Winnipeggers wait over a year for echocardiograms
June 19, 2019
WINNIPEG – Patients in Winnipeg are waiting more than a year for a diagnostic heart test that patients in major cities in Saskatchewan and Ontario can get in weeks. The wait list for elective echocardiograms – a heart ultrasound used to detect disease and defects – has ballooned to over 7,000 patients in Winnipeg, with the wait time pegged at an average of 66 weeks between the city’s two major hospitals.
An interview with Health Minister Cameron Friesen was declined, but in a prepared statement he said that all Canadian jurisdictions face the “challenge of sustaining healthcare.”
The CBC reached out to the health minister’s office to ask if his government would be open to encouraging more private-public partnerships. Friesen’s statement did not respond to the question.
“We are not ideological about the manner in which a service is provided, but we are determined to get the best service possible to all Manitobans,” he said in a prepared statement.
Jon Gerrard (pictured), a Manitoba Liberal MLA who is also a medical doctor, says the government needs to be doing a better job at exploring its options, including moving to the Saskatchewan system.
“Echocardiograms are very basic tests. They need to be available quickly as they are in Saskatchewan. It’s embarrassing that Manitobans have to wait so much longer than Saskatchewan,” he said.
“It’s pretty disheartening,” Dr. Chris Simpson, an Ontario cardiologist and vice-dean of the Queen’s University School of Medicine, told CBC News. “I don’t know of anywhere else that has this sustained problem with this degree of magnitude in echocardiography access.”
At Regina’s Advanced Echo Lab, a patient with a referral from a doctor, can get an echocardiogram – covered by Saskatchewan Health – within one week, said Cindy Geni, the medical office assistant charged with booking appointments.
Meanwhile, according to data obtained by Shared Health, the newly created provincial health organization in charge of diagnostic services, the wait list at St. Boniface Hospital has increased to 70 weeks, compared to 48 weeks in 2017-18 and 21 weeks the previous year.
At Health Sciences Centre, the current wait is 63 weeks, compared to 42 weeks in 2017-18 and 17 weeks in 2016-17.
Leonard Kaplan, 63, has chronic obstructive pulmonary disease (COPD) and is awaiting approval for a lung transplant. Part of that process means he has to undergo an echocardiogram. About three months ago, he was told he would be waiting 14 months or longer for the test.
He says it is shocking that a patient can get hip replacement surgery before he gets a simple test. The current median wait for a hip replacement in Winnipeg is nine weeks.
“I mean I’ve got the time to do these tests and they haven’t explained why there’s such a delay. And that sort of frustrates me,” he said.
An echocardiogram is a procedure that takes about 30 minutes and requires a technologist placing a probe on the patient’s chest to take images of the heart, similar to the way an ultrasound would be conducted on a pregnant woman. The images are then sent to a cardiologist for interpretation.
Kaplan’s lungs are only at 37 percent capacity and he requires oxygen daily. While his doctor says he could have an immediate echocardiogram in an emergency, he wonders why it needs to come to that.
“All I need is one tiny little infection or something and I’ll be hospitalized and they could be forced to do those tests at a cost far more than it would be to do it right now while I still have my health,” he said.
Simpson is also the former president of the Canadian Medical Association and remembers a visit to Winnipeg in 2015. At that time the echocardiogram wait list was 4,000 patients long and patients were waiting about 38 weeks. He told the Winnipeg Free Press there was “no excuse” for these wait times.
Echocardiograms were in the spotlight in 2015 after a report on the Winnipeg Regional Health Authority’s Cardiac Science Program described the echocardiogram wait as “way outside the acceptable value.”
National benchmarks say a non-urgent cardiogram should be scheduled within 30 days of a doctor’s referral.
A spokesperson for Shared Health said that it brought in seven additional sonographers to conduct the tests at HSC and St. Boniface, which has seen the wait list reduced by 2.5 weeks.
She said anyone in need of an emergency echocardiogram will get one immediately, while those deemed “urgent” will get one within 72 hours and patients deemed “semi-urgent” will be seen within 12 weeks.
Simpson says there are no similar wait times for echocardiograms in Ontario cities. “Nothing like you’re experiencing in Manitoba right now,” he said.
Part of that can be attributed to a private-public model used in Ontario and Saskatchewan, which uses community doctors or technologists in clinics to do the tests and bill the respective governments, he said.
There are over a hundred clinics listed across Ontario where an echocardiogram can be performed. In Manitoba, all echocardiograms are done in a hospital setting.
Simpson says fixing the wait times isn’t simple and isn’t just about increasing staff, but also resources. “You can’t simply just say well we’re going to put four more sonographers on and we’ll check in again in a couple of years. It takes … a commitment to get the wait list down,” he said
According to Manitoba Health, current regulations only allow for this type of diagnostic procedure to be conducted in a hospital or a “facility approved by the minister” if it is to be covered by Manitoba Health.
No private facilities are currently approved for provincial coverage.
Prota Clinic, located on Lorimer Boulevard, offers Winnipeggers elective echocardiograms for $650.
In 2014-15, the Maples Surgical Centre was contracted by the Manitoba government to complete 10,000 echocardiograms over three years. The private clinic completed roughly 3,500 a year before the contract ended in 2016-17.