While patients wait months for life-altering surgery, a fully equipped, state-of-the-art operating room sits empty much of the time at Richmond Hospital. The reason: a shortage of anesthesiologists.
"There have been 42 days since October 2011 where we haven't been able to perform surgeries due to shortages. That's 230 patients," said Richmond Hospital anesthesiologist Dr. Paul Draper.
About eight months ago, health authorities provided the hospital funding so it could hire an anesthetist to make its seventh operating room functional. No one applied.
The lack of interest reflects B.C.'s noncompetitive fee schedule and poor working conditions for anesthesiologists, according to Draper, and explains the recent threat of job action by B.C. anesthesiologists.
"There was a case where one anesthesiologist from Saskatchewan expressed interest," said Draper. "But (Saskatchewan) negotiated a competitive wage so he stayed there."
In response to the current pay schedule and working conditions, last week, the B.C. Anesthesiologist Society (BCAS) planned to withdraw their services from elective surgeries. However, an injunction sought by health authorities was approved last Friday, forcing the workers back to the hospital this past week. A hearing for the injunction is set for April 18 to give the BCAS's lawyers time to prepare.
Meanwhile, the association of Chinese Canadian Professionals sponsored a panel discussion with B.C. anesthesiologists, Monday night at the Richmond Caring Place to familiarize the public with their work and answer any questions they may have about the job action.
Draper and many anesthesiologists from Richmond Hospital sat on the panel.
"There was a good variety of people," he said. "We got good, insightful questions and it opened the public's eyes to what we do. It was generally fairly supportive."
To address their demands, some 400 of the province's anesthesiologists are fighting for a spot at the negotiating table to help reach a new - and legally binding contract - with the B.C. government and the BC Medical Association (BCMA), according to Draper.
This move would separate them from the BCMA, which has been appointed by the government to represent them.
"It's time to take a stand for a system that's broken and for an organization, the BCMA, that's no longer representing our issues," said Draper.
In December, the Ministry of Health announced that $2.5 million would go towards dedicated obstetrical anesthesia services in Victoria General, Royal Columbian and Surrey Memorial hospitals.
However, funding increases such as these actually concern the BCAS, because they still don't address the "critical and worsening shortage of anesthesiologists in British Columbia," according to a press release on the BCAS website. Extra services and equipment does not make B.C. any more desirable for anesthesiologists.
The BCAS website recognizes funding is stretched thin, but argues that increased wages and shorter hours could be accomplished with a redistribution of the funding that is already there.
If anesthesiologists were given more influence, they could show health authorities how that could be done, said the BCAS online.
On its website, it cites the example of St. Paul's Hospital, writing, "Anesthesiology-led pilot projects - such as St. Paul's regional (nerve block) program - have generated up to 80 per cent more care from each health care dollar, while receiving praise from satisfied patients."
The BCAS has attempted to negotiate in the past; however, the agreements haven't been legally binding, allowing the province and the BCMA to walk away, according to Draper.
A spokesperson at the BCMA declined to comment, stating they are in the midst of figuring out what to do and negotiations are at a stand still.
Prior to the injunction, CEO and president of Interior Health, Dr. Robert Halpenny, speaking on behalf of all health authorities, said, "the anesthesiologists have created max-imum confusion for patients, our surgeons and other frontline staff around whether or not they will fulfill their ethical and legal obligations to provide patient care as we would expect them to do."
However, health authorities had been given three-months notice of their plans and still continued to book patients, placing them in the middle of the dispute, said BCAS president Dr. Jeff Rains.
Besides, a withdrawal from elective surgeries would not put many anesthesiologists in violation of their ethical and legal obligations, as performing an elective surgery is not an essential service. "We would still provide emergency and urgent surgeries," said Draper.
The province is divided into five health regions, where Richmond Hospital falls under the Vancouver Coastal Health Authority. Many of these hospitals, such as the case with Richmond, have hired anesthesiologists on a fee for service basis.
But some anesthesiologists at other hospitals have been able to negotiate a contract instead of the fee for service model. These are the workers who might be in violation of their obligations depending on the stipulations of their contract.
"So the debate is not between those on contract vs. those on fee for service," said Draper. "It just means that some can't participate as much because of whatever contract they have."
Regardless of the outcome of April 18's hearing, it's clear there needs to be a reconstruction of the relationship between the province, the BCMA and the BCAS.
