Orthopaedic surgeries down 25% in B.C. public hospitals as private sector picks up slack

The surgeons who replace worn-out joints and fix broken bones report that they’re doing only three quarters of the surgeries they used to in British Columbia's public hospitals, with an increasing number of taxpayer-funded procedures carried out in private facilities.

The anecdotal figures come as multiple orthopaedists have contacted CTV News to report wait times have grown so long for their patients, some of them are no longer seeing new people for assessments.

“In terms of the days I have allotted in the operating room, they're still running at maybe 75 per cent (of what it used to be),” said Dr. Cassandra Lane Dielwart, president of the BC Orthopaedic Association, from her practice in Kelowna. “We're booking less surgeries, we're putting less people into that surgical slot because we don't have the hospital capacity to get the same amount of work done.”

Dielwart and other healthcare workers describe a scarcity of experienced peri-operative nurses, staffed recovery beds, and other resources resulting in fewer patients each day a surgeon takes up a scalpel. 

On the North Shore, Dr. Richard Nadeau said that where he used to have around six dedicated operating room days a month pre-pandemic, he only gets about four now.

“The time from when they see a surgeon to the time they have surgery, there's a higher proportion of patients that are waiting longer,” he said. “These patients do live with a significant amount of pain and disability so we do want to advocate for them.”

MORE PRIVATE CENTRES PERFORMING PUBLIC SURGERIES

This comes at a time the health minister says that the province is performing record numbers of surgeries.

“The number of people waiting for surgeries has dropped,” claimed Adrian Dix on an appearance of CTV Morning Live on Monday.

But sources say not only are surgeons willing to see fewer new patients as wait times grow, they’re also sceptical of all the government’s claims because only part of the patient’s experience – from the time their pain begins to the day they have a hip replacement, for example – is captured in government statistics and doesn’t include delays in medical imaging.

Dielwart revealed that government has increasingly gone to privately-operated surgical clinics for day procedures, like arthroscopic surgery, which is contracted with taxpayer dollars so the patient doesn’t pay. She emphasized there are wide variations in wait times and reliance on private surgical centres throughout the province.

In the 2020/2021 fiscal year, the province spent a record $27 million for private delivery of public healthcare at surgical clinics, so CTV News asked the ministry of health for updated numbers; four business days after our request was made, they still have not provided them. 

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Despite criticism that there’s only one pool of healthcare workers in the province and use of private surgical centres undermines the public system, Dix has defended the growing use of those centres since the numbers are so small: from 3.5 per cent of total surgeries in 2018 to 4.4 per cent in 2020.

“Having a small number of surgeries that increase our capacity,” he told CTV News last August. “As long as there's no extra billing and they follow the Medicare Protection Act, I don’t have any objection to that.

But even Dielwart, who has been a proponent of the increased use of private surgical centres to clear patient backlogs and improve their quality of life, is concerned about the most complex cases relying on a public hospital system that’s deteriorating. 

“My biggest fear and the fear of many different surgeons is this becomes our new normal – that all of a sudden our Canadian healthcare system our British Columbia healthcare system is operating at 75 per cent,” she said. “Efficiencies have gone so low that thinking forward, we're going to have a hard time keeping up even to what's happening right now.”