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Background: Breast cancer is a common condition, and the number of cases is projected to increase 52% between 2012 and 2030. Care of breast cancer patients occurs along an interdisciplinary continuum involving family physicians, general surgeons, radiologists, pathologists, medical oncologists, radiation oncologists, and allied health workers. There are national benchmarks for wait times between each step from diagnosis to treatment. In this quality improvement project, we sought to measure these wait times at our hospital by comparing results for 2013 and 2023, identifying causes of delays, and proposing solutions to reduce wait times. Methods: We included all patients who were diagnosed with breast malignancies and referred to the general surgery service at Vernon Jubilee Hospital in 2013 and 2023. Results were analyzed using the two-tailed t test and Fisher exact test for continuous and categorical variables, respectively. A P value less than .05 was considered significant. Results: The number of patients increased from 69 in 2013 to 113 in 2023. Mean wait times from initial imaging referral to surgery increased from 67 to 114 days (P < .01) during this period. Mean wait times from imaging referral to pathology diagnosis increased from 36 to 71 days (P < .01), due primarily to an increase from 34 to 80 days for symptomatic patients who were referred by their family physician (P < .01); wait times for asymptomatic patients who were identified by the Screening Mammography Program increased from 40 to 58 days (P = .09). Mean wait times from biopsy to final biomarker report (ER/PR/HER2) increased from 25 days to 29 days (P = .25), from surgery to final pathology increased from 11 to 17 days (P < .01), from surgical consultation to surgery increased from 17 to 31 days (P < .01), from referral to medical oncology consultation increased from 14 to 30 days (P < .01), and from referral to radiation oncology consultation increased from 78 to 106 days (P = .025). Most wait times met benchmark wait times in 2013 but failed to meet them in 2023. Conclusions: Wait times increased at every stage of the care continuum for breast cancer patients between 2013 and 2023 at Vernon Jubilee Hospital. Implementing an interdisciplinary approach to care is necessary to remediate sources of delays at each step. Possible solutions include creating a fast-track pathway for symptomatic patients, performing biomarkers and pathology slide preparation locally, increasing operating room time, and tripling the number of oncologists in the region. [ABSTRACT FROM AUTHOR]

Background: General surgeons play a vital role in the health care system and require hospital resources to provide patient care. British Columbia had 5.0 general surgeons per 100 000 population in 2022, less than the Canadian average of 5.7. A study conducted in 2012 showed that BC needed 232 general surgeons but had only 158 full-time equivalents, a deficit of 74 surgeons, and projected a need for 260 general surgeons by 2022. This study examined the general surgery workforce after a 10-year period and compared the results with those of the 2012 study. Methods: A survey was sent to all members of General Surgeons of BC. Respondents were asked to report the number of surgeons, both by head count and by full-time equivalent, at the hospital where they worked and the number of operating room days available per 4-week block. They were also asked to provide individual wait-time data and open-ended comments. Benchmark operations such as appendectomies and breast cancer operations were tabulated using MSP data from 2012 to 2022. Population data for 2022 were obtained from BC Stats. The Mann-Whitney U test and Wilcoxon signed-rank test were used to analyze the data. A P value of less than .05 was considered significant. Results: To meet the national average in 2022, 302 general surgeons were needed in BC. The actual number was 217 by head count and 197 by full-time equivalent, a deficit of 105. The greatest deficit was in the Fraser Health Authority, where 115 general surgeons were needed but there were only 57 by head count and 51 by full-time equivalent, less than half the number needed. The number of general surgery operating room days by hospital per 4-week block increased between 2012 and 2022 (18.6 vs 21.9, P = .033), but the number of operating room days per full-time equivalent was relatively unchanged (4.6 vs 4.4, P = .42). Operating room days per surgeon and wait times for cholecystectomy, hernia repair, bowel resection, and colonoscopy did not change significantly between 2012 and 2022. Many surgeons reported difficulties in recruitment due to nursing shortages and a lack of hospital resources. Appendectomies increased 22% between 2012 and 2022. Breast cancer operations increased 28% in the same period. General surgery consultations for malignancy increased 42% between 2013 and 2022. Conclusions: The demand for emergency surgery, cancer operations, and other general surgery procedures increased between 2012 and 2022 due to a growing and aging population. The number of general surgeons needed in 2022 was greater than that projected in 2012. Despite adding 39 full-timeequivalent surgeons, the deficit increased from 74 to 105 between 2012 and 2022. This illustrates the importance of planning and deploying adequate resources to recruit the number of general surgeons needed for the future to keep up with increasing demand. [ABSTRACT FROM AUTHOR]

Dr. Ahmer A. Karimuddin, a colorectal surgeon at St. Paul's Hospital, has been elected as the new president of Doctors of BC. He has extensive experience in the medical field and has held various roles within Doctors of BC. Dr. Karimuddin aims to address the challenges faced by physicians in the post-pandemic world and inspire positive change in the healthcare system. He believes that by focusing on individual patient care and acknowledging their frustrations, improvements can be made. The text also emphasizes the importance of balance in physicians' lives and the role of the Specialist Services Committee in improving healthcare. Additionally, it highlights the need for diversity, equity, and inclusion in healthcare and the importance of involving physicians in decision-making processes. [Extracted from the article]

