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Orthopaedic Surgeons Say Surgical Wait List Remains Too Long at PGRH

By 250 News

Tuesday, July 07, 2009 04:00 AM

Prince George, B.C.- It has been three months since orthopaedic surgeons in Prince George announced they would no longer take new patient referrals, at the time they said their surgical waiting lists were too long.
Northern Health responded saying changes were in the wings, changes that would ease the pressure.
 
Orthopaedic surgeon, Dr. Mike Moran says since then, things have gotten worse, not better “Last week, I  operated on a patient who has been waiting three years for their surgery” says Dr. Moran. He says his operating room time over the past three years has averaged five and a half hours a week.  
 
Dr. Moran is asking why other facilities in the province have been able to clear their orthopaedic surgical back log, but PGRH has not? 
 
The most recent information on the Province’s surgical wait list indicates that when it comes to hip replacement, Prince George has the lowest case completion to waiting list percentages in the Province.
(Hospital Location)
Patients Waiting
Cases Completed for the 3 Months ending Apr 30/09
% Completion to Wait cases
Province of BC
1489
1104
74%
 
 
 
 
Abbotsford (ARH)*
22
29
131%
Burnaby
37
36
97%
Campbell River & District
53
25
47%
Chilliwack
30
27
90%
Comox (St. Joseph's)
8
22
275%
Cranbrook
17
16
94%
Dawson Creek
21
7
33%
Duncan
40
28
70%
Greater Victoria
61
96
157%
Kamloops
85
40
47%
Kelowna
122
90
73%
Kitimat
2
6
300%
Langley
40
29
72%
Maple Ridge
14
14
100%
Nanaimo
66
60
91%
New Westminster
8
9
112%
North Vancouver
66
61
92%
Penticton
32
21
65%
Port Moody
19
10
52%
Prince George
125
27
21%
Prince Rupert
3
2
66%
Richmond
49
48
98%
Surrey
36
24
66%
Trail
24
24
100%
Vancouver (St. Paul's)
18
23
127%
Vancouver (U.B.C.)
212
189
89%
Vancouver General
185
94
51%
Vernon
69
30
43%
White Rock
25
17
68%
 
Dr. Moran was hailed as a hero nine years ago when thousands packed the CN Centre to call for improvements to the delivery of health services in the north. He had made a commitment to stay in Prince George at a time when other specialists were leaving town to find greener pastures elsewhere., He says the surgical wait lists tell only part of the story, “There are hundreds more who are waiting just to see an orthopaedic surgeon in Prince George.”   He says he and his colleagues stopped taking new referrals because those patients would be waiting too long to see a surgeon here and longer still to have their surgery. 
 
 “In the lower mainland, the surgical waitlists have been virtually eliminated in many hospitals” says Dr. Moran, who points to Richmond, which he says opened multiple operating rooms to make a significant dent in their wait list.
 
Dr. Moran says while it is typical for Prince George Regional Hospital to keep only 4 operating rooms going during the summer months as staff take holidays, the current situation is far worse, with PGRH down to 2.5 operating rooms right now “We have lost OR (operating room) nurses, lost two anaesthetists and only found one replacement.” While aware Northern Health is facing some budgetary challenges, he is concerned the patients will be the ones to pay “The easiest way to save dollars is to keep the OR closed” says Dr. Moran.   If the OR is closed, there is reduced need for services throughout the hospital from nursing staff to the laundry department.
 
Northern Health Communications Manager Steve Raper disagrees.  He says the Hospital is running 4 OR's (as was promised)  for the summer, and that the situation should improve this fall "We have recruited two new anaesthetists, one will start in August the other in September and there is a potential for a third".  Raper says  the nursing staffing  situation is "stable" but there may be some shortages because of illness or retirements.  As for  the budget challenges,   "We are still in the proces of budget planning but  we are  going to keep it (cost savings) away from the patient front." Raper says  they hope to  find savings through administrative areas.
 
“There was a promise of changes three months ago that would make things better” says Dr. Moran who has been waiting to hear from  Northern Health just what changes would be made to improve the OR situation, “Since then the silence has been deafening.”

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Comments

The question is why are we were we are?
Are we committing our dollars in a different area?
If all hospitals are funded equally, then where are the dollars being spent?

Next question is why the difference in data. Are there 4 OR's operating full time or not? Considering Dr. Moran's history in this city, I tend to believe him.
A friend will be starting her 4th year of nursing and has been advised by the hospital, they will be laying off nurses and not hiring any new ones. So.... what is that all about? I realize the hospital/or powers that be regularly lay off the nurses then call them back on overtime. I think there needs to be a serious rethink on how matters are organized not only at the hospital but also within this Health Authority in the Region
I agree, I also believe Dr. Moran.
My child has chrones desease and when in a flare up we spend many nights in the emergency. We have never been able to be seen and out of there in less than 5 hours and most of the time over 7. I had to go to White Rock for surgery 3 months ago and on the day I was released I had to visit the Port Coquitlam emergency. I was checked in, seen by the doctor and released in under 2 hours. It was a Friday night and 10 times busier than this emergency every is. It is rediculous! I have seen so many gross things going on in there such as new patients put into beds/cots where the bedding has not been changed from the previous patient. (this I seen more than once!). I can not and will not believe that a doctor would say anything to the press that was untrue. I believe what he says! IMO The people who run our hospital are putting all the money into administration and ultimately taking from staff that actually care for us. Someone needs to be replaced and soon. God forbid that we ever see a epidemic here where lots of people get sick. You got to wonder when your own doctore sends you to Vancouver for surgery and says " I dont want you having that here!".
what I don't get is when you phone for an appointment with your doctor they are booked up solid they will tell you when your doctor will be at the walk in clinic and to go there that is pretty bad, you try to stay out of emergency and walk in clinics but when you can't get an appointment you have no choice.
Once again we have this so called great City, Jewel of the North, BC's Northern Capital, not living up to its hype.

