Canadian Spine Society out of joint over Manitoba plan to send patients to North Dakota

The Canadian Spine Society wants Manitoba to back off on a plan to send hundreds of Manitoba spinal patients to North Dakota for their surgeries.

Manitoba Shared Health is in the process of finalizing a deal with non-profit Sanford Health Fargo to conduct spinal surgeries on patients who've waited a year or longer for spinal surgery north of the Canada-U.S. border.

Shared Health has identified 150 to 300 patients who could qualify for the transfers, which would help reduce a backlog of spinal surgeries in Manitoba.

The Canadian Spine Society, which represents 192 spinal surgeons — including six in Manitoba — said Manitoba's plan to send patients south will create more problems than it solves.

"Sending patients to the United States for spine surgery redirects badly needed money that could be applied to improving access within the province," society director Hamilton Hall and president Scott Paquette wrote in a letter dated Thursday.

Citing research conducted by surgeons in Saskatchewan, they said 1,000 surgeries could be conducted in Canada at the same cost as 300 in the United States.

In a subsequent interview, Hall said patients won't have the same quality of care if they travel south.

"You don't have family support. You have strangers working with you. When complications happen, things go wrong. It's poor patient care," Hall said in a telephone interview from Toronto.

"So what you're getting is a quick and easy, 'We'll just cut the waitlist by 300 people.' It's going to cost more. It's going to take money away from the system, which could be used elsewhere for long-term gain."

Hall said Manitoba, like other provinces, has underfunded spinal surgeries for many years now. The pandemic has only exacerbated the wait for spinal surgery, he said.

The chair of Manitoba's surgery backlog task force said he agrees the province must devote more resources to spinal surgeries — but that won't happen overnight.

"We would rather tomorrow wake up and say, 'let's just do more spine surgery here, but human resources in the middle of the Omicron crisis will not allow us to do that," said task-force chair Dr. Peter MacDonald. 

"So we feel like over the next three or four or six months, there's going to be people who are going to get spine surgery."

MacDonald said Hall is incorrect about the cost of surgeries in North Dakota, insisting Medicare rates for the procedures are competitive.

"It's not much different than what it costs us here," he said.

MacDonald also said the compensation for North Dakota surgeons would ensure patients are properly cared for before and after surgeries.

Surgeons in Manitoba helped develop the North Dakota plan, MacDonald said, suggesting Hall is only speaking on his own behalf.

Hall said that's not the case.

"I can tell you that the surgeons I spoke to in Manitoba were very angry about this," he said, adding the province forbade them from speaking to media. "They accepted it, but they were very unhappy about not being allowed to speak."

In any case, it will be some time before Manitoba spinal patients travel to Fargo.

Shared Health initially said the first patients could go under the knife in North Dakota as soon as next week but walked back that claim one day later.

Now, both Manitoba and Sanford Health Fargo pegged the start of those surgeries at some undefined point in the future.

"Sanford Health Fargo is not preparing to accept any new patients from Manitoba in the immediate future, and will only do so at a mutually agreed upon time as the pandemic and our capacity allows," said Brittany Sachdeva, Sanford Health Fargo's vice president in charge of operations.

"We are pleased to be able to consider partnering around specific, limited high-end specialty services similar to what many other major medical centers located along the United States and Canadian border have done," she said.

 "Right now, we are committed to caring for our local communities during their time of greatest need."