An anesthesiologist shortage is delaying surgeries across Canada, physicians say

The Current16:50Anesthesiologist shortage puts surgeries in jeopardy

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Kelly Konieczny is one of many people who've had their surgeries delayed because of a lack of anesthesiologists in Alberta. 

"I was shocked because I would have never thought that this was a possibility, and I felt like we just had the rug pulled out from under us," said Konieczny.

Konieczny has a chronic kidney disease and has been waiting for a living kidney donor for more than four years. 

But she was told earlier this month by her transplant coordinator that the transplant agency for northern Alberta temporarily pulled out of the National Kidney Paired Donation Program, in part, because there aren't enough anesthesiologists available for surgeries. So her wait continues. 

Alberta Health Services says the pause is temporary, and that the northern Alberta transplant team will work with Canadian Blood Services to help highly sensitized patients with limited options during the pause. 

But Konieczny's story isn't a rare one.

Dr. Lucie Filteau, president of the Canadian Anesthesiologist Society, says the anesthesiologist shortage is not just a problem in Alberta. Provinces across Canada are dealing with vacancies, which was amplified by the pandemic, she said.

According to 2019 numbers from the the Canadian Medical Association, there are approximately nine physician anesthesia care providers per 100,000 people in Canada, which is well below other high-income countries such as Germany, Australia, the United States and the United Kingdom.

Burnout among health-care workers

Dr. Kevin Gregg, president of the anesthesia section of the Alberta Medical Association, has seen the effects of the shortage first hand. He says many anesthesiologists retired during the COVID-19 pandemic. He added that burnout among physicians is a factor, and morale at hospitals has been low the past few years. 

It's not a surprise that there's been some fatigue — he says he works, on average, 60 hours a week. 

"At some point, people burn out and want to slow down. We have people that used to pick up a lot of extra calls to help out the group and do extra cases, and we're just not seeing that right now," Gregg told The Current host Matt Galloway. 

But the challenge isn't just a lack of anesthesiologists. He says that with the aging population in Canada facing a variety of health issues, there has been a rise in the number of surgeries needed. 

Prioritizing surgeries

Gregg, who works in Edmonton, says the lack of anesthesiologists means hospitals and provincial health authorities have to make hard decisions. 

"At the end of the day, the operations team makes a decision on which surgeries get prioritized," he said. 

This means cancer-related surgeries are scheduled first, while non-urgent surgeries, and those related to quality of life, have to wait. 

Filteau says rural areas are the hardest hit. 

"It is sometimes more difficult to recruit anesthesiologists to rural areas. And as a result, if there's short staffing and there are very few people in the rural areas, it becomes a snowball effect," she said.

"The few people that would be in a rural area providing anesthetics will be on the hook for working much longer hours and covering call shifts."

Calls for more anesthesia assistants

A potential solution is to have one anesthesiologist cover multiple surgeries at a time, but Filteau says she doesn't recommend that approach as it wouldn't provide patients with an appropriate level of care in line with Canadian standards. Instead, she suggests focusing on efficiency. 

She says part of the solution is to hire more anesthesia assistants, who work closely with anesthesiologists to care for patients undergoing surgery. It would make the care team stronger, and the work environment better, she said, but it requires having more people trained as assistants.

The Canadian Anesthesiologist Society, in a statement on their website, also suggests streamlining the process to license foreign-trained physician anesthesiologists, make it easier for anesthesiologists to move between provinces, and find ways to help physicians dealing with burnout.

But Filteau says there are inefficiencies in hospitals that need to be solved first. 

"Unlike private industry, the hospitals can have a lot of bottlenecks to the process of care. We're not talking about a race car pit crew here," she said.

"There are inefficiencies that happen, and addressing those inefficiencies would make a lot more sense."