Why are we the worst at 21%. If you think that this type of publicity does not impact on whether or not people come to this town, you are just kidding yourself.

We need to provide better hospital services, lower taxes, better roads and infrastructure so that people will want to come here and stay here.

People in the outlying areas count on Prince George for these services, and we have a responsibility to provide them. We have people at Northern Health that get paid close to one quarter of a million dollars per year to solve these ;problems, and its time that they did so.

Its time to get rid of the accolades, and put pressure on these people to provide the leadership and organizational skills that they are being paid to provide. Less pomp and circumstance, and more basics, is what we need.

We shuld be striving to ;provide the best hos;pital services in British Columbia.
"Less pomp and circumstance, and more basics, is what we need."

Palopu for Mayor! (I'll vote as many times for you as I am legally permitted to do).

Well said Palopu! Thank you. :}
Simple answer, as to why:
Too much bureaucracy.
Too many administrators.
metalman.
Bang on Palopu!
Well said!
Prince George may be worse off than other hospitals in the Province but since Gordo has stated that he wants our health care system to emulate the present U.S. system you may be assured that things are only going to get worse.

I understand that he plans on a multi billion dollar International Health Care facility to be built with private and government funds on the U.B.C.grounds and that it will operate on a user pay basis so you can bet that this is going to suck a lot of the quality doctors and nurses out of the public system and starve the latter system even more both staff and funding wise.

To think I voted for this guy. He is even starting to make the N.D.P.look good. :-((
"Dr. Moran is asking why other facilities in the province have been able to clear their orthopaedic surgical back log, but PGRH has not?"

I would think that he is closer to anyone on here to being able to provide that answer.
Looking at the little information provided, the second column provides the cases done in 3 months. If the cases waiting in the first column is divided by the patients done in the second column one would get an average number of months or weeks it would take to process the waiting patients.

The average waiting times for some key communities then become:
1. Prince George = 60.2 weeks
4. Kamloops = 27.6
6. Vancouver General = 25.6
14. Kelowna = 17.6
15. UBC = 14.6
17. Nanaimo = 14.3
25. St. Paul’s = 10.2
27 Greater Victoria = 8.3
29 Kitimat = 4.3
The provincial average is 17.5 weeks.

However, the site which provides this information has more detail on it. It includes the actual surgeons in each hospital, their patient numbers waiting for an operation and their personal wait time.
http://www.swl.hlth.gov.bc.ca/swl/swl_db/swl.WaitlistPkg.GetWaitListBySurgSpecNLF?IHospital=102&IEvent=93.51

There are a total of 108 surgeons on the lists with 13 of them having patients with operating times in 2 hospitals.

Dr. Moran has the longest waiting time at 63.8 weeks with 46 patients. There are no stats given with the numbers of cases completed in the last 3 months for individual doctors, just for the hospital total for all doctors operating there.

Dr. Richardson in Vernon is the second longest at 52.6 weeks with only 6 patients waiting.

Dr. Van Der Merwe in Kitimat is the third longest at 34.8 weeks with only 2 patients waiting. How that works with his past 3 month record as reported for the Kitimat hospital, I do not know. Could be he is taking a half year off or the operating room is shut down for a while. Or maybe he is a new doctor and it is another doctor who provided the stats for the last 3 months. These are the kinds of details we really do not know.

The best for length of waiting time in Prince George is Dr. Nelson at 11.7 weeks with 6 patients.

If you can become Dr. Malish’s patient in Kelowna, you can join the 3 others and have an average waiting time of 2.1 weeks.

Questions that are not answered in the article.
1. Why the vast difference in the number of patients per doctor
2. Why the vast difference in waiting times with various doctors which does not seem to correlate very well with the number of patients (Dr. Dreyer in PG has 33 patients, yet a below average waiting time of 12.8 weeks)
3. Why is Prince George sitting with such long wait lists when other hospitals in the Northern Health region are not?
4. What is the number of new patients coming in each 3 month period. Without that we cannot see whether we arte moving towards lower numbers over a foreseeable future.
5. Why bother providing statistics that are incomplete and thus are meaningless?

Since this tracks hip replacements only, I assume the main reason is that some doctors have other preferred operations they do, thus hip replacements get in line with many other surgeries, while other doctors may specialize a bit more in such surgeries.

Maybe Dr. Moran could provide a better explanation for what is going on than the teaser provided.