B.C.'s orthopedic surgeons urge use of private clinics to halt ballooning waits

Faced with physically-deteriorating patients increasingly relying on opioids to manage chronic and debilitating pain, British Columbia’s orthopedic surgeons are urging the province to expand the use of private clinics to mitigate ballooning waits for surgeries.

The BC Orthopaedic Association says musculoskeletal surgeries and procedures ranging from ACL surgeries to joint replacements have been disproportionately impacted by pandemic-driven surgical postponements and more needs to be done to help patients facing crippling pain and diminishing mobility.

"I can't tell you how many times I have to wipe my patients' tears away, when they come into my office and tell me how bad they're suffering and I just have to tell them there's nothing I can do,” said president-elect, Dr. Cassandra Lane Diewart.

“When I speak to my colleagues across the province there's nobody who's gone down in their wait list, people have doubled, people have tripled their wait list.”

Diewart is urging the province to make better use of private surgical clinics, where people living in B.C. but not eligible for MSP pay or have insurance-covered surgeries, in addition to WorkSafeBC approved surgeries for on-the-job injuries.

RCMP are also able to access care there, though there's been a small number of procedures performed with public health dollars in the past.

“I'm not talking about creating a two-tiered health-care system today. I'm talking about using centres and using operating rooms that are functional, well-staffed and provide excellent care and using them to the benefit of this province," said Diewart, pointing out that most orthopedic surgeons only have one or two days' worth of operating room time each week at public hospitals.

LONG-TERM ISSUES AS COVID-19 BECOMES A CHRONIC STRESSOR

Though COVID-19 hospitalizations have slowly been decreasing, those seriously sickened by the virus continue to require specialized hospital care, often in intensive care units. With ICU nurses in increasingly short supply, post-operative care nurses (who have similar training and qualifications) have been redeployed to do that work and are unavailable to support surgical recovery.

That has thousands of British Columbians still waiting for the kinds of procedures that will allow them to return to work, recreation, and even basic activities that are out of reach for them right now.

Surgeons warn that many of them deteriorate from needing a cane and Tylenol, to wheelchairs and opioids as they wait.

Joanna Tremblay’s mother was put on the wait list for a knee replacement just before the pandemic, and while she has a date scheduled in the coming weeks, they are anxious until she actually goes under the knife.

“We're getting into a more and more precarious situation, which is the general weakening of her entire physicality,” she told CTV News. "On paper it looks like it's not life threatening, it looks like you can grin an bear it and put a few handles in your house but I disagree. From my perspective the ‘elective surgery’ they're calling, this has become a life-threatening thing for my mom."

Tremblay described her mother as a once-vibrant, outgoing person who is increasingly home-bound and struggles to handle basic errands and tasks, impacting her mental health.

GROWING CALLS FOR COLLABORATION RATHER THAN DICTATION

Critical cardiac procedures and emergency surgeries have continued as needed during pandemic, but there have been delays in those areas as well.

Radiologists, anesthesiologists, cardiac and general surgeons have all spoken up to CTV News in recent weeks pleading with the minister of health to take immediate and decisive action to address their growing wait times as their patients get sicker and require more medical resources the longer their treatment is delayed.

The orthopedic surgeons have joined them in describing a situation where frontline specialists in surgery, nursing and related fields are not consulted when policy decisions are made at the ministerial level, instead being told about new policies or directions after closed-door meetings.

“The problem is there's been no policy change since the beginning of the pandemic of how we're going to deal with this (surgical backlog),” said Dielwart.

“I don't know if next month we're going to be well-staffed and get a bunch of OR time to catch up or if there's going to be yet another Omicron stealth that's coming through and going to break the system again.”