In today’s message you will find:
- Pandemic Backlog Progress Report
- Unnecessary Administrative Burdens
- CMA Invite on Reconciliation
- Health System Updates
- Physician of the Week – Dr. Suzanne Robinson
- Health in the News
- Upcoming Events
Pandemic Backlog Progress Report
Earlier this week, the Diagnostic and Surgical Recovery Task Force provided a public update on its work towards eliminating the backlogs that had accumulated during the pandemic.
According to the update, provided by Task Force Chair Dr. Peter MacDonald and Head of Surgery Dr. Ed Buchel, the surgery backlog has been reduced by 32% and the diagnostic backlog by 31%. This equates to about 26,500 cases in additional capacity since 2020, suggesting the remaining backlog is about 85,000 cases. Together, this totals the total backlog was about 111,000, which is very close to the last estimate Doctors Manitoba provided last year of 102,000 to 128,000.
It is important to note that eliminating the pandemic backlog means restoring a service to its pre-pandemic wait time or wait list. For many procedures, wait times before COVID-19 were unreasonably long or much longer than other provinces. We were encouraged to hear the Task Force say this week that part of its work is also to go further than the pandemic backlog and work towards reaching Canadian benchmarks. This is important in an area such as cataract surgery, for example. While the Task Force says the pandemic backlog has been eliminated, the pre-pandemic wait time was unreasonably long. Only 33% of patients in Manitoba received their cataract surgery within the 16-week benchmark in 2019 according to CIHI, which is second lowest among provinces and much lower than the Canadian average of 70% and the goal of 90%.
The Task Force reports that backlogs in 10 of 30 service areas have been fully eliminated. These areas include:
- Cataract surgery
- CT scans
- Ultrasound tests
- Cardiac catheterization lab tests
- Pacemakers surgeries
- Pediatric neurodevelopmental assessment
- Urology tests
- Orthopedic surgeries (excluding hip, knee and spine surgeries)
- Oral surgery and dentistry
- Echocardiography tests
The Task Force further reports that backlogs have been partially reduced in five other areas:
- Cardiac surgery (reduced by 54 per cent)
- Bone density (reduced by 53 per cent)
- Pain management (reduced by 47 per cent)
- Orthopedic spine (reduced by 94 per cent)
- Adult allergy testing (reduced by 66 per cent)
From this, Doctors Manitoba’s analysis would suggest significant backlogs remain in several other areas. Based on our earlier analysis and feedback from physicians, these areas likely include:
- Sleep disorder testing
- Hip and knee replacements
- Pulmonary function testing
- MRI scans
- Other surgical areas, including general surgery, plastics, vascular, thoracic, ENT, neurosurgery, gynecology, bariatric
- Pediatrics, including surgery and allergy testing
- Cardiac-related procedures including holter monitoring and electrophysiology lab
While Doctors Manitoba is no longer generating our own monthly dashboard of the backlog, we will be doing some audits of these updates, and we welcome your feedback about whether this update reflects what you are seeing in your work. You can email us at firstname.lastname@example.org with any comments.
In the update, the Task Force also described work underway to add capacity and reduce wait times. This work includes:
- Launching the surgical waitlist information system, or SWIM, this fall.
- Expanding eConsult and eReferral.
- Expanding OR capacity, including in Brandon, Ste. Anne, Steinbach, Interlake Eastern RHA, and in Winnipeg at HSC, Concordia, Victoria, Pan Am, Misericordia, and St. Boniface.
- Additional capacity for endoscopy in Flin Flon, Selkirk, Beausejour, Steinbach, Ste. Anne, and in Winnipeg at Seven Oaks, St. Boniface, HSC, and Victoria. New capacity will also be added at Manitoba, Winnipeg, and Assiniboine Clinics.
- Additional training and recruitment, for physicians and other providers. This includes surgeons, anesthesiologists as well as anesthesia clinical assistants, new OR assistants and other providers.
→You can watch the full presentation here.
Physician Concerns Aired
This week has seen news stories about two groups of physicians expressing frustration about their proposals to address the backlog being held up and a lack of communication from the Task Force. This includes physicians with the Sleep Disorder Clinic and orthopedic surgeons at Grace Hospital. Doctors Manitoba has been in touch with these physician group to offer our support. We’ve also been in touch with the Task Force to address the concerns, specifically about the repeated frustrations we hear from physicians about the onerous process to submit ideas and the lack of communications with physicians.
