Dozens of orthopedic surgeries delayed due to staffing shortages

By Catherine Griwkowsky August 18, 2021

Alberta Health Services announced the Orthopedic Surgery Centre at the Royal Alexandra Hospital in Edmonton would close four operating rooms for 72 hours due to a lack of physician coverage for post-surgical care.

The move meant 53 patients were forced to have their surgeries rescheduled.

Dr. Curtis Johnston, deputy medical director for Edmonton Zone of AHS, told reporters the hospital had anticipated doctors taking summer vacation leave, but other unplanned vacancies — including physicians moving away from the hospital — meant AHS could not plan to fill the gaps.

As the province heads into a fourth wave of Covid, there is no guarantee there won’t be more gaps in the system, he added.

“Our health-care workforce is tired,” Dr. Johnston said. “They’ve worked extremely hard and they’ve done the best they can to serve Albertans. We have limits as humans, and we need that time to recover and rest and recuperate.”

While there are surgeons, anesthetists and nurses available, there was no post-surgery physician oversight in the orthopedic ward, per AHS.

To fill that gap, the province is recruiting both clinical associates and clinical assistants. The clinical assistants will be brought in as full-time AHS employees, while associates are family physicians who will be contracted to help based on the availability of their schedules.

Part of the gap was due to vacation time built up over 20 months of the pandemic, but physician fatigue is also a factor, Dr. Johnston said. As of Tuesday, there were 163 hospital bed closures throughout the province.

NDP Health critic David Shepherd accused Health Minister Tyler Shandro of lying about the dire staffing situation, noting health-care workers had warned this was coming since Christmas. The shortages are being exacerbated by the UCP’s war with doctors, the NDP critic said.

“These critical staffing shortages are the direct result of the Kenney’s government’s botched handling of the pandemic alongside his war with Alberta doctors, nurses and front-line health-care workers,” Shepherd told reporters.

Shepherd quoted a memo from Edmonton’s chief of orthopedics, Dr. Paulose Paul, which said a single junior resident at the Royal Alexandra Hospital would be left responsible for 120 patients.

“That situation is not safe,” Shepherd said.

Dr. Johnston said due to the recent cancelled surgeries, that ratio would no longer be in place.

Chartered clinics on their way in
The waitlist for orthopedic surgeries is already long, something the UCP plans to tackle through its surgical wait times initiative, which involves channelling public funding toward chartered surgical facilities.

A request for proposals for the publicly funded, privately owned facilities was issued by the province last month. Chartered clinics are already providing ophthalmology surgeries, but currently all orthopedic surgeries take place in AHS facilities.

When the RFP was announced, the Alberta Union of Provincial Employees warned the government was starving the public system to pad corporate profits.

“Kenney’s crew is just taking bread from our starved public system and feeding it to the rich,” AUPE anti-privatization committee chair Kevin Barry said on July 22. “Our government should be bolstering the public system, not hollowing it out. And it certainly shouldn’t feed profit-hungry providers that will likely just skim the wages of nurses or bust unions to sabotage decent working conditions for their own financial gain.”

At the time, Barry pointed to a for-profit orthopedic surgery clinic that operated in Calgary in 2004, which wound up costing the province more per surgery and was bailed out after it signed a lease that cost more than its contract provided for.

The government plans to spend approximately $13 million on orthopedic surgeries in the 2021-22 fiscal year via chartered facilities.

As of July, there were 10,000 patients on the knee surgery wait list and 3,500 patients waiting for hip surgery.