging from cardiologists to pediatricians and orthopedic surgeons are pushing the British Columbia government to alleviate backlogs that have worsened wait times.

Their stance comes as the head of the Canadian Medical Association says it's time for innovative solutions to address the same problem across the country.

Twenty-six doctors sent an open letter Wednesday to Health Minister Adrian Dix, saying they want an urgent meeting with him due to a "crumbling" health-care system that is leaving them "exhausted and demoralized."

By Thursday, 135 specialists had signed the letter, which was uploaded to the Consultant Specialists of BC website.

"Patients are getting sicker and dying on our wait-lists," says the letter, which outlines examples of the effect on patients, including one who experienced sudden hearing loss and permanently lost their hearing after waiting too long to see a specialist.

It says one million patients in B.C. are waiting to be seen, based on data from the Consultant Specialists of BC, which surveyed members in August.

Dr. Chris Hoag, a North Vancouver urologist who signed the letter, said a broad base of specialists joined forces to pressure the government to act because they're burned out while trying to see more patients that have become sicker.

"I do everything I can to keep that wait as short as possible. But you know, there are times when I have a huge load of patients waiting for cancer surgery, and I can't sleep because I don't know how I'm going to get them all done in a time frame that is appropriate."

Unlike family doctors, who have recently received temporary funding of $118 million to offset overhead costs, specialists who run practices that also amount to small businesses have had nothing, Hoag said.

"It's been incredibly distressing to specialists to see that there has not been conversation about the same issue shared in specialty care," said Hoag, president of Consultant Specialists of BC.

"Primary care is an absolute disaster and definitely needs to be fixed," Hoag said about the lack of family doctors, adding that delays referrals to specialists, potentially worsening patients' condition to the point they end up in an emergency room. 

"Then they're taking up hospital beds, which takes away from surgical procedures because we have nowhere to move the patient to out of the (operating room), so we can't do the surgery. So, it's a huge domino effect that's happening and not just isolated to primary care issues."

Even patients with a general practitioner are lingering on wait-lists for an average of 10 months and sometimes up to two years, he said.

Hoag said Dix had not responded to the letter.

The Health Ministry said the minister was not available for an interview, but it provided a written statement.

All doctors, including specialists, have ways to get their concerns addressed through Doctors of BC, the association that represents them in talks with government, the statement says.

Doctors of BC said a so-called physician master agreement that expired in March is currently being negotiated with the government on behalf of all doctors but that the needs of specialists go beyond its scope and can't be addressed through compensation.

"Rather, in many cases addressing specialist wait-lists can only be accomplished through improvements to health authority infrastructure, processes and resources such as increasing (operating room) time," it said in a written statement.

"We fully intend to advocate specialist issues, and work with Consulting Specialists of BC and the different specialty sections," the association said, adding its board would determine when that would happen.

Dr. Alika Lafontaine, president of the Canadian Medical Association, said specialists in all provinces and territories are dealing with a "collective crisis" as millions of patients wait for their services.

"Primary care and specialty care are all being overwhelmed at the same time," he said, adding the letter by specialists in B.C. points to major, unprecedented issues involving multiple problems like overcrowded and closed emergency rooms in various jurisdictions due to a lack of nurses and other health-care providers.

"These sorts of letters were not going out even mid-pandemic," Lafontaine said of the stress that health-care providers are under. 

"There's a human cost for patients, but there's also a human cost for providers showing up to work day after day with this high degree of tension."

Lafontaine said collaboration is needed by provinces and territories to find innovative solutions like more virtual and team-based care, not merely more requests for funding, which has been increased in all jurisdictions.

"I don't think a lot of provinces have leaned into team-based care, making sure that the care is distributed to the right people at the right time and in the right place," he said.

"Places that are decreasing administrative burdens on physicians are definitely creating more time for physicians to provide care," he said of doctors having to repeatedly submit information to multiple regulatory agencies.

Lafontaine called for an emergency meeting between federal, provincial and territorial governments to create a long-term, sustainable system.

He said the association will be gathering this fall with other advocacy groups, including the Canadian Nurses' Association and patient advocacy groups, to discuss how best to address similar needs.

This report by The Canadian Press was first published Sept. 22, 2022.

Camille Bains, The Canadian Press