Dr. Candace Bradshaw, President of Doctors Manitoba, said earlier this week that “physicians want to help tackle the backlog, so it is discouraging to hear many have faced red tape and barriers in submitting and advancing their ideas to speed up patient care. We have suggested ways to better support doctors in submitting proposals and to improve communication with them, and we look forward to working with provincial officials to put those ideas into action.”
Backlog Task Force Chair Dr. Peter MacDonald responded in the Free Press saying he’s aware “there’s been some dissatisfaction” over proposals led by physicians and noted the task force is working with Doctors Manitoba to smooth out red tape. “We’re working with the leadership at Doctors Manitoba to make sure it’s as easy as possible, but procurement processes such as (request for service agreements) are intrinsically complicated, so we’re trying to simplify it as much as possible.”
Unnecessary Administrative Burdens
Can you help estimate how much time physicians spend on unnecessary administrative tasks? You are being asked to respond to a one-question poll that should take less than one minute to complete – details follow below.
Doctors Manitoba continues to hear from many physicians about the unnecessary administrative burdens on your plate and how it eats up precious time out of your already busy day. Your feedback has described this as inefficient, frustrating, distressing and some have talked about how it’s contributed to their burnout.
A Task Force has been struck to reduce administrative burdens on physicians, reporting jointly to Doctors Manitoba and the provincial government. The Task Force has met twice and is reviewing your feedback to help identify the top unnecessary administrative burdens to target for improvement.
As part of their work, the Task Force is asking for your help to to estimate how much of the time physicians spend on administrative tasks is unnecessary. This will be used to set a goal to reduce the time that physicians spend on unnecessary administrative tasks. Some of these tasks have been described as totally unnecessary and should be eliminated completely. Of course, some administrative tasks are necessary and can’t be eliminated altogether, but portions of them are unnecessary because they could be streamlined or improved in some way, or perhaps they are needed tasks but unnecessary for a physician to complete as they can safely be executed by another profession, such as a nurse, pharmacist, or physician assistant.
To help fine-tune the estimate of what is unnecessary for physicians to complete, physicians are being asked to complete a one-question poll that should take less than one minute of your time. This is completely optional, but you are encouraged to respond if you have time in the next few days.
You can also send the Task Force examples of specific unnecessary administrative tasks and your ideas to improve them. Send ideas and copies of unnecessary or overly complex forms and tasks to email@example.com.
The Joint Task Force was formed last month and has been reviewing hundreds of constructive suggestions from physicians. An update on its work is expected next month, including the biggest opportunities for improvement.
CMA Invite on Reconciliation
The CMA will host a 3‑part series on reconciliation titled “Fireside Chats on Indigenous Health”. The disparities faced by Indigenous Peoples – poverty, food insecurity, inadequate housing, lack of access to care, culturally unsafe health experiences and lack of support for traditional health models, among many others – have a significant impact on First Nations, Métis and Inuit Peoples. Dr. Alika Lafontaine, the CMA’s first Indigenous president, will be leading a 3‑part series of virtual discussions on how we can move forward on reconciliation in health care and toward a better future. The three sessions will focus on the importance of cultural safety in health care for patients and providers (May 10), improving the health of Indigenous Peoples (May 24) and the meaning and importance of an apology to Indigenous Peoples (June 12). Dr. Lafontaine will be joined by author and journalist Tanya Talaga and other guests, as they share various perspectives on these important topics.
→ Register now to join the series, part of the CMA’s commitment to tangible action in allyship with First Nations, Métis and Inuit Peoples.
Health System Updates
We have several health system updates this week to help you keep track of what’s changing.
Infant Formula Shortage
Health Canada issued an updated advisory this week on supply chain disruptions to certain types of infant formula. Disruptions first affected formula for babies with food allergies and other medical conditions. Health Canada addressed this shortage by facilitating the importation of formula from other countries through its interim policy and working with pharmacists for many months to make sure these were reserved for babies who needed them for medical reasons. These conservation measures have since been lifted, as the shortage of hypoallergenic formulas has now largely subsided. However, the supply of regular infant formula has been strained since last Fall. Although the supply of liquid formulations has been relatively stable, powders are more popular and are more often out of stock. This situation is anticipated to continue for the weeks to come.
Health Canada has prepared an information package containing resources that complement information found on the Health Canada webpage dedicated to the infant formula supply. Please feel free to distribute these broadly within your networks.
