Vascular surgery woes overstated, says Sydney physician
‘This is not a problem area, compared to some of the others’
A doctor in Sydney says there are legitimate concerns about the current state of health care in Cape Breton but access to vascular surgery isn’t as poor as it’s been presented recently.
In an interview Tuesday, Dr. Rex Dunn said a vascular surgeon did leave the region but that doesn’t mean there is no vascular service available. Dunn noted that he himself has not retired and still dedicates about four days a month to surgeries, sees patients in the vascular clinic and performs services for dialysis patients. There is a 0.6 full-time equivalent position based in Cape Breton, which he currently fills.
There is also a visiting vascular surgeon who travels regularly to Cape Breton from Halifax.
“Letters have been sent out to explain what the service will be and now has become,” he said. “You should be reassured that there is a way for timely consultations, timely surgery, whatever surgeries are appropriate to do here, we will continue to do them.
“This is not a problem area, compared to some of the others.”
Dunn acknowledged most of the procedures he does are considered to be on the more minor end of the scale, but they are still necessary, and he would also respond if called to a vascular emergency.
He added he is acutely aware of the difficulties the region is facing in recruiting in certain specialties and the concerns of doctors that their voices are not bring heard.
In a letter to the Cape Breton Post, Dunn noted that with the departure of the previous vascular surgeon, administration both locally and provincially supported the development of a hospital-based vascular clinic, located in the Health Park. It operates two days each week. There, Dunn alternates with the visiting vascular surgeon and local doctors have been sent contact information for referrals to the clinic.
The approach to more complicated vascular surgeries has changed, Dunn said.
“This is a tremendously changed specialty over the past 30 years,” Dunn said. “A lot of this work is done in vascular suites that are highly technical and combined with some surgical procedures, so if you want your patients to have the best they should have access to that.”
Dunn said the issue here is looking at what is practical versus what is reasonable.
“If you are going to get a recently trained vascular surgeon at the top of their game, they would end up working alone. there’s no cross-coverage for them here so you would be on call 365 days a year, it’s just not sustainable,” he said.
He said Prince Edward Island went through a similar situation and the single vascular surgeon there essentially “collapsed under the strain,” and instead moved to a model similar to that which now serves Cape Breton.
“You need something that will be sustainable for a long time,” Dunn said.
Dr. Mahmood Naqvi is a former medical director of the Cape Breton District Health Authority. It’s his opinion that the level of vascular surgery currently available in Cape Breton is not adequate. He has argued that due to the current lack of a full-time vascular surgeon there are patients who are being transported to Halifax and ending up with amputations or worse.
“Only consultation service is available at this time by a consultant vascular surgeon visiting surgery on a regular basis,” Naqvi said. “There has to be a full-time vascular surgeon practising from Sydney, not from Halifax.”
The less complicated vascular surgeries, including amputations, can be performed by other surgeons, Naqvi said. He said the visiting surgeon doesn’t perform operations in Cape Breton, instead those patients are transported to Halifax.
“Vascular surgery is presently very limited in Sydney and we need to have a full-time vascular surgeon,” he said.
Dunn said he has the greatest respect for Naqvi, but he disagrees that the vascular service locally has deteriorated. He added he’s not aware of any delays resulting in increased amputations.
It’s been about 18 months since there was a full-time vascular surgeon based in Sydney, Naqvi said.
“People should know that we’ve been losing so much health care from this area that in the coming generation it will be very difficult to improve health-care services,” Naqvi said. “If you live in Cape Breton Island, your chances of living is two years shorter than if you lived in mainland Nova Scotia.”
Dr. Rex Dunn says that while a vascular surgeon has left the region, that doesn’t mean there is no vascular service available on the island.
Dr. Mahmood Naqvi believes the level of vascular surgery currently available in Cape Breton is not adequate.