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Wait-time reality fails patients

Man told test could be delayed up to a year

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Selma Gilfix shakes her head when she hears that Manitoba boasts of its short wait-time lists for medical procedures.

Gilfix said her 87-year-old father, Max Pressman, was told in January that he'd have to wait nine months to a year to get an echocardiogram, a period of time that government officials don't even acknowledge when counting waiting times.

"His heart is failing," Gilfix said of her father's condition. "How long do we have to wait to see what can be done, or do we have to wait for him to just die?"

Gilfix said her frustration was heightened when she recently learned echocardiograms are being performed in Calgary on two days' notice.

"People need to know we don't have that (in Manitoba). And why don't we?" she said.

Gilfix said her father's condition has been getting worse for the last three years, as shortness of breath robs him of his ability to walk. Pressman's doctor thought a pacemaker -- a simple, outpatient procedure -- could be the solution, so he referred Pressman to a cardiologist.

The first cardiologist appointment was in January, and while he booked Pressman for an echocardiogram, the doctor also referred Pressman to another cardiologist for a second opinion; that second specialist didn't see Pressman until June 3 and decided he couldn't give an opinion until Pressman had an echocardiogram -- which the doctor hoped could be done by September.

Last week, Health Minister Theresa Oswald boasted of the "A" score the province had been given from a coalition of professional medical associations for the patient wait times associated with elective open-heart surgery.

But the assessment by the Wait Time Alliance only measures the period of time a patient waits for a procedure -- after -- a medical specialist makes a decision on what procedure needs to be done until the procedure is completed.

Based on that definition, the clock hasn't even begun ticking for Max Pressman, a situation the medical community says is all too common -- not only for Manitoba but for the rest of the country as well.

"Lots of people will tell you about long waits in the emergency room, about long waits for echocardiology like (Pressman's)," said Dr. Chris Simpson, the incoming chairman of the Wait Time Alliance and head of the cardiology division at Queen's University School of Medicine in Kingston, Ont.

Simpson said provinces cannot allow themselves to be judged based on the wait time for a single procedure or test -- in real life, the clock starts ticking from the point when a person decides to seek medical help until the problem is fixed.

"The total wait-time experience is the whole process, not just the wait for one test, or one consult, or one procedure," Simpson said. "It's the whole wait from the very beginning of the experience, right at the family doctor's office right through to recovery."

Manitoba doesn't have a benchmark for wait times for echocardiograms or for the hundreds of other procedures for which the Wait Time Alliance has developed optimum standards. The Canadian Cardiovascular Society of Canada places the optimum wait time for non-emergency and non-critical patients to get an echocardiogram at 30 days.

There's a happy ending of sorts for Pressman. When Gilfix told her father's cardiologist that she planned to send Pressman to Calgary for the echocardiogram, the office called her back two hours later and said an appointment had suddenly become available for the next day, June 9.

"It's just a 15-minute procedure," Gilfix said of the echocardiogram. "I don't see how there can be such a long waiting list."

The wait, however, still continues for Pressman. His cardiologist was on vacation, and he doesn't know the results yet of the echocardiogram. And, if the decision is to install a pacemaker, Gilfix said, she was told the waiting list is another two months.

Definition of patient wait time:

Ottawa and the provinces agreed on wait-time benchmarks for medical treatment for certain procedures, defining wait time as "the time between the decision to treat by the specialist and the actual start of treatment."

What is it an echocardiogram?

Similar to an ultrasound of the heart, either in 2D or 3D imaging.

How long does it take or should it take to get an echocardiogram?

Ottawa and the provinces have not agreed on an appropriate wait time for echocardiograms.

The Canadian Cardiovascular Society says it should be 30 days.

Medical surveys found they vary from city to city across the country:

British Columbia -- 10 weeks*

Halifax -- 20 weeks*

Brandon -- 14 weeks**

Winnipeg -- 46 weeks **

Selma Gilfix said her father's cardiologist said the wait time in Winnipeg is nine to 12 months, and she said she was told St. Boniface General Hospital is only now doing echocardiograms that were ordered in July 2010.


** Manitoba Health/Winnipeg Regional Health Authority

Republished from the Winnipeg Free Press print edition July 4, 2011 A7

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