- A printable fact sheet for families summarizing information found on our webpage
- A list of new products or formulations to be imported under Health Canada’s interim policy in the coming months
- An infant formula summary sheet prepared by Alberta Health, to help you advise parents that cannot locate their usual product
COVID and Respiratory Updates
Manitoba Public Health produces a weekly report on respiratory viruses.
COVID-19 activity in week 15 was similar to the previous weeks. The number of reported cases was similar in the last few weeks while the number of COVID-19 associated hospital admissions seemed to decrease. The incidence rate in people aged 80 years and older decreased in the last week. Overall, laboratory detection decreased from the fall of 2022. Older adults continue to have higher risk for COVID-19 infection, associated hospital admissions, and fatalities.
Wastewater surveillance data up to April 11 indicated sustained activity of COVID-19 in Winnipeg and Brandon at lower levels compared to the fall of 2022.
Influenza activity level in week 15 continued to be low at inter-seasonal levels. This week, there were sporadic laboratory-confirmed cases of influenza A and B. Overall, influenza activity this season had an early start and also decreased earlier than would be expected.
Other respiratory viruses continue to co-circulate. The RSV detection and testing positive rate in week 15 was similar to the previous week. The activity level observed nationally was low for both influenza A and B.
COVID Immunity Updates
The COVID-19 Immunity Task Force’s recent update includes several helpful updates on understanding the level of population protection and addressing vaccine hesitancy.
The Seroprevalence Dashboard, relying on Canada Blood Services testing, continues to find strong levels of seroprevalence for both infection-acquired and vaccine-induced. Overall, 77% of Canadians have infection-acquired seroprevalence as of February 2023. In Manitoba, the number is similar, at 78%. A CITF analysis found that younger people (age 17 – 24) and people who are racialized continue to have higher infection-acquired seroprevalence. A study published in CMAJ Open validated that seroprevalence data is very useful to monitoring prevalence of COVID-19 among the population when compared to PCR testing.
Vaccine hesitancy can be fueled by how vaccine data is presented. A perspective, published in the International Journal of Infectious Diseases, reported that various biases in how data are collected and analyzed could lead to false negative conclusions regarding vaccine effectiveness. Such potential biases should be addressed when communicating real-world immunity research. A separate study published in BMJ Open focused on the South Asian community, demonstrating that understanding factors such as community dynamics, language, and cultural context can help build vaccine confidence and acceptance among diverse populations. Developing tailored outreach strategies can guide approaches to serve different communities during the current and future pandemics.
→ You can view the full CITF newsletter here.
National Advanced Skills and Training for Rural Practice
The goal of the National Advanced Skills and Training Program for Rural Practice is to increase opportunities for access to training by providing support/funding for practicing rural physicians, including international medical graduates and those in their first year of practice, to increase their skill sets based on the needs of rural, remote, and Indigenous communities. Examples of training may include diagnostic procedures, emergency medicine, general surgery, obstetrical care, and anesthesia. Rural physicians may receive funding for up to 30 days of training, travel, accommodation, locum expenses, preceptor stipend and overhead.
The program will fund training opportunities to upskill practicing rural physicians, including specialists, nationwide, enabling them to meet specific community needs and reducing the need for patient transport out of communities to receive these services.
The SRPC’s primary mandate is to support rural physicians and communities, and enhance access to high-quality care, close to home. The SRPC has a history of engagement in education and capacity-building projects, and these activities are core to the organization’s current activities. Learn more.
Physician of the Week – Dr. Suzanne Robinson
Paediatrician Dr. Suzanne Robinson provides a safe learning environment for learners and sets an example by engaging compassionately with patients and families. Described as a “powerful communicator and incredible mentor” by medical student Lisa Kim, Dr. Robinson is “an inspiration for the type of healthcare professional” students hope to become. Dr. Robinson practices child maltreatment medicine and general paediatrics care on Treaty 1 Territory at HSC, the Manitoba Youth Centre, and in Wasagamack First Nation. She also covers the Social and Northern Ambulatory Pediatric (SNAP) and Manitoba First Nation Call, which services Southwestern Nunavut, Western Ontario and Manitoba. Dr. Robinson feels privileged to have an impact, no matter how small, in her patients’ lives and when needed, to “advocate for them and their family with patience and objectivity”.
Health in the News
It’s been another busy week with news stories about medical and health care issues. We’ve curated the top stories, with exclusive access to subscription content.
