Ontario doctors want to build free-standing surgical centers to help eliminate waiting lists

The Ontario Medical Association is calling for the creation of new surgical centers across the province to ease pressures on the hospital system and help eliminate the backlog of scheduled surgeries that has increased during the pandemic.

The proposed stand-alone centers would offer same-day surgeries and procedures, including those for hip and knee surgeries, freeing up operating rooms for sicker patients and shortening wait times overall. according to the OMA.

These “integrated outpatient centers” would merge with the state-funded health care system, partnering with local hospitals to provide OHIP-insured medical services, said Dr. Jim Wright, pediatric orthopedic surgeon and vice president. OMA’s Executive Chairman of Economics and Policy. and research.

These centers have been shown to provide more efficient surgical care for certain outpatient procedures and can help reduce the burden on hospitals, Wright said.

“They move patients out of the acute care facility, which allows them to focus on the most seriously ill; that’s what hospitals do best,” he said.

The OMA’s call to expand how the province delivers surgical care was one of three solutions offered Thursday during a virtual panel on how to relieve pressure on the health care system.

The organization, which represents Ontario’s 43,000 practicing and retired physicians and medical students, is also calling on the government to create additional avenues for internationally trained physicians to work in the province to reduce the doctor shortage and increase funding for palliative care beds.

“We call for these solutions to be implemented now,” said OMA President Dr Rose Zacharias, noting that these are “extremely vital areas” that need to be addressed. “We had gaps in the healthcare system before the pandemic, but the strain … is now evident to all of us.”

In February, the OMA released a report that called for integrated outpatient centers and said the province was facing a backlog of around one million surgeries by the end of 2021. This analysis was done before the government was forced to issue a directive – its third of the pandemic – to suspend elective surgeries during the Omicron winter surge.

Wright said the OMA has had “very positive conversations” with “several branches of government and with several departments” about integrated outpatient centers, which will require new legislation moving forward.

“We believe it is time to bring together an advisory group of experts to help the government with this implementation,” he said, noting that the first of these centers could open “optimistically” in 12 to 18 months. However, the February report from the OMA suggests that it could take between five and eight years to open such centers.

According to Ontario Health data, about 212,000 people are waiting for scheduled surgery, up from 198,000 in January 2019. Health system leaders have said patients who wait beyond recommended clinical targets are prioritized for scheduled surgeries.

The OMA recommends that integrated outpatient centers be multi-specialty and says many less complex surgeries and procedures could be performed at these facilities, including hernia repairs, hysterectomies, and some nose and throat surgeries.

Wright said Ontario lags other provinces, including Saskatchewan and Alberta, in adopting these centers and pointed to data showing that ambulatory care facilities can “offer surgeries 25% more efficiently “.

“The (surgical waiting) list is growing day by day, so if we can offer a wider range of procedures safely, with better efficiency, outside of an acute care setting, that’s what we should do,” he said. noting that any Ontario plan for integrated ambulatory centers should have funding models that do not disadvantage acute care hospitals.

The provincial government’s new health care plan outlines how it will reduce surgical wait lists, including an increase in surgeries at “existing private clinics covered by OHIP” and potentially “increasing the number of procedures surgeries covered by OHIP performed at independent healthcare facilities”.

Critics and policy experts worry that these statements signal the expansion of private, for-profit facilities in Ontario and that the creation of new outpatient clinics will lead to greater competition for health care workers.

The OMA said that because integrated outpatient centers would partner with or be controlled by local hospitals, they are a different type of care model than independent health facilities.

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