Richmond Hospital and some others within Vancouver Coastal will be affected by the job action of anesthesiologists.
Health authorities have sent letters to 3,200 B.C. patients booked for elective surgery in the next few weeks, warning them their cases may be cancelled due to a fee and staffing dispute with anesthesiologists.
The letters were sent after protesting anesthesiologists announced Wednesday that as of next week, they'll only perform about half their usual work.
Other hospitals affected by the job action are those in the Fraser region, Vancouver Island, and some hospitals within Vancouver Coastal such as Lions Gate, and St. Paul's.
(Anesthesiologists at Vancouver General Hospital, UBC, BC Children's and Women's Hospitals and those in the Northern Health region are not part of the dispute.)
Dr. Jeff Rains, president of the B.C. Anesthesiologists' Society (BCAS), said the slowdown will be comparable to what happens during summer months and holiday periods.
"We've been warning for the past three months that service reductions were coming April 2 but the health authorities have continued to book patients for surgeries," said Rains.
"They have intentionally put patients into this dispute and patients will not find out their surgeries are cancelled until the day of the operation, after they have already booked off work, arranged child care, and fasted overnight," Rains added.
Anesthesiologists who do work next week will be on hand for extended hours to lessen the impact on patients, he said, while acknowledging that doesn't mean operations will still go ahead since other health professionals, like nurses, must also be available.
Health Minister Mike de Jong said about 200 anesthesiologists have indicated they will not be withdrawing service. That figure essentially covers specialists who have not been expressing complaints about fees because they are paid a salary, not a fee for each service.
There are about 470 anesthesiologists in B.C. and de Jong refused to be more specific about the actual number who will or won't be working. "Health authorities are also contemplating making an application to the courts later this week, so I'm not going to say a lot more about that at this point."
De Jong said he is just as confused as anyone about the latest BCAS statement that says anesthesiologists are withdrawing services but will work after hours to mitigate disruptions to patients.
"The point is this, patients need certainty. Patients get surgeries booked. They're generally required or often required to fast. They go off their medication. ... It's not logical, satisfactory, professional or in my view, ethical, to be saying to patients, 'Well, come to the hospital, but we may or may not.... on our schedule we'll decide when to do surgery,'" de Jong said in a media scrum at the legislature.
"I think it shows the height of unprofessionalism towards patients, towards colleagues - doctors, nurses, surgeons, support teams."
The health minister said health authorities are developing contingency plans that may include moving patients to facilities where anesthesiologists are working. He didn't rule out the possibility of sending patients out of province or out of the country "if it becomes necessary."
De Jong then suggested the government may copy a U.S. trend where nurses are trained in anesthesia.
"Down in the U.S., there is a profession called nurse-anesthetists. We have nurse practitioners. With appropriate training, this is an area that they could step into in the longer term. Yes, it requires legislative change, and yes, we are prepared and preparing to make those legislative changes so that we'd have a larger body of professionals capable of providing this service on a reliable basis.
"The anesthesiologists that are involved in this are, among other things, independent business people, independent contractors. If, at the end of the day they say they don't want to work in British Columbia, then they won't work in British Columbia. But if that's the approach that they ultimately want to take, we will and are in the process of developing a contingency and an option that would see a whole other group of professionals acquire the skills that they have in the United States to provide not all of these services, to be sure, but a good chunk of the anesthesiology services that are required.
"This is a profession, this is a scope of practice, that exists in the U.S., and there is great enthusiasm on the part of nurse practitioners to acquire that enhanced training.
"If I am a patient, I want my surgical team to be comprised of people who want to be there, who want to do the work, and there's a whole group of people who fit into that category and, with some additional training, would be prepared to do that," de Jong said.
Meanwhile, the Vancouver law firm representing health authorities has been collecting forms that anesthesiologists were told to fax in to indicate their intention to keep working. Legal action has been threatened against those who don't work. In addition, hospitals may revoke the hospital privileges of anesthesiologists who actually withdraw services April 2.
Sun health issues reporter
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