Surgical and Diagnostic Backlog
- Manitoba’s backlog task force highlights wins after criticism from doctors who resigned • CBC Manitoba • Apr 19
- Surgery, diagnostic task force puts dent in backlog • Winnipeg Free Press (Print Edition) • Katie May • Apr 20
- Diagnostic, surgical backlogs down considerably, Manitoba task force says • Canada News • Apr 19
- Big cuts in backlog; Significant progress made as 30% reduction recorded, task force says • Winnipeg Sun (Print Edition) • Ryan Stelter • Apr 20
- Sleep doctors resign from Manitoba’s backlog task force, saying proposal was ‘completely ignored’ • CBC Manitoba • Apr 18
- Grace Hospital surgeons wait months for government action on ‘dire situation’ • Winnipeg Free Press (Print Edition) • Danielle Silva • Apr 19
- ‘I am the minister of the art of the possible’: Gordon on Grace doctors’ plea for help • Winnipeg Free Press (Print Edition) • Danielle Silva • Apr 20
- Doctors decry province’s tactics • Winnipeg Free Press (Print Edition) • Katie May • Apr 21
- Minister defends private ‘investments’ to reduce backlogs • Winnipeg Free Press (Print Edition) • Danielle Silva • Apr 20
Addressing the Physician Shortage
- U of M seeks to increase intake of medical students • Winnipeg Free Press (Print Edition) • Maggie Macintosh • Apr 15
- Manitoba wants 150 new family doctors for the province, and recruitment specialists to find them • CBC.CA News • Apr 17
- Manitoba seeks recruiter for 150 doctors • Winnipeg Free Press (Print Edition) • Carol Sanders • Apr 18
- Manitoba seeks help to fill physician gap • Brandon Sun (Print Edition) • Apr 18
- Health region turning to career expos to attract workers • CJRB-AM • Apr 19
Other News Stories
- Over two years before BRHC expansion complete • Brandon Sun (Print Edition) • Apr 17
- Decommissioning Manitoba’s over-budget personal care home visitation pods will cost $5M • CBC Manitoba • Joanne Levasseur • Apr 17
- Health regulators need prescription for transparency • Winnipeg Free Press (Print Edition) • Apr 18
- Health care workers need more training to help transgender patients say physicians • APTN National News • Sav Jonsa • Apr 19
- Doctor says cases of whooping cough spiking in Southern Health • SteinbachOnline.com • Apr 20
Here are some of our top recent posts, in case you missed them:
- We hosted three Family Medicine Town Halls — Primary Care for All
- Read last week’s Surgical/Diagnostic Backlog Update
- Apply now for Group CME Funding! Grants are available for up to $20,000 each to support group-based continuing medical education.
- Review Current Practice Opportunities
- EIA Disability Webinar available on demand
Upcoming events are always listed on our events calendar.
Doctors Manitoba Annual General Meeting | May 11 at 6:30 PM
Join us in-person or virtually for our AGM. The event features a fireside chat with Senator Dr. Gigi Osler, updates from President Dr. Candace Bradshaw and CEO Theresa Oswald, and an important vote on changes to our by-laws that are intended to make Doctors Manitoba more inclusive, representative of members, and improve how members are consulted about decision-making. Learn more and register now!
Connection Event for Black Physicians, Residents and Medical Students | May 4
In partnership with the UM Black Medical Students Association, Doctors Manitoba is hosting a social event for Black Physicians, Residents and Medical Students. Please join us on May 4 from 6:00 – 9:00 for an interactive cooking class being held in-person at The Food Studio on Roblin Blvd in Winnipeg. Don’t miss this opportunity to connect and network with other Black physicians and medical learners.
Seats are limited. Click here for more information and to register!
The culture of health care tends to view leadership as “solving problems,” but the conventional wisdom of fixing weaknesses has been shown to be limiting and ineffective in the long term. Sponsored by George & Fay Yee Centre for Healthcare Innovation and open to practicing physicians and residents, this interactive course will help identify strengths and offer ways leaders can leverage the strengths of their people to increase work engagement, well-being and drive innovation.
- MCFP Scientific Assembly on April 28. Register here and see the program here.
- 2023 Doctors Manitoba Awards Gala — Saturday, May 13 6pm
- Leadership for Equity: Expanding Inclusive Medical Culture : Session 3: Ableism 101: Learning to Diagnose and Treat Often-Fatal Ableism in Canada’s Healthcare System — May 23 6:30 – 8pm