Manitoba to allow U.S. option to cut spinal surgery wait list By: Danielle Da Silva Posted: 3:10 PM CST Wednesday, Jan. 19, 2022 Last Modified: 7:13 PM CST Wednesday, Jan. 19, 2022 Updates

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Manitoba is sending some patients out of province and shifting thousands of cases to private clinics in an effort to reduce a massive surgical backlog amid the COVID-19 pandemic.

The province is finalizing an agreement with South Dakota-based organization Sanford Health to perform operations on patients who have spinal stenosis, chronic degenerative disc or who require other spinal surgery at its centre in Fargo, N.D.

A few hundred Manitoba patients could be eligible. However, referrals will only be made as capacity at Sanford Health allows as COVID-19 disrupts operations and staffing. No such surgeries were scheduled, as of Wednesday.

“This is an interim measure while Manitoba builds its own capacity and a new option for patients who are willing to travel and have the cost of their care still covered by this province,” Health Minister Audrey Gordon said during a news conference at the legislative building, alongside members of the newly minted diagnostic and surgical recovery task force.

Complex, outpatient or life-threatening cases will not be eligible and potential Fargo candidates will be asked if they want to undergo surgery south of the border. The cost to the province will be comparable to providing the operations in Manitoba.

“This is an interim measure while Manitoba builds its own capacity and a new option for patients who are willing to travel and have the cost of their care still covered by this province.”
– Health Minister Audrey Gordon

“This is in no way a forced approach,” the health minister said. “This is having discussions and reaching solutions that ensure the person doesn’t continue to suffer or their case or their injury doesn’t worsen.”

There are no plans to send patients awaiting other procedures to Fargo, but that option hasn’t been ruled out, officials said.

The task force also outlined three other initiatives developed since the committee was formally announced Dec. 8.

Over the coming months, approximately 2,000 patients requiring gynaecological surgery will be referred to the Maples Surgical Centre in Winnipeg for treatment under a new agreement with the private facility.

An estimated 3,000 people are in need of gynaecological surgeries, with some waiting since 2019. About two-thirds can be performed as out patients.

Meanwhile, the province will change how it screens for colorectal cancer to reduce demand on endoscopy services.

Some 10,000 Manitobans were estimated to be waiting for an endoscopy, as of Wednesday; pre-pandemic, the wait list was about 1,500.

Fecal immunochemical tests will now be the primary screening tool. The change is expected to reduce the backlog by 10 to 15 per cent per year, the province said.

Up to 13 new anesthesia clinical assistants will also be trained and hired over the next three years to support operating rooms across Manitoba.

Dr. Peter MacDonald, chairman of the task force steering committee, said the group has been focused on implementing short-term solutions to help patients needing care, while high-level planning continues to deal with systemic issues.

However, HR issues underscore many of the current challenges.

“We’re sensitive to that, in having to train or come up with alternatives in terms of a human resources plan,” MacDonald said. “We’re looking at it actively. It’s our biggest problem, it has many common threads, it overrides a lot of our wait-list issues, so we really want to concentrate on human resources.”

No timeline has been established to clear the surgical and diagnostic backlog because the impacts of the pandemic on planning can’t be predicted, MacDonald said.

Dr. Ed Buchel, head of surgery with Shared Health, said the task force has started recruiting new surgeons to the province, alongside the training and hiring of licensed practical nurses and anesthesia clinical assistants.

Buchel said the recruitment plan is focused on areas where services can be ramped up quickly and based on current case volumes and capacity. Hiring targets have been set in each surgical specialty.

“If you’re looking at what we’re going to need, the wait list kind of tells you,” Buchel said. “There’s an active recruitment because it takes months to recruit surgeons.”

Buchel said he hopes to have an accurate surgical wait list as early as spring, following the implementation of a new information management system.

Doctors Manitoba president Dr. Kristjan Thompson said Wednesday he was encouraged.

The physicians advocacy association has been calling for the province to take action since June, and estimates nearly 60,000 surgical cases and more than 95,400 diagnostic cases have been delayed.

“Physicians’ top concern is seeing their patients get the tests and treatment they need as quickly as possible. Though we would like to see more capacity built here in Manitoba for local physicians to be able to meet the care needs of their patients close to home,” Thompson said in a statement.

Uzoma Asagwara, health critic for the Opposition NDP, described the plan to send patients out of the country for surgery as unacceptable and called the task force’s update a disappointment for many Manitobans.

“Yet again, another government announcement that was short on details, had no timeline, and no target date attached,” Asagwara said. “What we were left with was many unanswered questions and again many Manitobans simply waiting.”

— with files from Chris Kitching

danielle.dasilva@freepress.mb.ca