Specialist doctors report 1 million B.C. patients on waitlists

Dozens of specialist doctors have signed a letter to B.C.’s health minister with dire warnings that the health-care system has deteriorated to the point that one million patients are waiting to see them.

CTV News has obtained the letter, dated Wednesday, Sept. 21, which describes patients getting sicker and weaker, with worsening prognoses as they wait months or even years to see a specialist who could help improve their quality of life through medical imaging, surgery or other specialized treatments.

“We request a meeting with you emergently, and that is not a word we use lightly,” write the surgeons, pediatricians, dermatologists, immunologists and others.

“We see the decline in specialist care first hand every day and we are exhausted and demoralized; it is soul-destroying to be unable to provide the specialty care that B.C. patients need and deserve.” 

Dr. Chris Hoag, the president of the Consultant Specialists of BC, was blunt when CTV News asked him if the health-care system is on the verge of collapsing, or has collapsed. He cited critical staff shortages in every department and aspect of the system, saying the sickest patients are sometimes the only ones now seen by overwhelmed specialists.

“We are at that state of collapse,” said Hoag, noting widespread emergency department closures and the inability of a million people to find a family doctor in the province.

“It's so distressing to all of us specialists who want to be able to see these patients. We know they're out there and we know that they are deteriorating and we want to be able to help them."

He echoed complaints made by colleagues in the spring, who were the first specialist physicians to allege they were being ignored by government. 

“People in the trenches often feel unheard by the health authorities and by government above them,” said Hoag. “There are a lot of very intelligent people in the trenches, doing the work – doctors, nurses, allied healthcare professionals – and we have a great ability to bring solutions to the table.”

FRONTLINE IMPACTS OF SPECIALIST AND FAMILY DOCTOR SHORTAGES

One of the letter's signatories, the president of the BC Orthopaedic Surgeons Association, said the family doctor shortage has some specialists co-ordinating tests and other care for some of their patients. This means they don’t have time to see as many people who need their special skill-sets, according to Dr. Cassandra Lane Dielwart of Kelowna General Hospital, who says specialists are also facing long delays for medical imaging.

“I walked down to the emergency department to see a patient in consultation the other day and there were patients everywhere and my heart just broke — it looked like a war zone,” said Dielwart. “And what about the person sitting at home waiting for this query of a cancer biopsy? That, to me, is just as gut-wrenching as seeing a full emergency department." 

Dielwart says patients who don’t have a family doctor or have been referred from walk-in clinics often suffer for months or years without physiotherapy or other treatments that could improve their condition in the meantime. She also pointed out the “mental burden” for patients spending months or longer not knowing how serious a health issue is or if it can be treated.

MEDICAL IMAGING A CHOKEPOINT

Medical imaging is now a requirement before virtually every surgery, but with many medical appointments taking place virtually, sometimes patients don’t have a physical exam at all and go straight for imaging.

That has delays growing under the mountain of requests, even though there are record numbers of MRIs, CT scans and other imaging taking place. In smaller communities, scant or no staff to operate the equipment means patients are driving hours to the closest town, while those in big cities are waiting longer and longer.

“It’s worse than when we spoke about this in the spring,” said Dr. Charlotte Yong-Hing, president of the BC Radiological Society and another signatory of the letter.

She noted waits for some services are now four times longer than they were at the start of the pandemic. 

“Many of us have discussed we're probably going to see a tsunami of cancers coming,” she warned. “COVID has exacerbated problems we had before and made things really, I would say, dangerous now in terms of the wait times.”

MINISTRY OF HEALTH RESPONDS TO THE LETTER

The Ministry of Health acknowledged receipt of the doctors’ letter and issued a statement.

“We want to reassure people that we will always meet with doctors when they have concerns or suggestions on how to improve services,” wrote a spokesperson.

He went on to say, however, that “all doctors, including specialists, have avenues to have their concerns addressed, through Doctors of BC who represent them in talks with government.”

For months, physicians of all stripes – from family doctors to surgeons – have expressed frustration to CTV News that formal meetings and negotiations have thus far not produced the modernizations and reforms they believe can improve the system and lead to better care and smoother operations, not all of which require huge sums of funding.

“I don't think there's a good understanding of the extent of the entire health-care crisis,” said Yong-Hing.

“There’s no central database to track the actual number of patients that are waiting to see a specialist,” said Hoag, when CTV News pointed out the million-patient figure would be new information to government.

“While they're waiting, their health is deteriorating and they end up in our emergency rooms, which then takes up a hospital bed and that blocks surgical patients and the problem just dominoes and goes on and on.”