Horizon Health exec denies thoracic surgery 'crisis' in Saint John

A Horizon Health Network official denies there is a "crisis" in thoracic surgery coverage in the Saint John region, even though the only thoracic surgeon is onindefinite medical leave.

Dr.EdouardHendriks, vice-president of medical, academic and research affairs, says all patients in the region who need thoracic surgery have been successfully referred to other surgeons and none have faced "undue delays."

They may, however, have to travel farther for treatment, he said.

"I'm calling this a difficult situation, a situation that needs to be managed, a situation that needs to be monitored on a daily basis,and this is what we are doing," Hendriks told reporters during a news conference in Fredericton on Friday morning.

I'm not saying it's all easy for everyone, but we've been able with the co-operation of everyone to meet all of the demands.- Dr. Edouard Hendriks, Horizon Health

Thoracic surgeons are specialists who deal with structures of the chest, such as the esophagus, lungs, and diaphragm muscle, but not the heart.

Theytreat diseasesranging from cancer togastroesophagealreflux, remove benign tumours, performchest reconstruction after major traumasand handle lung transplants.

'Adequate number' in N.B.

"At this point in time in New Brunswick we have, I would call it, an adequate number of surgeons providing this service to the province," said Hendriks.

"Now the question that we had for the past few months is how can we better consolidate the service.

Horizon isreviewingpatient volumes and meeting with the New Brunswick Medical Society and medicare to discuss whether more thoracic surgeons are needed, given the aging population and high cancer rates,where they should be located, and what the best remuneration model would be.

"The discussion has been going very positively in the past few months so we are expecting potentially good news in the very near future,"Hendrikssaid without elaborating.

• Horizon and Health Department were warned about thoracic surgery 'crisis' 4 years ago
• Horizon Health scrambles to cope with thoracic surgery 'crisis' in Saint John region

Internal Horizon memos obtained by CBC News over the past couple of weeks have referred to thethoracic staffing shortage as a "crisis."

Dr. David Tees, chief of surgery for the Saint John area, sent an "urgent" memo to all members of the department of family medicine on Feb. 28.

"We are working on finding a solution to this crisis," he wrote.

On March 14, in a memo marked, "CONFIDENTIAL," Tees told doctors the "situation is likely to continue for at least another four weeks."

Nova Scotia, Quebec surgeons may assist

Hendrikstold reporters the thoracic surgeon'sleave "came quite unexpectedly" and he is off for "an undefined period of time."

But alternative arrangementshave been made with other surgeons in New Brunswick, as well as Nova Scotia and Quebec "if need be" to "ensure, of course, proper access to care."

"So far, all the patients that needed in the past couple of weeks to have their surgeries done, have been successfully referred to [other] surgeons, so there has been no undue delay or problems," he said.

"So at this point in time, I'm not saying it's all easy for everyone, but we've been able with the co-operation of everyone to meet all of the demands."

'Really scary'

Earlier this week, a 65-year-old Saint John woman with esophageal cancer told CBC News her gastroenterologist referred her to four different surgeons in New Brunswick and Nova Scotia and she was turned away by all of them.

"It's really scary," said EileenShaw, who is having difficulty getting food past the growing tumour in her throat.

"I'm thinking, 'Oh my goodness, where am I going to go? Am I going to die?'"

Hendriks said agroup of clinicians hasbeen established to review cases and wait lists "at least twice a month."

"In between of course there is a daily review of the situation so if someone is in need of a more urgent surgery, we have processesin place to ensure a patient will be actively and positively referred to a surgeon," he said.

"I'm aware of one case that needed [a]more urgent referral."

Dr. Patti Forgeron, the president of the medical staff organization for the Saint John region, says Horizon and the Department of Health have been warned repeatedly for the past four yearsabout the current "crisis."

She says having one thoracic surgeon covering from Sussex to St. Stephenby himself foryears was simply "not sustainable" and nowhe's on medical leave.

Forgeron contends the region needs a second thoracic surgeon and the current fee-for-service remunerationneeds to be changedto some form of salary model.