Wait times to see specialists still growing
B.C. tests patients’ patience more than any other major province
Waiting times to be treated by a specialist doctor in B.C. are continuing to grow and are among the longest in the country, according to a survey by the Fraser Institute.
Median waiting times from referral by family doctor to treatment are 22.4 weeks, or almost six months in B.C., longer than all provinces except those in Atlantic Canada, according to the 25th annual survey of 2,382 medical specialists.
And waits between the first appointment with a specialist and getting treatment are 14 weeks in B.C., the highest since the survey began. The doctors who take the survey are asked to give their best estimates of waits for care.
Waiting for treatment and diagnostic tests is a hallmark of the Canadian health care system, especially for orthopedic surgery, the conservative thinktank observes.
The report’s author is Bacchus Barua, a senior economist with the Fraser Institute. He said Canada’s aversion to “out of the box thinking” is stifling innovation and urged provincial governments to consider procedures in Germany and Switzerland, which have universal health insurance but feature shorter waiting times.
Barua singled out Saskatchewan for having the most dramatic turnaround, going from having the worst waiting times in 2011 (29 weeks) to having the shortest waits (13.6 weeks). He cited a few of the changes made by Saskatchewan — partnering with private medical clinics and setting up a pooled referral system in which patients are matched to doctors with shorter waiting lists.
B.C. Health Minister Terry Lake said that while the methodology of the Fraser Institute survey is always questionable, one can’t ignore the findings. “It’s hard to put much faith in it since it’s a survey, not scientific. But there is no question, some of the waits are far too long.”
Lake said population demographics — a growing and aging population — are a huge contributing factor to growing waiting times. Asked whether B.C. would look more closely at what Saskatchewan has done to improve waiting times, Lake said that province poured huge sums of money — $200 million for a much smaller population — to get control of waiting times when it was lagging behind other provinces.
He said B.C. is always trying various things to improve waiting times; for instance, it has asked health authorities to consider contracting out to private health facilities when waits are too long in public hospitals. Last year, there were 542,000 publicly funded surgical operations performed in hospitals; of the total, only 5,500 were done in private facilities.
While private clinics are limited to bidding on cases in which patients will stay only one night, the government is considering legislation that would permit operations in private clinics requiring patient stays of as many as three nights. The College of Physicians and Surgeons of B.C. is involved in exploring the feasibility of longer stays in private centres.
Lake said part of the mandate for the Provincial Surgical Advisory Committee is to come up with ways to streamline care and shorten waits. Approaches used in Saskatchewan may be copied, especially referrals to the first available surgeon.
A comprehensive human resources strategy for the health sector is also on the government’s agenda. It will take into consideration factors like the aging workforce, the supply of health professionals, their compensation models and how allied professionals like nurse anesthetists or physician assistants might be able to help.
He said a shortage of health professionals is part of the problem, but the government has earmarked funds to help fill doctor and nurse vacancies. The government also wants to expand telemedicine so rural and remote patients can have “virtual” appointments with specialists instead of travelling long distances.
“It’s a system that is working very well in the Northern and Interior health regions, especially for followup visits,” he said.
Dr. Charles Webb, president of Doctors of B.C., was not available for an interview. But in an emailed statement he said: “Wait times continue to be a problem in the system. The ministry has identified it as a priority item and it is for Doctors of BC as well.”
The overall national response rate to the survey was 21 per cent. In B.C., the survey was mailed out to 1,530 doctors and 535 (35 per cent) responded.