surgical restrictions?

[aaronjw]

Does anyone here know of articles or bodies of research that detail the gov't restrictions on surgeons and supply of surgical procedures?

 

Thanks!

[bloh]

Huh? I have no idea what you are asking

[rmorelan]

Does anyone here know of articles or bodies of research that detail the gov't restrictions on surgeons and supply of surgical procedures?

 

Thanks!

 

good question - I thought there wasn't just restrictions directly but rather is was done solely at the hospital level with broader funding restrictions. If that is not the case I would love to learn the details!

[NLengr]

Are you talking about operative procedures that aren't covered by public insurance? For example, the whole Zamboni procedure thing? That's decided at the level of the province.

[aaronjw]

good question - I thought there wasn't just restrictions directly but rather is was done solely at the hospital level with broader funding restrictions. If that is not the case I would love to learn the details!

 

Yes this. I am looking for a body of evidence that explicitly shows that gov't has ratcheted the funding for surgical procedures.

 

I hear quite often that funding restrictions have made OR time less and less available to surgeons with surgical supply effects for the population but I've ever encountered evidence that can explicitly show this.

[A-Stark]

I don't think there's any kind of policy about this. OR time is not "less and less available" given a constant supply of surgeons, but hospitals absolutely do make changes to OR hours, nursing funding, etc on a near-constant basis, and this affects bed availability, time for non-OR procedures (e.g. scoping), and any other relevant factors.

 

I'm not sure what you're hearing, but if anything governments have provided funding for specific procedures to be done faster.

[aaronjw]

So then these "cuts" aren't necessarily in total supply but rather limiting of hours available to each doctor to operate?

[rmorelan]

So then these "cuts" aren't necessarily in total supply but rather limiting of hours available to each doctor to operate?

 

because the total hospital budget has been restricted and thus all levels of the hospital including surgeons are affected. For surgeons that is OR time, for many other areas that is beds and support staff, and for rads it is restricting the techs and equipment to do scans, for path is the total staff etc, etc.....

 

Politically it is easier and safter to simply cap the total. They get to say the didn't restrict OR time etc when in reality that is exactly what the effect is - not to say of course they aren't good reasons to cap things . Then the government adds metrics that they want hospitals to met forcing them to channel some of the funding along those lines - usually in areas the public is very concerned about. Like emerg wait times, or cancer therapy.

 

anyway with so many ORs that are allowed to run under budget, then there is only so many OR days each specialty and ultimately each doc can do. This prevents them from operating say 5 days a week etc. An interesting side effect is sometimes a department is allocated so many OR days but there is a staff shortage. You can end up with some docs then doing more than the usual number of OR days as a result.

[Ian Wong]

The way I see physicians being limited is by capping or limiting the access to infra-structure. Many physicians need hospital resources in order to perform their work. Good examples would include radiologists and surgeons.

 

For radiologists, there are waitlists for all imaging studies, whether that be U/S, CT, MRI, PET, etc. The waitlist develops because there is a limited number of machines and technologists to perform the scans, not because there is a limited number of radiologists to read them.

 

This is the major reason why the radiology job market in major urban centres is tight. Currently, each hospital has enough radiologist man-power to read the number of exams being performed. However, if there were more CT/MR scanners, and the technologists to run them, each radiology group could either read more cases, or hire more radiology residency graduates to read them. As it stands now, assuming no extra machines are added and if the current machines are run at their current utilization rates, there's no room for new hires.

 

Similarly, there is no incentive for a group of surgeons to hire a new surgeon as all of the current hospital operative time is already being used by those surgeons.

 

Ian

[Savac]

The way I see physicians being limited is by capping or limiting the access to infra-structure. Many physicians need hospital resources in order to perform their work. Good examples would include radiologists and surgeons.

 

For radiologists, there are waitlists for all imaging studies, whether that be U/S, CT, MRI, PET, etc. The waitlist develops because there is a limited number of machines and technologists to perform the scans, not because there is a limited number of radiologists to read them.

 

This is the major reason why the radiology job market in major urban centres is tight. Currently, each hospital has enough radiologist man-power to read the number of exams being performed. However, if there were more CT/MR scanners, and the technologists to run them, each radiology group could either read more cases, or hire more radiology residency graduates to read them. As it stands now, assuming no extra machines are added and if the current machines are run at their current utilization rates, there's no room for new hires.

 

Similarly, there is no incentive for a group of surgeons to hire a new surgeon as all of the current hospital operative time is already being used by those surgeons.

 

Ian

 

!!!!!!!!

 

Welcome back, Dr. Wong