Prior to the pandemic, the government had invested and made some progress on addressing wait times in a number of areas. The pandemic response has erased this progress. In June, Doctors Manitoba estimated the pandemic disruptions had created a backlog of over 100,000 surgeries and diagnostic procedures. This number continues to grow, and Manitoba appears to have had more disruptions than other provinces.

Doctors Manitoba made three recommendations to the province to address this massive issue: 

1. A clear provincial commitment to fully address the pandemic backlog by a fixed date. 
2. The creation of a surgery and diagnostic recovery task force, including both health system leaders and front-line physicians and health care workers, to lead the immediate and sustained task of addressing the backlog. 
3. Monthly public reporting on the size of the backlog and on actions to improve the situation. 
   

Will you adopt these recommendations and provide the support, leadership and resources needed to fully address the pandemic backlog? 

Shelly Glover:

Addressing the damage the pandemic has done to our health care system will be a priority. We will collaborate with all health care stakeholders in this task and we discuss all ideas and required solutions in an open and honest manner. We will place strong emphasis on action in ensuring our health care system remains sustainable. 

We will take immediate action to begin to address the surgical backlog caused by the pandemic. Measures such as removing the cap on knee and hip surgeries as well as allowing surgeries on weekends are potential solutions that should be given priority consideration.We are committed to better public communication across government. Communication regarding the pandemic and concerning the surgery backlogs is very important to effective health care. 

Heather Stefanson:

I have been clear on my position since receiving the Doctors Manitoba report. After preparing and getting through the fourth Covid wave, there is no higher priority than addressing the surgical and diagnostic backlog in healthcare. 

In my last meeting with your President (Dr. Thompson), I committed to adopting and following through on all three recommendations made. I stand by that commitment and hope to provide a more fulsome update on all three in the immediate future. 

Throughout Canada, we know that Covid has affected provincial health systems in many different ways, and equally as important, at different times. Your update earlier this month shows the scope of just how many of those surgeries, diagnostics, and procedures were either halted or postponed. 

This project is an enormous undertaking in both time and resources, and I am fully committed to providing both. For some perspective: London is looking at a ten-year plan for their backlog. In jurisdictions with similar circumstances to Manitoba, estimates say that raising and maintaining the surgical capacity to 125 – 130% would mean four years to eliminate their backlogs. Four years is too long for people who have been waiting in pain and for those whose conditions have worsened. 

There is a real opportunity for partnership and creating a made-in Manitoba-based solution that will provide the needed capacity and volume in the shortest timeframe possible. This is a time for innovative solutions and outside-the-box ideas, which will only be found through collaboration with physicians, healthcare professionals, and leadership. 

We need to work together to make sure we get this right. 

Doctors Manitoba and the province were able to rapidly negotiate and introduce virtual care options for physicians early in the pandemic. This was a new tool, and it has since proven to be a very effective option to keep patients connected to physicians. While some other provinces have already committed to making virtual care a permanent option after the pandemic, Manitoba has not. This means physicians are left with uncertainty about investing in new technology to expand the use of video visits and other modalities. 

Will you commit to keeping virtual care after the pandemic, to ensure patients in rural and northern areas, as well as in Winnipeg, continue to have this option for physician visits, when medically appropriate?

Shelly Glover:

Yes.

The use of virtual care during peak times of the pandemic has proven to be effective. We must also maintain best practice guidelines for virtual care to ensure all Manitobans benefit.

Heather Stefanson:

One of the positive things to come out of the pandemic has been the number of innovative care solutions that have been enhanced or created to help close the distance and provide alternative methods of care for people. Virtual care is instrumental to many Manitobans during the pandemic. 

It gives most a safe, fast, and reliable way to interact with their doctor or healthcare professional. Many Manitobans have voiced their opinion that they prefer it in many situations. 

The key here is that there is a choice, both for the patient and for the physician.

Continuing to give Manitobans a choice virtual care offers is a game-changer, especially for those in our rural and northern communities and those with other challenges. 

Manitoba has such diverse population groups and centres, and virtual care is an incredible tool to help bridge the gap to many who otherwise would have struggled without it.

Physicians respect the role of elected officials to create policy and make decisions, including during emergency situations such as the COVID-19 pandemic. As Premier, your first job would be to protect the health and safety of Manitobans. Physicians would like to be reassured that you will listen to the advice of public health and medical experts and use that advice in making decisions about the pandemic response and recovery. 

Will you seek and act on public health and medical advice during the pandemic response and recovery period?

Shelly Glover:

Yes.

Heather Stefanson:

Protecting the health and safety of Manitobans is paramount.

To make the best decisions for Manitobans, we must listen to our Medical Experts and Public Health officials, who give evidence-based, scientific advice, and who use the best research and informed information they have at the time.