The article discusses the challenges faced by patients and physicians when dealing with anorectal complaints, particularly hemorrhoids. Patients often attribute various symptoms to hemorrhoids, which can hinder them from seeking appropriate medical help. The article emphasizes the importance of taking a comprehensive history and performing a thorough physical examination to accurately diagnose anorectal pathologies. It also highlights the significance of patient-tailored treatment regimens and the need to educate patients about the underlying triggers of their symptoms. The article concludes by emphasizing the importance of considering more serious conditions, such as colorectal neoplasms, when managing patients with rectal bleeding. [Extracted from the article]

The article discusses the challenges faced by patients in accessing timely and appropriate care in the Canadian healthcare system, particularly in areas such as mental health services, medical imaging, consultations, and surgical care. The COVID-19 pandemic has further exacerbated these issues. The article highlights the impact of longer wait times on cancer outcomes, community outpatient care, and mental health. It also points out the shortage of hospital beds and healthcare professionals in Canada, particularly in British Columbia. The author proposes bold initiatives, such as increasing hospital beds, operating room capacity, community resources for seniors, and the number of doctors in BC, to improve patient access to specialist care. The article acknowledges the steps already taken in this direction, such as the announcement of new hospitals, cancer centers, and long-term care beds. It emphasizes the need for collective effort and bold initiatives to address the ongoing challenges in the healthcare system. [Extracted from the article]

The article discusses the concerns of patients and doctors in British Columbia regarding access to surgery. It highlights the physical and emotional pain experienced by patients who have to wait for surgical procedures. The article presents data on the availability of surgical services in rural communities, revealing the challenges faced by these areas in providing critical procedures. It also addresses the increased demand for surgery and the shortage of general surgeons. The article emphasizes the need for collaborative efforts to address the issue and reduce surgical wait times. [Extracted from the article]

The article, titled "Better, together," emphasizes the importance of unity and collaboration among healthcare professionals in British Columbia. It highlights the positive changes that have occurred in the medical field, such as the enrollment of family doctors in the Longitudinal Family Physician Payment Model and the training of physicians in quality improvement and healthcare leadership. The article also acknowledges the challenges faced by the healthcare system, including increased wait times and a lack of resources, and emphasizes the need for doctors to work together to provide the best possible care for patients. The author, the President of Doctors of BC, expresses their commitment to improving patient care and calls for increased collaboration and engagement with stakeholders to create a more functional and sustainable healthcare system. [Extracted from the article]

Background: There has been longstanding concern among orthopaedic surgeons regarding timely access to consultation and, if warranted, surgery. On behalf of the British Columbia Orthopaedic Association, we sought to measure aspects of the patient journey from referral to surgery, and to consider regional variations in access. Methods: Currently, 49 orthopaedic surgeons from five BC health authorities contribute anonymized scheduling data to a secure server that aggregates information about key time points: the date a patient is referred for surgical consultation, the date consultation occurs, the date a decision is made regarding surgery, and the date of surgery. Data collected for consultations and surgeries occurring between 1 May and 31 July 2017 were analyzed to establish wait times for patients seen or treated in this 3-month period. Results: Consultations were completed for 4100 patients and surgeries were completed for 1129 patients during the study period. Patients waited 19.5 weeks on average for consultation, with significant regional variation. All health authorities had difficulties with long waits for consultation, with 10% of patients identified as long waiters. Patients waited 34.1 weeks on average for surgery after consent. Less regional variation was seen for average surgery wait times (between 29.4 and 36.3 weeks) than for average consultation wait times (between 15.7 and 31.0). Among patients who had surgery, the average time from referral to surgery was 59.5 weeks, with regional variation between 49.5 and 66.5 weeks. Conclusions: All health authorities in BC have on average long waits for consultation and surgery. Regional variation in access to orthopaedic consultation exists in BC, and the average journey from referral to surgery is worrisomely long. Lower wait times for consultation in Island Health, Interior Health, and Vancouver Coastal Health may be attributed to surgeon-led multidisciplinary clinics that utilize centralized intake and "first available surgeon" strategies to reduce wait times. We believe that standardized recording of patient unavailability dates would help us better understand the situation of patients who experience very long waits, and we remain committed to improving patient access to orthopaedic care by promoting best practices that match the right patient with the right surgeon at the right time. Greater focus on the experience of patients accessing orthopaedic care is required in all regions of BC. [ABSTRACT FROM AUTHOR]

The article discusses aspects of health policy that focus on wait times for general surgery in British Columbia and presents the activity-based funding as mathematical model in reducing wait times for surgical procedures.

The authors reflect on their experience of being a part of a team of British Columbia (BC) specialists and health care executives who traveled to the not-for-profit Cleveland Clinic to learn about best practices. According to the authors, there are several innovations at the Cleveland Clinic that would be inexpensive to implement in BC. The authors say wait times at the clinic have been reduced by shared medical visits.

The article reports on the 1.08 billion Canadian dollars lost in time and productivity in 2011 because of the lengthy waits for surgery among patients in Canada, according to a report from the Fraser Institute.

The article focuses on a report titled "Why We Wait: Physician Opinions on Factors Affecting Health Care Wait Times" released by the Fraser Institute on the factors behind increased wait times for medical care and surgical procedures. The report cited a lack of operating room time and changes in patient case loads as the most common cited factors. Radiation oncologists, however, said the availability of technical staff was the primary reason for both increased or decreased waiting times.