Spotlight on Health – Wait Times
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Georgia Balogiannis: In this podcast the Ontario Medical Association looks at current issues of interest in health care. Spotlight on Health gives you all the straight talk. We're Ontario's doctors and your health matters to us. I'm Georgia Balogiannis for the Ontario Medical Association.
Balogiannis: The COVID-19 pandemic has created a backlog of 21 million surgeries and procedures, adding to wait times that were already too long. In this episode, we speak to Dr. Mary-Anne Aarts, chief of surgery at St. Joseph's Health Centre, who shares how delayed surgeries are affecting patients.
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Dr. Mary-Anne Aarts: We service about 500,000 people at St. Joseph's Hospital in Toronto, and our community, and we have 400 hospital beds. We have one of the busiest emergency rooms in the city.
Even prior to the pandemic, there was a waitlist for surgery. And this only grew during the pandemic to make up this backlog that we now have.
When I started on as my role of Chief of Surgery at St. Joe's, there were about 3,000 people on the waitlist — this was this past June in 2021. And really what we did was try to mobilize all the resources that we had in order to manage and treat these people that have been waiting. We opened an extra operating room, we extended our operating days, and despite all of these measures and getting our number of cases up to 110%, we hardly made a dent on our waitlist.
By December of this past year, our waitlist was still around 3,000 people waiting for surgery. Now, with this last wave of Omicron, we've seen that number just rise — it's about 3,200 patients.
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Dr. Aarts: Each wave of this pandemic, most non-urgent and non-emergent types of surgery have been put on hold in order to have enough hospital beds and resources to treat very sick patients of COVID. As a result, this means that individuals waiting for surgery have been asked to wait — wait for shoulder surgery so that they can be independent and dress themselves, wait for hip or knee surgery so that they can walk or exercise or return to work. The years have passed and many of these patients are still waiting.
We are going to see a real increase now in patients returning to the hospital, to the physicians, and we're going to have increased demand on our services for diagnostic reasons and also for surgery. So, that's what we're trying to brace ourselves for, and what we're most concerned about – that our backlog is going to increase, our wait lists are going to increase because of this. So, that's what we have to prepare ourselves for.
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Dr. Aarts: I think one of the things is, when we talk about these surgeries — which are non-urgent, non-emergent — they're not elective surgeries. All these people on this list have not chosen to have surgery, they need it. And we've just been kind of pushing them down the list as a more urgent case comes along. And that's just how we prioritize in an acute care hospital. That's all that we can do. But all of these patients are suffering emotionally, psychologically, often many of them are using opioids on a daily basis to manage their pain, and they're not working.
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Dr. Aarts: There was a directive from the Ministry of Health in place where we were only doing urgent and emergent surgeries. That was partially lifted and we are now resuming at least 70 percent of our elective or scheduled surgeries.
This has its challenges though. There are a lot of patients that are still taking up acute care surgery beds, so we do not have many beds for patients who are undergoing scheduled surgeries that need to be admitted. There's still some I.C.U. requirements, so we're not yet at 100% or even at 110% — it's been kind of a graduated increase. And really, it's because of the demand for the hospital resources that we haven't been able to move more quickly.
As a surgeon, it's really hard to see this. It's really hard to not be able to offer patients care who are waiting and in need of it.
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Balogiannis: This podcast is brought to you by the Ontario Medical Association and is edited and produced by Jodi Crawford Productions. To learn more about the Ontario Medical Association, please visit oma.org.
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