Our province has seen its best results when government, Public Health, and medical experts work together, communicating, listening, and planning proactively. We also need to be flexible enough to change our plans if the situation changes.

A good example of this can be found in how Manitoba has been dealing with the fourth wave. Many recommendations were made leading up to summer, and from those, we made choices with our restrictions, vaccination campaign, and immunization cards that greatly differed from our neighbors. As a direct result of listening, learning, and planning together, we have been able to blunt the fourth wave so far.

As any government considers major changes to the health care system, physicians can offer valuable advice and they can play a role in communicating with the public and patients about changes that could be controversial. In the past, physicians were not always consulted about major challenges and changes to health care, changes that affect their ability to offer patient care. 

Doctors Manitoba is the non-partisan organization that represents all physicians in Manitoba. We can offer constructive feedback on potential changes and, perhaps most significantly, we are the best positioned organization to help government and health system leaders seek feedback and partnership from physicians when changes are contemplated.

Will you commit to working with Doctors Manitoba to consult physicians about challenges or significant changes to health care, and ensuring health system leaders do the same?

Shelly Glover:

Yes. Real collaboration is at the heart of good government. We will welcome all stakeholders and Manitobans to the table. We will share ideas and discuss solutions openly and honestly. And we will take action together.

Heather Stefanson:

Without open dialogue and communication, there can be no success in dealing with major challenges or changes to our healthcare system. It must be a foundational element, especially with physicians and their leadership. 

During the pandemic, we have seen that you are the first point of contact for many Manitobans regarding their own health issues or for advice and understanding of the wider system. It is in Manitoba’s best interest to recognize this and ensure that there is a constructive, robust, and strong relationship there.

Over the last few years, Manitoba underwent some of the largest health systems changes our province has ever experienced, and when the pandemic hit, many of those changes were affected.

I think everyone can agree that Manitobans deserve the best possible healthcare possible and deserve the best possible system to deliver that care. Physicians have not always had a seat at the table, but now more than ever, we need to be talking and receiving feedback.

Physicians are in the best position possible to help Manitoba succeed, and that needs to be recognized, and it needs to become part of how we improve. The next few years are crucial for our system, as it is now moving to a ​‘living with Covid’ reality.

Prior to the pandemic, 30% of physicians across Canada were estimated to be showing signs of burnout (CMA, 2017). We know physicians who are burned out are more likely to have clinical errors which can impact patient safety. Some also decide to leave their practice. 

Practicing during the pandemic has only exacerbated these concerns. Based on a survey of over 1,400 members in Manitoba, we estimate approximately 45% are showing signs of burnout. In addition to burnout, many physicians report feeling traumatized by what they have witnessed and experienced during the pandemic and now have moral injury due to providing care within a system that was not prepared to address the pandemic. Some areas of the health system have major health human resource challenges, such as significant shortages in ERs, ICUs, ORs and other areas.

Will you commit to develop a Health Workforce Pandemic Recovery Strategy that focuses on system change to reduce burnout, improve patient safety and retain physicians working in Manitoba? 

Shelly Glover:

Yes. Burnout among front line health care professionals is a significant concern and must be a key part of any and all recovery plans.

Heather Stefanson:

Covid has made it clear to Manitobans that our health professionals are our system’s most precious resource. No matter how many beds or ventilators you may have, nothing can be done if the people behind them aren’t there.

I am committed to doing whatever it takes to ensure there is enough trained and qualified staff in our healthcare facilities and that they have access to the resources they need. That action is taken to help with the mental health burden that burnout is causing.

This is why I signed the MNU petition for staffing resources and improvements because I know that we can do better and that the solutions don’t involve treading the same, tired ground.
We cannot succeed as a system unless our incredible healthcare professionals are given the tools and resources to succeed, including needed systems changes.

One of the issues contributing to burnout and uncertainty is the added costs of operating a medical practice during the pandemic. Many physicians operate in an independent practice, funded primarily through fee-for-service remuneration from the Province of Manitoba. This model works most of the time to help remunerate physicians and cover overhead costs to maintain and operate a medical clinic. During the pandemic, however, patient visits have decreased and overhead costs have increased. 

In an unprecedented emergency situation with provincial direction and restrictions, physicians could use the government’s help with the added precautions such as additional PPE and rapid test kits. 

Will you pledge to support physicians in offering safe medical care by ensuring the province covers the cost of added precautions necessary during the pandemic, as it does for RHA-run clinics and health facilities?

Shelly Glover:

We must ensure all of the health care system is subject to assessment when we are developing recovery plans. The impact of the pandemic on doctors’ practices is an important consideration in that process.

Heather Stefanson:

Nothing is off the table to ensure we can succeed together in this, and I would welcome further discussions on what can be done to help.