B.C. radiologists sound alarm over backlogs as province claims wait times are down

As the province's radiologists raise the alarm about extensive backlogs impacting patients, B.C.'s Ministry of Health is claiming that wait times for medical imaging and even surgeries are shorter than before the pandemic started.

The BC Radiological Society couldn’t provide specific data for how long waits are for medical imaging (including MRIs, CT scans, and ultrasounds) because the Ministry of Health does not make that data public. But, the society says, waits to access the scans are growing due to aging machinery and staffing shortages that have worsened during the pandemic and grown more acute during the Omicron wave.

"There's an email chain going around right now with the breast radiologists in the Lower Mainland saying, 'Can you take our patients?’ And everyone is saying, 'No, we've got our own crazy waitlist,’" said Dr. Charlotte Yong-Hing, who serves as president of the society, as well as medical director of breast imaging at the BC Cancer Agency, while treating patients herself.

“We all work as hard as we can, but there are not enough ultrasound technicians, not enough ultrasound machines, not enough breast radiologists – there just isn't enough capacity."

Dr. Simon Bicknell, who specializes in diagnostic and interventional radiology, pointed out that most surgeons won’t see patients until they have imaging in hand, and that impacts patients facing all sorts of medical challenges.

"If it's an acute inflammatory event, an abscess can develop and by the time they get to the hospital, that abscess might be bigger,” he said. “If the problem is a cancer, if you've put off getting that assessed by your primary practitioner or a specialist, that can change a stage by just sitting on it and waiting for months."

Bicknell emphasized that patients needing urgent emergency scans are getting them right away. However, while the national standard is 30 to 60 days’ wait for most scans, he said he knows many British Columbians are now waiting months.

MINISTRY OF HEALTH DISPUTES FRONTLINE PRACTITIONERS

British Columbia’s radiologists are speaking up with province-specific concerns and anecdotes in the wake of their national organization warning that patients Canada-wide need more staff and better equipment to handle a backlog that was concerning before the pandemic, but has worsened considerably since. 

That’s why the insistence of B.C.’s Ministry of Health that surgical waits have remained “about the same,” while wait times for MRI exams are “lower” is confounding.

“For MRI exams, not only have health authorities and health-care workers continued to build on the progress that has been made since government launched its Surgical and Diagnostic Imaging strategy, today the wait times for MRI exam are lower than they were before COVID,” wrote a ministry spokesperson.

The spokesperson included two charts showing improvements for the vast majority of surgical waits and MRIs, presented in a format that Bicknell and Yong-Hing found unconventional and baffling. They say the charts’ presentation of wait times is not how waits are typically tracked and the percentile presentation comes without medical indicators.

Notably absent are results for CT and ultrasound scans, which make up a significant proportion of medical imaging in the province. And, the chart does not include priority levels, which the province outlines as having different targets (hours versus weeks). 

SHORT- AND LONG-TERM SOLUTIONS TO IMPROVE OUTCOMES AND REDUCE ANXIETY

Waiting for medical imaging that can tell a patient if they’re a candidate for life-improving back surgery – or whether the tumour causing them discomfort is benign or not – often causes tremendous anxiety; their work and family lives are impacted, in addition to their prognosis.

"That has enormous societal implications," said Bicknell, pointing to loss productivity in addition to quality of life considerations.

“We'd love to run (scans) 24/7, but don't have the workers to do it.”

While it takes years to train technicians and physicians to do the highly technical work, investments in new technology not only increase reliability, but also efficiency. Newer machines require less effort to operate and can provide results more efficiently, often with fewer scans or images required.

In the short-term, Yong-Hing believes the Health Minister could slash wait times with improved compensation for those already on the job.

"It’s a money problem, there's not enough money. If there was money to pay the technologist to provide MR scanning time, to adequately to remunerate the people who are providing the service, I think the capacity would improve,” she said. “Even before COVID, we were overwhelmed, so COVID has just exacerbated the pre-existing situation with unacceptable wait times and outdated equipment."