In today’s message you will find:
- Board Modernization
- New Major Report on Surgical and Diagnostic Backlog
- Weekly Update: Rural and Northern ERs
- Tariff Approved for Virtual Management of Pregnancy Termination
- COVID Updates
- Other Health System Updates
- Fantastic Physicians
- Upcoming Events
Help Us Represent You Better
Doctors Manitoba was established over 100 years ago to bring together and represent the medical community. Periodically, our Association has made changes to ensure it is representing the broader membership in the best possible way to deliver the best possible results for physicians. Below, you will learn about the latest review of our structure, with an invitation to share your views on this important subject.
“Doctors Manitoba is your medical association,” said Dr. Candace Bradshaw, President of Doctors Manitoba. “Doctors Manitoba exists to represent the interests of physicians and medical learners and to push for the support and resources you need to do your jobs well. To achieve this, we need to ensure Doctors Manitoba decisions and priorities are responsive to physicians’ and medical learners’ needs and concerns.”
Recognizing a lot has changed in the profession over the last two decades, the Board of Directors created a Special Committee on Board Modernization to consider whether or not changes are needed once again to improve our governance structure and how we engage members in decision-making. You can see the full terms of reference for the Special Committee here.
The Special Committee is chaired by former Doctors Manitoba President Dr. Aaron Chiu, who is joined by a group that reflects a cross section of members. Their role is advisory, to review the latest in governance best practices, how other medical associations are governed, and to seek the views of members on the issue. This will be used to make a recommendation to the Board about pursuing governance changes or maintaining the status quo. Ultimately, any significant changes to the governance structure or how decisions are made would be subject to members’ approval.
Dr. Chiu and Dr. Bradshaw noted there are several reasons the Board has tasked the Special Committee with reviewing how Doctors Manitoba is governed and how members are engaged in important decisions:
- Some of Doctors Manitoba’s governance structures haven’t changed in years and might be considered outdated (e.g. medical district boundaries).
- The medical profession is growing and changing, and it’s important to ensure Doctors Manitoba is able to understand and represent its members.
- Doctors Manitoba needs to be positioned for what is coming. There are many challenges on the horizon coming out of the pandemic, including a health care system that is struggling, record levels of burnout in the profession, and the potential for economic instabiity and fiscal restraint.
- Corporate boards are striving to ensure they have access to technical skills and expertise to make the best possible decisions.
- Many Boards are prioritizing equity, diversity and inclusion because of growing evidence about the value of diversity in decision making.
Dr. Chiu added: “This is the time to have your say about how Doctors Manitoba should represent the profession for the next decade and beyond. Could our governance structure be improved to make better decisions on behalf of our members? Should we review and update our Medical Districts? What’s the best way to engage members on important issues? Please take five minutes to share your views.”
Share your views by taking this 5‑minute survey. Your feedback will help to guide the Board Modernization Committee in making recommendations to the Board and membership on these issues.
New Major Report on Surgical and Diagnostic Backlog
A year after releasing our first report on the pandemic backlog of surgical and diagnostic testing, we have released a new report with an updated estimate that suggests the backlog is between 102,000 and 128,000 cases.
This backlog includes between:
- 31,664 and 39,674 surgeries
- 12,346 and 17,039 diagnostic imaging tests
- 58,192 and 71,734 other procedures, including allergy testing, endoscopies, mammograms, seep disorder studies, lung function tests and chronic pain assessments
Our previous estimates relied solely on comparing the volumes of procedures to determine how many were missed during the pandemic. After two years, some of those missed procedures may no longer be required. Our new approach looks forward, using a more comprehensive analysis to estimate how much work is required to return the system to pre-pandemic performance. The new estimates incorporate a variety of data, including decreased volumes during the pandemic, wait lists, wait times, and reports from physicians and health system leaders.
→ See our latest report on the backlog here. See our backlog dashboard and past estimates and reports here.
Doctors Manitoba has been reporting on the backlog as part of our work to raise awareness around the issue and advocate for the resources needed to address it. Over the last year, a task force has been created, over $160 million has been committed to adding more capacity, and the government has said on the record they will do “whatever it takes” to clear the backlog.
We also reviewed progress on the three recommendations we made a year ago to the health system, and added a new recommendation as well:
- Create a task force to oversee reducing the backlog (COMPLETE)
- Provide monthly updates including the size of the backlog (IN PROGRESS)
- Set a target date to clear the backlog (INCOMPLETE)
- Ensure the health system not only catches up, but also keeps up with a growing population and advances in medical practice through annual increases in surgery and diagnostic volumes when needed. (NEW, and accepted by the Task Force)
With monthly updates expected to start this summer from the province, the June report will be Doctors Manitoba’s last monthly update on the backlog.
