Ontario is facing a backlog of more than 1 million surgeries and a group of doctors has an idea to fix it

Ontario is facing a backlog of more than one million surgeries, in large part because of the COVID-19 pandemic, and now a doctor’s group is recommending the province fund a new model of outpatient care centres to help tackle the problem. 

In a new report, the Ontario Medical Association proposes creating what it calls integrated ambulatory centres, which would work with local hospitals to perform medical services insured by the province.

The group, which represents Ontario’s more than 43,000 physicians, medical students and retired physicians, says the plan would free up hospital beds so hospitals can focus on responding to acute and emergency patients without sacrificing non-acute care.

“Lengthy wait times for surgery and other medical procedures were an issue even before the COVID-19 pandemic exposed the gaps in our healthcare system,” said OMA president Dr. Adam Kassam. 

‘An urgent problem’

“This is an urgent problem that requires immediate action.”

The surgeries backlog doesn’t account for procedures that were cancelled during the recent Omicron wave of COVID-19 and people who need services but had to hold off on accessing them during the pandemic.

Altogether, the OMA estimates the pandemic has delayed 21,000,000 patient services, including surgeries for preventative care to cancer screenings to diagnostic tests.

On top of that, it says doctors are reporting that patients “who would have been diagnosed and treated sooner are coming in later and sicker” because of the pandemic.

Dr. Mary-Anne Aarts, chief of the surgery department at St. Joseph’s Health Centre in Toronto, said the health system is preparing for backlogs and wait lists to grow in the coming months as more people seek out treatment now that the Omicron wave of infections is subsiding.

“We’re going to have increased demand on our services for diagnostic reasons and also for surgery,” she said. “That’s what we’re trying to brace ourselves for and what we’re most concerned about.”

The group says Ontario’s health care system now faces two main challenges: clearing the surgical backlog, and shoring up resources to help care for an aging population.

Province not ruling out looking at model in future

Ontario currently has more than 1,000 independent health facilities, but the report said most of those are not licensed to deliver publicly funded surgeries and instead focus on diagnostic services like ultrasounds and x-rays.

Integrated ambulatory centres, as proposed by the medical group, could focus on outpatient surgeries and procedures in orthopaedics, gynecology, urology, plastics, otolaryngology or ophthalmology.

The OMA says the process of opening new care centres could take up to eight years, and the total cost will depend on various factors, including how many new spaces need to be built and how many can be renovated.

Dr. Jim Wright, a surgeon with the group’s policy and research division, said the group hasn’t set a number of clinics, as some could be transitioned out of existing facilities and some regions might continue running procedures out of hospitals depending on resources available.

A spokeswoman for Health Minister Christine Elliott didn’t rule out looking into the new model in the future, while also calling on the federal government to give the provinces more money for health care.

“The ministry continues to review opportunities to leverage ambulatory surgical models to help create additional surgical capacity in the province,” Alexandra Hilkene said in an emailed statement.

She also pointed to the existing range of surgical models in Ontario and $300 million in funding announced last summer to help hospitals catch up on surgeries and other services.

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