Manitoba doing more surgeries, but wait times issue unresolved: docs

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Manitoba is funding more surgeries in its health-care system than ever before says Shared Health, even though wait times for medical procedures – and gaining access to specialists – remains a persistent problem say a local doctors.

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“My heart honestly sinks and I get emotional about it when I have to send somebody to the hospital for a test that I know could’ve been done right away,” said Dr. Rob Bohemier of ordering MRI, CT scans and ultrasounds for his patients. “Because I know I’m subjecting people, particularly the elderly and frail, to an environment that is conducive to suffering. And that’s what we are seeing right now.”

Some of Bohemier’s patients are waiting 30-50 weeks for an MRI and 12-15 weeks for CT and ultrasounds.

“It causes harm to wait for tests, particularly procedures for cancer, because patients won’t start chemotherapy until they get a tissue diagnosis,” he said. “I’ve seen patients present to us when their cancer is getting worse because they never got their diagnostic procedure.”

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Although there’s much more to the problem of priority procedure wait times in Manitoba than diagnostic imaging, Bohemier said family medicine patients are seeking CT, MRI and ultrasounds in ERs because of a lack of access. That exacerbates the ER wait time crisis, he said.

“Which is a significant public issue,” he said. “You see people with undiagnosed cancers and gallbladder problems that may have been caught earlier.”

Seeking care in America

There was an uptick in the last year of Manitobans seeking hip and knee replacement and other surgeries in North Dakota, said Dr. Matt Friederichs, founder of OrthoDakota, an orthopedic practice in Fargo that charges around USD $25,000 for same day a total knee replacement.

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“We’ve had a couple police officers and a firefighter come down,” he told the Winnipeg Sun. “They can’t get back to work because they can’t get surgery. They are back to work in two weeks.”

Friederichs said he is concerned for Manitobans, including his own mother-in-law who lives in Brandon. She is traveling to Fargo at the end of September for urgent spine surgery that might not ever happen in Canada.

“You pay whatever percent on your taxes and you can’t get care,” he said, noting the typical demographics in his clinic are 20 to 40-years-old for knee scopes and 55 to 85-years-old for hip and knee replacement.

Not only is OrthoDakota care expeditious, but Friederichs uses the latest technology for less invasive surgery. That means less blood loss and less soft tissue damage. Patients receiving robot-enabled surgery also get a preoperative CT scan for $275.

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Wait time politics

University of Winnipeg political analyst Malcolm Bird told the Winnipeg Sun it’s pointless to blame the previous Manitoba government for current wait time problems.

“This government, in particular, has enjoyed a prolonged honeymoon period, but now the realities of governing are making themselves known,” said Bird, noting the wait time problem is a significant political issue for the NDP, which campaigned on improving health-care access.

“In a year or two they will have to show some tangible improvements,” he said, adding the NDP are working hard to fulfilling their promises.

Long wait times are a cross-Canada problem, said Bird, adding the province faces the difficult task of building in-province access to priority medical procedures as costs rise “at twice the rate of inflation.”

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“This government wants to expand the provision of health-care services through the pubic system,” said Bird.

“What’s important is public health insurance – the single payer system. Whether the delivery of services is done by a public actor or private sector actor, in my mind, it doesn’t matter.

National numbers

According to Canadian Institute for Health Information data, as of 2023, Manitoba had the second longest waits for CT scans in the country (36 days vs 17 day national average). Manitoba had the longest waits for MRI (110 days vs 60 national average).

In 2023, Manitoba had worse-than-average waits for hip replacement (154 days vs 140 nationally). Knee replacement wait was (215 days vs 188 nationally).

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In 2023, Manitoba had worse-than-average waits for cataract surgery (75 days vs 41 nationally). Manitoba had worse-than-average waits for cardiac surgery (11 days vs 8 nationally).

Manitoba in 2023 had worse-than-average waits for radiation therapy (17 days vs 10 nationally), and lung cancer surgery (31 days vs 28 nationally). Manitoba in 2023 had the longest wait times in Canada for breast cancer surgery (28 days vs 20 nationally). Manitoba continues to have the best wait time in the country for hip fracture repair, with a 20 hour average compared to 34 hours nationally.

Emergency room wait times

A Winnipeg doctor is calling for innovation to resolve escalating ER wait times that have seen some patients experience cardiac arrest in waiting rooms.

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The issue is complex, but often comes down to the challenge of transferring patients from emergency department treatment to post-emergency treatment, said Dr. Noam Katz, noting the problem has become worse over the decades because of a lack of innovation from politicians who sometimes “throw money” at issues while avoiding change.

“Many people feel like we are watching the collapse of our system in real time,” he said of ER bottlenecks.

It’s now common for patients to wait up to 15 hours or more for care, a potentially hazardous situation said Katz, who works at St. Boniface Hospital — noting bottlenecks aren’t in ERs, but rather in patient output from ERs.

“If your sink is clogged, the solution isn’t to build a bigger sink,” he said. “You have to fix the clog.”

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In some cases, patients have gone into cardiac arrest or suffered other severe deteriorations in ER waiting rooms, said Katz.

More long-term care beds and more high-quality home care are needed to help alleviate the problem, he said.

Currently the province is creating more minor injury and illness clinics to divert patients from ER’s. In 2023, media reports said one in three patients left the Health Sciences Centre ER without seeing a doctor.

“When you become so jaded and cynical — quite frankly from spinning your wheels in the hospital, I applaud people who are starting to do some of these things on their own,” said Katz of Winnipeg’s privately owned, publicly funded, Minor Illness and Injury Clinic.

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