Our monthly update on behalf of physicians received wide media coverage, including:
- CTV News (Watch Here: ‘All hands on deck’ Task force to release new tool measuring Manitoba’s surgical, diagnostic backlog)
- Global News (Watch Here: Doctors Manitoba says province’s surgery backlog at 128K)
- CBC News (Read Here: Manitobans will be able to see diagnostic, surgical backlog data with online dashboard: task force)
- Winnipeg Free Press (Read Here: Surgical, testing estimates highlight declining backlog)
- Winnipeg Sun (Read Here: Doctors Manitoba revises surgical, diagnostic backlog estimates)
Weekly Update: Rural and Northern ERs
We are making weekly updates to RuralCare.ca, our new public awareness tool to support Manitobans in accessing care amidst frequent and widespread rural and Northern ER closures.
→ Learn more about why we launched this online resource in our update last week.
This week, changes to ER schedules include:
- Southern Health — Santé Sud (check current RHA schedule here)
- Altona ER is open 12 hours daily, but is scheduled to be closed July 4 – 7
- Notre Dame ER is open 24/7, but it is now scheduled to be closed periodically, including July 4, 6, and 8 – 10
- Prairie Mountain Health (check current RHA schedule here)
- Carberry and Glenboro ERs, which have a shared schedule, will both be closed July 8 at 3:30PM to July 11 at 8AM
- Grandview ER, which is typically open 24/7, will be closed June 30 from 8AM to 8PM and July 3 from 8AM to 9PM. Effective July 8, the ER will move to reduced hours of Mon-Fri, 8am-8pm.
- Melita ER continues to be closed until July 15
- Roblin ER, which has reduced hours to weekends only, will not be open this Saturday (July 2 8:30AM to July 3 9AM) and Sunday night (July 3 7PM to July 4 8:30AM
- Souris ER will reduce hours starting July 4 for the summer, with the ED closed on Mondays and Wednesdays.
- Ste. Rose ER, which has reduced hours to 12 hours per day, will be closed from July 1 at 8PM to July 3 at 8AM
- Interlake-Eastern (check current RHA schedule here)
- Pine Falls ER was expected to re-open July 1, but the ER will remain closed for now.
- ERs in Beausejour, Eriksdale and Arborg continue to have frequent shifts with no doctor available.
- Gimli is expected to be open, but may be closed on July 7 during the day due to physician availability.
Over the last week, our initiative has been shared extensively on social media and in the news, including:
- CTV News (Read Here: ‘Not sustainable’: Doctors Manitoba concerned about rural and northern Manitoba health-care system)
- Steinbach Online (Read Here: Concerned doctors create resource for rural care)
- CBC News (Read Here: ‘At the breaking point’: Doctors call staff shortages in rural, northern Manitoba a crisis)
- Winnipeg Sun (Read Here: Doctors Manitoba sound alarm over rural ER closures)
- Global News (Watch Here: ER closures expected as doctors concerned over rural and Northern Manitoba health care)
- Winnipeg Free Press (Read Here: Doctors raise alarm over rural ER closures)
Tariff Approved for Virtual Management of Pregnancy Termination
A new tariff has been approved to enable the virtual management of early pregnancy failure or elective pregnancy termination. Until now, the Physician’s Manual guidelines required an in-person exam, which was a significant barrier to accessing this care for patients in rural and remote communities.
The new tariff will support providing this care remotely, which aligns with the Mifegymiso product monograph that was updated before the pandemic. Online training on providing medication abortion is available for primary care providers through the National Abortion Federation Canada, with Mainpro+ credits available.
The new tariff is effective retroactively to December 1, 2021. For any claims before of the 6 month billing window, you can submit but please let us know so we can advise Manitoba Health to ensure your claims are processed.
For more information about this tariff, review the guidance and notes below or contact Braden at email@example.com
(Click the arrow to expand for notes)
Rural and remote medical termination
Virtual management of early pregnancy failure/elective pregnancy termination, management and monitoring of patients taking cytotoxic and/or prostglandin medications (e.g. Methotrexate/Misoprostol). This service may include administration of the medication, ordering blood tests, interpreting results, inquiring into possible complications and adjusting dosage(s) as necessary
- Follow up care to ~8427 to be billed under Regional Examination.
- Includes telephone/facsimilie/email communications with other physicians or health care providers regarding the patient.
Public Health now posts weekly COVID-19 Surveillance Reports on Thursdays. This week’s report, which is again showing“decreased activity,” covers the week ending June 25. Highlights include:
- Severe outcomes from COVID-19again“decreased compared to the previous week”. There were 46 hospital admissions, down from 58 the week before. This includes 5 ICU admissions, down from 8 last week. Hospital admissions peaked most recently at 264 the week ending April 16.
- There was 1 death recorded, down from 6 recorded the previous week. There have now been 2,043 deaths related to COVID-19.
- There were 157 lab-confirmed cases reported in Manitoba over the week, down from 203 the previous week. The test positivity rate was 10.9%, down slightly from 11.3%.
The updated wastewater surveillance dashboard shows ongoing activity at much lower levels than earlier this year.
