I’ve been letting off warning cries for months but to no avail. Now I have to watch as my patients are going blind because I practice in a region where the public healthcare system is a failure. This is not a so-called developing nation but rather beautiful Vancouver, BC Canada. Despite an assurance of all glaucoma surgery being performed within 6 weeks, only half my patients are meeting this target as I watch others suffer permanent visual loss. Surgery is a money loser for the hospitals in a system that can save the most money by NOT treating patients instead of treating them.
What does it say of a society that prioritizes shortening of cataract waitlists, an elective procedure which certainly is of benefit, over glaucoma surgery - needed to prevent permanent visual loss? The government mandates that the different health regions meet certain benchmarks for wait times or be subject to large fines. Cataract and hip surgery are both part of this mandated benchmark approach but glaucoma surgery is not. There are many more patients who await cataract surgery so this can be seen as a move for popularity for a government if it can boast that these thens of thousands of patients can get their elective cataract surgery in a timely manner. However, delaying glaucoma surgery causes permanent damage but only hundreds of patients per year in our region need glaucoma surgery. Just because less people are in need of the surgery doesn’t mean it is less important. We have a self-imposed benchmark at the Vancouver Coastal Health/Vancouver General Hospital UBC Eye Care Centre of 6 weeks for 100% of glaucoma surgery to be performed. We are currently only getting about 50% of patients in within that benchmark. But, since there is no risk for financial penalty to Vancovuer Coastal Health, they have no financial incentive to re-allocate cataract time in favour of glaucoma surgery time or they risk being penalized for prolonging the cataract waitlist.
Several months ago I was getting tired of doing multiple after hour glaucoma emergency surgeries. I was told that my colleague, whose wait list was even longer than mine, would be glad to do the extra cases. Although he didn’t end up having to do those cases, I did give him a couple of my surgery days in order to help equalize the waits for all our patients. I brought up the issue again this past week and now discussions are about to begin on how to get more glaucoma surgery time to avoid watching our glaucoma patients go blind. I can’t keep adding emergency surgery cases at night and expect to stay alive; I won’t be around long enough to care for more glaucoma patients. They are looking at options such as opening up the operating room on Saturdays to deal with the backlog. G_d forbid they should actually take away operating room time from cataract surgeons in order to care for patients who risk permanent blindness. This reminds me of when McGill University made the decision to accept Jews into their medical school as long as it didn’t take away any positions from non-Jews so they enlarged their class to add a Jewish quota. Well, our operating room is already running at a loss so they can’t come up with new funds for a glaucoma quota. Sorry Vancouver Coastal Health and Eye Care Centre, you will need to take away time from qualified cataract patients to take care of those glaucoma patients who are being deprived of care in your failure of a healthcare system.
And, don’t even get me started as to how different hospitals work to falsify waitlist data such as removing patients from the list if they will exceed the wait or not even enter them on the list if the surgery is too far off. This province’s healthcare system is severely broken, corrupt, and is harming British Columbians.