painful joints, broken promises as sask. patients wait for surgery
“that’s why i love my job, because i get to give people their lives back. but not when the wait-list is two years long.”
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michael mcateer pays the price for a delayed knee surgery every morning.
“when i get out of bed in the morning, swing my legs over of the edge and stand up, that’s the start of my day. it’s painful,” he said.
mcateer, who lives in saskatoon, is one of nearly 4,000 saskatchewan residents who have waited more than a year for an orthopedic surgery, most of them knee and hip replacements.
michael mcateer is one of nearly 3,900 saskatchewan residents who have waited more than a year for orthopedic surgery.
matt smith
/
saskatoon starphoenix
saskatchewan used to lead the nation in cutting waits for such procedures. by 2020, it was one of the worst. then covid-19 forced the health-care system to suspend swaths of surgeries, deepening the problem.
doctors say some patients, like mcateer, are coping. others suffer pain that costs them independence, employment and enjoyment of life.
“even though it’s an elective surgery, for some people, (waiting for it) ruins their life,” saskatoon orthopedic surgeon dr. ian lutz said.
a medal
a decade ago, doctors sang saskatchewan’s praises for its success in reducing surgery wait times.
between 2010 and 2015, then-premier brad wall’s government poured more than $200 million into slashing wait-lists by pooling resources and outsourcing to third-party providers. under the catchphrase “sooner, safer, smarter,” the saskatchewan surgical initiative almost met an ambitious goal of bringing surgery waits down to three months by 2014.
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“we were the envy of the country,” saskatoon orthopedic surgeon dr. william dust recalled.
“things were great. we were operating our brains out, so to speak, and the wait-lists were all down.”
in 2013, the canadian orthopedic association awarded then-health minister dustin duncan an order of merit for “taming the queue,” which dust doesn’t remember happening at any other time in his more than three decades as a member of the organization.
dustin duncan in 2013 during his tenure as minister of health.
don healy
/
regina leader-post
“while the surgical initiative will formally wrap up in 2014, we’re going to work hard to make sure that the gains we’ve made on surgical wait times don’t slide back to where they were,” duncan told the regina leader-post at the time.
but that’s exactly what happened.
by february 2020, roughly 25,000 saskatchewan residents were waiting for surgery, an increase of about 12,000 from early 2015 and slightly below the roughly 27,500 who were waiting when the initiative began in 2010.
“essentially, they ran out of money. and the wait-lists started to go up. and we’ve been struggling with that ever since,” dust said.
“then, covid destroyed us.”
the saskatchewan health authority twice
suspended elective procedures during the pandemic.
the result is a record backlog of surgeries. an internal report obtained by the saskatoon starphoenix shows nearly 35,000 people were waiting as of earlier this month. about 12,250 — more than a third — were waiting for orthopedic surgeries. knee and hip replacements were the first and third most common procedures on the wait-list, respectively (cataract procedures were second), making up about 21 per cent of the total procedure backlog.
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health minister paul merriman said the backslide was the consequence of challenging economic years before the pandemic, including the 2017 budget that made cuts across the public sector.
his government unveiled an ambitious plan in december to eliminate the covid-19 surgery backlog by 2025. he has yet to say what it would cost.
“we’re going to work on that extremely hard. you’re going to see some stuff in the budget coming out in march that’s going to address a lot of the surgical backlog we have out there,” merriman said.
mcateer said he knows the voice-mail message at his clinic well. it advises patients the clinic can offer no estimates on wait times.
mcateer says his delayed knee surgery is holding up plans for travel.
matt smith
/
saskatoon starphoenix
he said some days are worse than others, but the wait for his procedure means he and his wife can’t plan the travel they’ve looked forward to for years.
“i want to get the damn thing done,” he said.
elective procedure
lutz said he became an orthopedic surgeon because he loves solving problems.
“it’s exactly how my brain works. it’s basically a mechanical job within medicine where you take something that’s broken and you fix it. it’s extremely rewarding.”
a new knee or hip can allow a patients to move freely, without pain. and as baby boomers age, hip and knee replacements are becoming more common and more important, dust said.
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lutz’s passion is tested by long, painful waits his patients face before they can see him in the operating room.
“it’s not ideal. there’s been more days than not when i come home super frustrated and have been hating my job lately than before,” he said.
dr. ian lutz said he loves orthopedic surgery because he gets to give patients “their life back.”
matt smith
/
saskatoon starphoenix
because hip and knee replacements are considered “elective” procedures, they were largely on hold for the worst periods of the pandemic.
the result is another kind of backlog: patients who have waited so long that their condition has become significantly worse. of the 8,300-odd patients who had already waited more than a year for a procedure as of feb. 13, about 44 per cent were orthopedic patients.
by the end of 2021, saskatchewan performed just 39 per cent of hip replacements and 23 per cent of knee replacements within the recommended six months.
saskatchewan’s performance has steadily fallen since 2016, according to the canadian institute for health information, and ranks among the worst in the country.
that means deepening pain and the risk those patients will never fully regain their previous quality of life.
“we know that the worse people are before they get their surgery … they don’t regain back to where they could have if they had their surgery earlier. so there’s a price to pay,” dust said.
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“they do pay, obviously, with pain. and they do pay in that when they do get their surgery, they don’t end up functionally as good as if they got their surgery earlier.”
he estimates as much of a third of his time is now taken up by patients who are already on the wait-list, whose pain is so severe they require additional care.
lutz said he has seen elderly people become dependent on pain medications and younger patients lose jobs and run into financial trouble because they can’t move.
“it’s a lot of hurting people, and you have the skills to affect peoples’ lives, and you’re not able to do it. you see their lives falling apart,” he said.
he struggled for years to get any engagement at all from the health authority and government at large to solve the problem — until recently, he added.
dust said the problem is complex, but the solution could be simple.
“it’s not rocket science. if they want to get the wait-lists down, we need to get more patients into the operating room.”
for that, saskatchewan will have to find more specially-trained operating room nurses, who are already in short supply.
merriman’s plan to address the backlog hinges on recruitment, training and — possibly — paying third parties to perform surgeries on the government’s behalf. a request for information issued by the saskatchewan health authority earlier this year sought information on potential private contractors who could operate in saskatoon, with a special interest in joint replacement procedures. government spokesman matthew glover said responses to that request are being reviewed.
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“we need patients to be very patient with us, because it’s going to be a challenge to get this done in a short amount of time,” merriman said. “we can’t get all of our surgery backlog done within 12 to 24 months, but we’re going to foot on the gas pedal and make sure we’ve got all our surgeries across the province going at full capacity.”
lutz said he hopes for the day he can once again solve the problems in front of him.
“that’s why i love my job, because i get to give people their lives back. but not when the wait-list is two years long.”
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