Long COVID Survey
The UM Rady Faculty of Health Sciences Respiratory Lab is looking for Manitobans who have had COVID or cared for someone with COVID to answer questions in a short 5 – 10 minute anonymous online survey. Download the poster or visit MBLongCOVID.ca to take the survey.
Fall Booster Recommended
The National Advisory Committee on Immunization (NACI) has recommended that a booster dose be offered this fall ahead of a possible next wave of COVID-19. The interim guidance was released now to help provinces and providers plan for a booster campaign.
The specific interim guidance includes:
- A strong recommendation that Individuals who are at increased risk of severe illness from COVID-19 should be offered a fall COVID-19 vaccine booster dose regardless of the number of booster doses previously received. This includes those age 65+, PCH and congregate living residents, individuals age 12+ with underlying conditions, and adults in or from Indigenous, racialized or marginalized communities.
- All other individuals age 12+ may be offered a COVID-19 booster dose in the fall of 2022, regardless of the number of booster doses they have previously received.
The booster shots should be offered six months after the last dose, though a shorter interval of at least three months could be considered if there are increased risks.
NACI is expected to provide advice before fall on the type of booster, as vaccine manufacturers are already working on Omicron targeting boosters.
Other Health System Updates
Infant Formula Shortage: Dr. Brent Roussin sent a message to all physicians today about the infant formula shortages. While the formula shortage is here is limited to these specialized formulas and not as widespread as in the U.S., parents are having challenges finding formulas for babies with allergies. The letter has links to resources including a decision tree to navigate the shortages, and mentions a provincial working group has been created to help manage the situation. Read Dr. Roussin’s update here.
HSC ER is struggling: The HSC ER has a critical nursing shortage, and is relying on redeploying nurses without full emergency training and paramedics to help fill staffing gaps. Doctors Manitoba has been in touch with the emergency physicians at the site, and will assist with escalating their concerns about the issues. The ERs at St. Boniface and Grace continue to face staffing challenges as well.
New Visitor Guidance: Shared Health has updated its guidance on visitation policies in health facilities, effective today. This includes having four designated caregivers for PCH and inpatient areas (up from two), or two designated caregivers in EDs, urgent care or outpatient settings (up from one). General visitors will also be allowed, with guidelines and limits set by individual facilities. You can see the full memo on the changes here.
More Ambulatory Care Clinics Open at HSC: On June 27 the New Ambulatory Care Clinic at HSC opened the final group of clinics. These include Allergy, Cardiology, Dermatology, Endocrinology, Gastroenterology, Hepatology, and Infectious Diseases. Get all the information, including updated fax numbers here.
Adult Epilepsy Surgery Program to be Establish in Manitoba: A comprehensive epilepsy program being established in Manitoba will offer life-changing surgery within the province for adults living with the chronic neurological condition, Health Minister Audrey Gordon announced today. An annual investment of more than $2.5 million in operating funding will support both the establishment of the adult epilepsy surgery program as well as the expansion of the pediatric program, which has completed about 15 surgeries per year since starting in 2017. When the expanded program is fully operational, approximately 50 epilepsy surgeries will be completed per year in Manitoba including 20 adult and 30 pediatric cases. The program, including surgeries, will be run at Health Sciences Centre (HSC) Winnipeg.
$30 million for patient-oriented research: The Rady Faculty of Health Sciences has landed $30 million in research funding to support patient and public involvement in research and the health system. This will continue the important work at the University and the Centre for Healthcare Innovation. The funders include CIHR, the Manitoba government, Shared Health and the University. Learn more here.
Two Manitoba physicians are being inducted into the Order of Canada! Governor General Mary Simon announced this year’s list earlier this week. Of the four Manitobans included, two are physicians! Dr. Michael West established the neurosurgery program at HSC and was the first in Canada to use the gamma knife as a less invasive treatment for brain cancer. Dr. David Rush is a leading transplant nephrologist and is recognized for his seminal work on the mechanisms underlying graft rejection. Congratulations to Dr. Rush and Dr. West!
Congratulations to Dr. Marcia Anderson who has received the 2022 Lieutenant Governor’s Award for Excellence in Public Administration. She has “repeatedly distinguished herself through her commitment to continual improvement of health care and her significant actions to promote anti-racism, tackle systemic discrimination, and improve health services for Indigenous people.” Congratulations and well-deserved, Dr. Anderson!
Here are some of our most read and notable recent updates, in case you missed them:
- Read President Dr. Candace Bradshaw’s recent letter about physician health. New statistics about the level of burden, depression and suicidal ideation are very concerning. Doctors Manitoba has been expanding physician health resources and supports.
- Earlier this month, Board President, Dr. Candace Bradshaw sent a letter outlining our efforts to have the government withdraw record-keeping regulations, which would have added an average of 72 minutes per day of documentation.
- Shared Health created new Long COVID resources for both the public and practitioners.
- Help Doctors Manitoba build a list of clinics/physicians providing Sexual Health & Gender Affirming care for LGBTQ2S+ Manitobans
- More physicians may be needed to care for Ukrainians arriving in Manitoba. Learn more and submit your name here