Overworked surgeons at risk of errors: sources
Surgeons at the McGill University Health Centre say they’re at risk of burnout and are worried about making errors on the operating table because they now have to work late into the evenings doing the administrative work once performed by secretaries.
Several highly placed sources — including doctors — have told the Montreal Gazette that the budgetslashing decision to cut back on secretaries is overburdening surgeons and other specialists. The sources spoke on condition of anonymity, saying they were not authorized to speak to the news media and some feared professional reprisals.
“It’s dangerous because the doctors are tired,” said a highly placed source. “There are surgeons still at work at 10 o’clock at night catching
up on paperwork. They’re pulling up charts, sorting test results, booking and scheduling things. These are doctors who trained for more than 15 years to become surgeons and you’re now asking them to do administrative typing and filing.
“Then they’re back at the hospital at 6 a.m. scrubbing and doing back-to-back surgeries all day,” the source added. “They’re becoming sleep-deprived.”
The MUHC has eliminated dozens of secretarial positions at the Glen site and is now doing so at the Montreal General, which specializes in orthopedic surgery.
The decision to reduce the number of secretaries is in response to more than $28 million in budget cuts imposed by the Quebec Health Department.
The government contends that the MUHC has been spending up to 30 per cent more on its secretarial pool than other hospitals in Quebec. As part of the reorganization, the MUHC has set up a centralized booking service and is requiring doctors to share secretaries.
Clinics are being combined into clusters to streamline some of the administration.
The MUHC is also considering the possibility of using voicerecognition technology for certain tasks.
Dr. Ewa Sidorowicz, director of professional services at the MUHC, acknowledged the hardships of some of the doctors.
“It’s a very big change for everybody,” she said in an interview Friday.
“We’re trying to mitigate the problems but it is creating anxiety. I’m not denying that. It is difficult.”
“We have to reorganize the ambulatory areas,” Sidorowicz added, “and that is difficult, because again, the model — in particular in surgery — was that the secretary would do a lot of these tasks: take care of the clinic, take care of the (operating room) booking, take care of the doctors’ correspondence. Unfortunately, that kind of model is — with the budgets that we have nowadays — just not sustainable.”
Another source said that some specialists are seeing fewer patients because of all the extra paperwork. The source estimated that up to 30 secretaries are being cut from the various surgical departments.
Sidorowicz was unable to confirm that number or say how much will be saved from reducing the secretarial pool. However, she did confirm that 20 fewer secretaries will be working in administrative support at the adult site of the Glen as well as the Montreal General.
“There were a lot of secretaries at the MUHC, and this ended up with us being very, very expensive relative to other hospitals, ” she explained. “The ministry has said in no uncertain terms that it will not tolerate that. We have had to look at how to reorganize all of these support services, and the transition is happening now, so I’m not surprised that you’re getting calls.
“It’s a cultural change but it has to be done, keeping in mind, though, that we want to make sure that the patients are well-served.”
Asked about the comments by some surgeons that they’re worried about making errors on the operating table, Sidorowicz responded:
“What I would say is come talk to us. We’re trying to reach out to as many people as we can, to hear their concerns and to see how things can be mitigated. I have a lot of respect for all of the docs who are working at the MUHC, and all of our staff.”
But a source said that MUHC management doesn’t seem to understand the importance of the secretaries: “There seems to be very little recognition of the vital role that medical secretaries play within the clinical team, the invaluable support that they provide to the physicians, patients, medical students and residents, and countless colleagues across the health-care network.”
The MUHC is negotiating with the government to secure more funding for surgery and other medical services to take into account the increase in clinical volumes.
Aware that the Health Department won’t budge on the issue of secretaries, the MUHC has decided to focus the negotiations on areas where the government might be willing to make concessions.