Cancer patient told of 5-month MRI wait

In growing pain, losing weight and becoming steadily more ill over the course of many months, Elizabeth Balagus's Winnipeg doctor suspected she may have cancer.

Late that year, he ordered an urgent MRI scan in an effort to help diagnose the 77-year-old, but Balagus was told there would be a five-month wait from November, 2009. An appointment for the medical imaging exam was set for April 2010.

"I couldn't believe it. I felt at this point, I'm not going to make it," Balagus told CBC News. "There's something terribly, terribly wrong with me and nobody, nobody can do anything more for me.

'People who need emergency MRIs get them very quickly.' —Jean Cox, Manitoba Health

"I'm in pain, I'm still losing weight, and I'm not going to make it," she said she recalled feeling at the time.

Her husband told The Manitoba Health Appeal Board late last year he considered a letter from the Winnipeg Regional Health Authority notifying his wife of the months-long wait "a death certificate."

Exasperated, Balagus and her family paid more than $11,000 US out of pocket for a trip to the Mayo Clinic in Rochester, Minn., which they got within about two weeks of the wait-time letter. She was diagnosed with pancreatic cancer.

Upon her return to Manitoba, she was quickly admitted into treatment for her condition.

Balagus's story highlights an ongoing problem in the province, namely wait times for MRI exams – a problem the health minister suggests is due to the growing number of them being requested by physicians.

According to the Canadian Institute of Health Information, the estimated maximum wait for an MRI in 2007 in Manitoba was 42 days. In 2009 that number had jumped to 119 days.

The provincial government states that as of this January, the estimated maximum wait is now 20 weeks (140 days). However, the province says that number reflects the wait period for MRIs on an elective basis, and not on an emergency one.

The provincial Acting Assistant Deputy Minister of Regional Programs and Services for Manitoba Health told CBC officials are aware there are problems.

"We are aware of the challenge," Jean Cox said. "I did go back and look at the estimated wait times for January of 2009, '10 and '11, and clearly that number has gone up.  That's of concern to us and as I say, we are taking steps to address it."

Cox said in January, the province gave the Winnipeg Regional Health Authority more money to operate the MRI equipment more often.

It's unknown what effect the strategy has had on wait times, but Cox maintained people who need the tests done in an emergency are looked after.

"People who need emergency MRIs get them very quickly," she said.

More doctors ordering tests

In February, Health Minister Theresa Oswald said the biggest reason for the long wait times is because in 2007, the WRHA elected to allow family doctors to order MRI exams, as opposed to only by referral from a specialist.

Because of the prominence MRI technology has taken on in diagnostic medicine, Oswald said physicians have been ordering more and more of the tests.

Manitoba Health has refused to reimburse Balagus for the cost of her Mayo Clinic stay, a decision she fought to overturn.

In a February decision, the Manitoba Health Appeal Board turned her down because she couldn't demonstrate that the medical tests she wanted weren't available in either Manitoba or elsewhere in Canada. As well her family doctor was not a specialist who could refer her to the U.S. clinic.

"The services sought by [Balagus] were a medical consultation with a specialist and medical tests," board chair Robert Filuk stated in a written decision.

"There are gastroenterologists, oncologists and other relevant specialists in Manitoba and elsewhere in Canada who could have been consulted," the decision stated.

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