Abbotsford cancer patients face surgery delays so out-of-town doctors can perform hip/knee operations at ARH

Abbotsford cancer patients face surgery delays so out-of-town doctors can perform hip/knee operations at ARH

Surgeons say focus on joint operations and a lack of anesthesiologists leave local patients waiting

This story has been updated with comments from Fraser Health and the provincial Health Ministry.

Surgery patients in Abbotsford, including those with cancer, are facing longer wait times because the city’s overcrowded hospital has become a regional hub for knee and hip operations, local doctors say. A

A lack of staff – and particularly a shortage of anesthesiologists – means a provincial drive to reduce wait times for knee and hip surgeries has left Abbotsford patients waiting significantly longer, more than two dozen physicians have told the provincial government.

The province and Fraser Health said developing a new knee and hip surgery program in Abbotsford was done in consultation with local doctors. But for several months, those doctors have been expressing concerns about the effect of the program on local residents.

In a letter sent in June and obtained by The News, an Abbotsford cancer surgeon warned Health Minister Adrian Dix that wait times for her services had increased by around 50 per cent.

The situation hasn’t improved and on Oct. 17, more than 30 surgeons and anesthesiologists sent a letter to Dix telling him that the government’s push to reduce hip- and knee-surgery wait times and trouble recruiting and retaining anesthesiologists was leading to longer waits for Abbotsford and Mission residents who needed surgery.

That letter (read below) said the problem was linked to the selection of Abbotsford Regional Hospital (ARH) as a site where out-of-town surgeons can come to perform hip and knee surgeries.

“As of September 2019, this program will displace the much-needed care of many local residents of Abbotsford and Mission,” the letter states.

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Surgical wait-list figures bear that out. The number of people waiting for medically necessary surgeries across the Fraser Health Authority has risen by 14 per cent, according to a surgeon patient registry obtained by The News.

ARH gets extra money to host out-of-town surgeons, but local doctors say that money hasn’t fixed the staff shortages that are taxing the system.

Although the surgeons and patients are coming from elsewhere in the Fraser Health region, which ranges from White Rock to Boston Bar, operating rooms rely on Abbotsford-based nurses, support workers and anesthesiologists. Most surgeries are still performed by Abbotsford surgeons on local residents. But about 40 per cent of those patients who receive hip and knee surgeries are from outside communities.

Patients also recuperate in beds at ARH, which has operated more than 15 per cent over capacity for years. Last month, Dix admitted the hospital faces “extraordinary challenges.”

The doctors say an inability by Fraser Health to hire and retain anesthesiologists is at the heart of the issue.

Over the last year, the hospital has lost three of 12 anesthesiologists, a situation the doctors’ joint letter says has resulted “in a critical shortage to the extent that essential services are likely to be compromised.”

The letter sent by the cancer surgeon in June highlighted the issue, saying the hospital had struggled with maintaining a full complement of anesthesiologists for years.

That doctor, who spoke to The News this week but wished to remain anonymous to protect her practice, said anesthesiologists are both overworked and paid significantly less than counterparts in Vancouver. That makes it difficult to recruit newcomers.

The doctor said Fraser Health has refused to use a private recruiter to find new anesthesiologists, and instead relied on a “passive” process that hasn’t yielded any results.

Catherina Mattheus, the co-chief of the anesthesiology department, said doctors want to see the “regional bureaucracy move out of the way” and allow local doctors to work directly with health recruiters.

“Abbotsford is itself: it is not generic B.C. or Lower Mainland,” Mattheus said in an email to The News. “If we want to recruit here, we need to sell Abbotsford and its strengths. Until we do that, we won’t have much success against the major centres.”

Until new anesthesiologists come on board, Mattheus says the priority should be on serving the local community.

The provincial health ministry has rebuffed The News’ request to speak with Dix. Instead, a ministry spokesperson has promised a statement.

The ministry statement said: “We know there is high demand across the province and the country for anesthesiologists. And we support ongoing recruiting and retention efforts at all health authorities.”

The statement pointed to money to reduce surgical wait times, and said it welcomes input from health professionals.

“As part of the strategy, Fraser Health developed the hip and knee surgery program at Abbotsford Regional Hospital in consultation with physicians. It was agreed the site had additional capacity and three additional operating rooms per week could be dedicated to the hip and knee program without taking away time from other surgeries.”

Fraser Health spokesperson Tasleem Juma also said doctors were involved in the planning process for the Abbotsford hip-and-knee-surgery program.

She said three-quarters of those surgeries are performed by Abbotsford doctors, and 61 per cent are done on Abbotsford residents.

Juma also said that it had been hoped that the hip-and-knee program would actually make Abbotsford more attractive to prospective anesthesiologists by increasing the amount of work that is available during the daytime. She said work continues on the recruitment and retention side.

“Everyone wants to make sure that patients are getting the best care possible.”

But while the authorities say local doctors were on board from the start, the cancer surgeon says that wasn’t the case when it came to “frontline surgeons,” who she said were never in support of the move.

“The original promise was that this extra joint time was not going to come at the expense of our local surgeons, but it doesn’t take much to see that this wasn’t true.”

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Abbotsford cancer patients face surgery delays so out-of-town doctors can perform hip/knee operations at ARH

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