Thousands of British Columbians living in pain as orthopedic surgeons raise the alarm on wait times

Amber Nurse has been struggling with a bad knee for two years, hoping she would land a surgery this spring.

So she was devastated to find that she's now on a two-year wait list for an operation in Prince George, in northern B.C.

"This is enough. I have to get it done," she said. "I'm frustrated."

Daily tasks and hobbies have become more painful by the day, says the Fort St. John resident and educational assistant.

"We're kind of just left here and stuck in pain with nothing we can do."

Nurse is among 8,315 patients waiting for knee surgery in B.C. as of March 31, 2022, according to provincial data. That's prompted orthopedic surgeons to issue a warning about what they describe as a "surgical crisis," exacerbated by staffing shortages and a lack of capacity in hospitals.

"These patients are losing their jobs. These patients are getting narcotic addicted, these patients are living in pain, they're getting depressed, and they are the ones who bear the burden of this problem," said Dr. Cassandra Lane Dielwart, president-elect of the British Columbia Orthopaedic Association.

According to the data, surgeries with the highest backlogs during the pandemic include elective or non-urgent total hip and total knee replacements.

"Orthopedics has been hit by closures at a disproportionately high rate compared to all other surgical specialties," Dielwart wrote in a letter to B.C. Health Minister Adrian Dix in March.

For example, 158 people are waiting for cranial surgery, 417 are waiting for open heart surgery, and 4,389 are waiting for hip replacement, according to provincial data.

Dielwart adds that the regions with the longest wait times are Prince George, Kamloops and the Lower Mainland.

Patients frustrated as cancellations mount

At the Royal Inland Hospital in Kamloops, in B.C.'s southern Interior, wait lists for orthopaedic surgery have gone up 40 to 50 per cent in the last two years, according to orthopedic surgeon Dr. Scott Hughes.

He says cancellations remain a daily conversation with patients who come in thinking they are getting surgery only to find out there is not enough staff.

"It's almost celebratory if we were able to make it through a full day without a cancellation," he said. 

Dix recently told reporters the provincial government is working to increase surgery capacity by opening new operating rooms.

For instance, two private Vancouver Island surgical facilities, View Royal Surgical Centre in Victoria and Seafield Surgical Centre in Nanaimo, will become part of the public health system as B.C. takes over their leases and buys equipment, the Ministry of Health announced last Thursday. The deal is expected to become final in the coming months at a cost of $11.5 million for both locations, according to a statement from the department.

Buck Shannon, a 71-year-old resident of Lillooet, says his knee replacement was cancelled twice just days before his surgery in Kamloops. 

He is also currently waiting for a shoulder replacement, which was supposed to happen six months ago, he says.

"I've been shot. I've been stabbed when I served in Vietnam. Nothing can compare to what I'm going through right now in my left shoulder," he said. 

"Makes me feel like as senior citizens we're not worth anything."

Shortage of beds, hospital staff

One of the reasons behind the backlog is that the Interior and north have fewer health-care facilities, says Dr. Dave Nelson, orthopedic surgeon at the University Hospital of Northern B.C. in Prince George, .

Multiple surgeons have to vie for the same limited operating space, and more beds are needed to accommodate more patients, he says.

In Kamloops, where capacity has been a chronic issue, according to Dr. Hughes, the pandemic, wildfires and floods have all exacerbated the problem. 

Understaffing has also posed challenges, he says.

Deeper changes needed, says policy expert

Andrew Longhurst, a health policy researcher and PhD candidate at Simon Fraser University in Metro Vancouver, says deeper changes are needed — especially as COVID-19 continues to impact hospital capacity. 

He suggested doctors refer patients to a group of surgeons rather than individual surgeons to increase efficiency. 

"Currently many primary-care providers only have the option of referring a patient to an individual surgeon," he said.

If patients were referred to a group of surgeons, the first available surgeon with the shortest waitlist could take the patient rather than delaying the operation, Longhurst explains.

He also suggested the province fund physiotherapists and occupational therapists to help decrease pain for patients waiting for surgery.

Meanwhile, Amber Nurse says she will continue to speak out about how the system is failing her. 

"I'm gonna keep talking to whoever wants to listen and try and change this," she said.

"I'm either going to blacklist myself or I'm going to get the help that I need."