Wait times to see a medical specialist have long been a serious concern in B.C. There are instances of patients waiting more than a year for hip or knee operations. Some patients with mental-health problems have trouble finding a psychiatrist.
Part of the problem is lack of adequate capacity in hospitals and diagnostic clinics. B.C. has a sufficient number of orthopedic surgeons to reduce wait times for hip and knee procedures, but there are not enough staffed operating rooms available.
Viewed from this angle, insufficient resources are to blame. If we want to cut wait times, we’re going to have to pay. And it does appear likely more money will be needed.
However, there is another way to approach the problem. There are about 5,400 medical specialists in B.C. They include not just surgeons, but geriatricians, urologists, dermatologists and so on. And many of these other specialists have equally protracted wait times.
There is an important distinction here. While the average waitlist within a given specialty might be unacceptably long, there can be significant differences between individual physicians in that field.
It might take eight months to see one gastroenterologist, for instance, yet only three months to see another. We don’t just have a shortage of resources, we make inefficient use of those we do.
Of course, some patients might prefer a particular specialist, and will accept whatever wait time that involves. But many more would happily see whoever is most readily available.
Years ago, the province’s Health Ministry took an initial step to address this problem. A surgical waitlist was set up online.
Using this registry, patients and their family physicians can select the surgeon with the shortest wait time. You can visit the Surgical Wait Times online tool at swt.hlth.gov.bc.ca/.
But as important as this registry is, it deals only with surgeries.
The reason is that most operations are conducted in hospitals or surgical clinics, and these maintain a record of every patient treated, as well as the attending specialist. Along with booking data, that allows staff in the ministry to work out each surgeon’s wait times.
But many other specialists practise in private offices rather than hospitals, and ministry staff lack the information to determine how long their wait times are.
In principle, this obstacle can be surmounted. The province has the authority to ask specialists for the required data. That would make it possible to broaden the surgery waitlist to other specialties.
Unavoidably, though, there are obstacles to overcome. GPs often form a bond of trust with certain specialists, and might be uncomfortable referring patients to someone previously unknown to them.
Then there would be significant difficulties in collecting enough data to present an accurate picture. There are about 50 medical specialties in B.C. It would be impractical to keep track of each one, and a major logistical task just to monitor the most heavily used.
Yet it’s hard to see a justification for keeping patients in the dark, especially when many wait times are well beyond best-practice guidelines.
A point of clarification is needed here. In emergencies, such as a broken hip, the patient is taken to hospital and treated at once. And those with less immediate, but still urgent, conditions go to the head of the queue and are seen much more quickly.
However, when it comes to less compelling, but nevertheless painful or mobility-threatening conditions, the situation is far from acceptable.
We need a better way of directing patients to whichever specialist is most readily available. And the only way to do that is to create an online waitlist that covers not just surgery, but other frequently used medical specialties.
