AVIS FAVARO
CTV health specialist, Oct. 26, 2002
A new study suggests Canada has an alarming shortage of anesthesiologists that is forcing delays in surgery. And the problem is only getting worse.
The study found that Canada needs about 250 more of the doctors right away. Another 1,000 will be needed in the next 15 years. That may not sound like many. But since no operation can be performed without an anesthesiologist to put a patient under and control their pain levels, the shortage means that surgeries are being cancelled across the country.
Canada's largest surgical cancer centre, the University Health Network in Toronto, is already feeling the pinch. The shortage has led to operating room closures, and longer waits for surgery.
The University Health Network should have 100 anesthesiologists at its three hospitals. But at present, it has only 67. That means it is short one-third of its required staff. And to make matters worse the network's anesthesiologists are expected to service Mount Sinai Hospital as well.
As a result, many of those on staff are required to work longer hours.
"There's such a shortage, we could all work 18-hour days and it there still wouldn't be enough of us," says Dr. Pat Murphy of the Toronto General.
A handful of replacements have been temporarily recruited, but Sept. 11 has hurt too. Usually there are many foreign trainees who come to learn the complex surgeries performed at the University Health Network. They aren't coming because of security concerns and visa problems.
Class sizes shrinking
Dr. Murphy teaches students about anesthesia at the Toronto General. Years ago, her class may have had 10 or more students. Now, there's only half that number.
"It worries me, because as the population gets older and sicker, we will need more anesthesiologists," says Murphy.
In the 1980s, the University of Toronto trained 24 anesthesiologists per year, and now they are at most training 12. They have problems getting enough funding for the school.
"If we're not here to train the physicians of tomorrow, we will be in an even bigger mess than we are now," says Murphy.
Wait for an OR growing longer
The network's 35 cancer surgeons are also worried. They have seen their operating room time cut, with patients waiting longer to have their cancer removed.
To determine just how bad the problem is, the surgeons have started tracking wait times. They've discovered that the wait to see the doctor or to get the diagnostic tests done hasn't changed much over the last year. But the wait to get into the operating room has been steadily rising.
"Over the last 12 months, we have seen about a 12 to 14-day increase in the time," says Dr. Jonathan Irish, Chief of Surgical Oncology.
Two months ago, the hospital had to shut down three of its operating rooms. With the continuing shortage of anesthesiologists, the hospital has begun cutting OR time, eliminating 15 per cent of OR days. On April 1, 2002 they cut an additional 10 per cent at Toronto General.
The cutback in OR time has led to doctors such as Dr. Tyrone David at Toronto General having one of the longest waiting lists in Canada, with 150 people in line for surgery.
"Normally I do 10 to 12 cases a week. Now I am doing six," says David.
The number of anesthesiologists per 100,000 people, by province:
- NWT-Nunavut - 0
- Yukon - 3
- Newfoundland - 5
- New Brunswick - 6
- Saskatchewan - 6
- P.E.I. - 6
- Alberta - 7
- Ontario - 8
- Quebec - 8
- British Columbia - 9
- Manitoba - 9
- Nova Scotia - 10
Source: Canadian Institute for Health Information. Info as of December 2001
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CTV News: Canada's operating rooms face critical shortage of anesthesiologists, Avis Favaro reports
