'Practically at the bottom of the heap'

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Barb Sweet
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Rheumatologists say wait times, patient loads unacceptably long

Three of the province's four rheumatologists pleaded Thursday for some attention to their plight at the Newfoundland and Labrador Medical Association's fifth session on doctor shortages.

The province needs at least 10 rheumatologists - in order to accommodate time with patients as well as teaching and research duties - but only has four, the media was told. Newfoundland and Labrador Medical Association (NLMA) president Dr. Brendan Lewis noted the three specialists at Thursday's session represent 75 per cent of rheumatologists in the province.

The Newfoundland and Labrador Medical Association (NLMA) held another information session at its offices Thursday. Doctors say there is a serious shortage of rheumatologists in the province. Shown here (from left) are Dr. Proton Rahman, NLMA president Dr.

Three of the province's four rheumatologists pleaded Thursday for some attention to their plight at the Newfoundland and Labrador Medical Association's fifth session on doctor shortages.

The province needs at least 10 rheumatologists - in order to accommodate time with patients as well as teaching and research duties - but only has four, the media was told. Newfoundland and Labrador Medical Association (NLMA) president Dr. Brendan Lewis noted the three specialists at Thursday's session represent 75 per cent of rheumatologists in the province.

"Pretty desperate, isn't it?" he asked.

Rheumatologists treat about 100 different conditions, which include diseases of the joints, muscles, bones and tendons. There are more than 89,000 people in the province with arthritis.

Dr. Sean Hamilton said in 2008, the outpatient waiting list for patients with inflammatory conditions was calculated to be 9.6 months. Those with chronic non-inflammatory conditions waited an average 42 months.

In order to cut the waiting times down for the urgent and semi-urgent cases, the rheumatologists have temporarily removed 1,000 patients with non-inflammatory conditions from their waiting list.

That was done to manage the list of more than 600 patients with the most dire conditions and to try to get their wait times down. At the time the change was made, the province had five rheumatologists, so the situation is worse again because one left. It could be years before the less sick patients get seen if more of the specialists aren't recruited.

"Right now there's no way we could provide what we call good service for all patients," Hamilton said.

"It's heartbreaking to leave 1,000 patients," Dr. Proton Rahman said, describing the situation as a vicious circle.

"It's far from ideal in terms of how it's being managed, but we had to set priorities."

Dr. Majed Khraishi said when the fifth rheumatologist left, the remaining doctors - in addition to their own workload - had to accommodate a sudden huge influx of sick patients "that had to be taken care of today, not tomorrow."

"Unfortunately, we have left the problem of thousands," he said.

"These patients are suffering. It's not ideal and there must be another solution."

All of the rheumatologists are in St. John's which means travel time and expense for patients, besides their long, painful wait times.

"You have to remember we live in Canada. We don't live in a Third World country," Khraishi said.

"We are practically at the bottom of the heap when it comes to the worst waiting list and access to specialists."

Hamilton said the national standards for following up the worst patients is to see them every three to six months.

"Given our current numbers, there's no way we can do that right now," he said.

"Four rheumatologists serving the needs of the entire population is just not enough," said Lewis, who is an orthopedic surgeon.

He performs surgery on arthritis patients, but because of wait times for rheumatology, by the time they see him, they have had a lot of pain and suffering.

"We know the number of hip and knee replacements performed annually is rising and is expected to continue to increase. The fact that many orthopedic surgeons are now operating at capacity, is a clear indication that the system may not be able to respond to the projected increases of people with arthritis."

Hamilton said there will be new rheumatologists avaliable to recruit across Canada, but this province must be competitive.

Lewis said that means not only Atlantic parity for pay, but a good working atmosphere.

The doctors have been involved in a tumultuous negotiations with the provincial government.

When the NLMA held a session on psychiatry last week, Lewis said Health Minister Jerome Kennedy told the House of Assembly the psychiatrists were trying to paint an inaccurate picture.

Lewis said the doctors' stories are "true and accurate."

"They are real stories about real problems that affect physicians and our patients everyday," Lewis said.

bsweet@thetelegram.com

Organizations: Newfoundland and Labrador Medical Association

Geographic location: Canada, St. John's

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Recent comments

  • Neil
    July 02, 2010 - 13:35

    Now it's like this....We live on an island in the middle of the North Atlantic with ok weather and an excellent standard of living with excellent salaries for dr's of all kinds....Problem is, St. John's and the province as a whole cannot compete with other major cities and provinces in Canada and states south of the border. We just can't compete. We all know it's the best place in the world to live, but not everyone knows that. Shortages are going to happen and waitlists are going to be bigger and bigger....You can offer $1 million dollar salaries, houses, cars, bonuses etc etc and you'll still have shortages and waitlists. That's life. Unless someone comes up with a time machine that we can go back to the start of the waitlist and do something about it then there is nothing that can be done....reality sucks.

  • Don
    July 02, 2010 - 13:30

    CB if you don't like the health care that is provided here move to Alberta and suffer what these people have to put up with. After the normal wait of 6 to 8 hours a few times and our health care will look a whole lot better!!! Shortages of doctors isn't only for Newfoundland but all across this great country of ours.

  • Manuel
    July 02, 2010 - 13:25

    Not to long ago these men stated on TV that you cant make everyone happy. Yet here they are demanding to be made happy with no give in them at all. Either meet their demands or else we start suffering. br Well as a man who has had 15 surgeries and half his right side replaced with steel i know your lies. br I had to threaten a lawsuit against 2 orthopedic surgeons in order to get proper treatment. Ive started seeking a doctor outside the province. I am now considering a lawsuit against the 2 doctors as the doctor in toronto says what was done was completely unnecessary and over kill. Now i have a steel ankle and knee that i shouldnt have. What are these doctors going to do to fix this. I suppose a huge undeserved salary increase is going to make it all better. With this money the doctors can treat you better. Are all you people that stupid to believe this. Spend the day at the Health Science and watch the doctors there and espically the nurses. If there was ever a waste of money, it is there. How many doctors do you see driving some old car, struggling to keep gas in it as most of the public does. Yet we have to pay them half a million dollars a year and more, plus all kinds of other benefits they enjoy as doctors just to keep them from holding us hostage against the government. They should be ashamed.

  • jaydee
    July 02, 2010 - 13:24

    Jerome Kennedy isn't going to do anything about Health Care, because Sir Danny doesn't see anything wrong with it. This from a man who can hop on a plane and get his medical care from anywhere in the world. So what does he care about the common man. As Dr Kraidshi said we are not a Third world country, even though you would think we are by the long wait lists to see specialists. We are going to be in big trouble if one of the rheumatologists that are still here decide to leave. I suffer from psoriatic arthritis and have been very grateful to be a patient of Dr Kraidshi for 5 years now. I pity the doctors work load. Some will say they are making big bucks so they should work for it. I agree but there is such a thing as overworking too. Burnout is a big problem. Come on Jerome Kennedy...open your eyes and ears and listen to what the doctors are telling you. They know more than anyone how badly the system is frayed.

  • CB
    July 02, 2010 - 13:23

    Ok so just what is the problem with Jerome Kennedy? Why, as an elected representative of the people and Health Minister to boot, does he show such a lack of concern for these major issues facing us. ...he has eyes does he not! I know! It must be that he has not had the grand tour from the other side...the patient's side, cause if he did he may have a different perception.

  • snapping back to reality
    July 02, 2010 - 13:19

    Manuel Clark from St.johns, Newfoundland threatening to sue doctors wouldn't give them any impetus whatsoever to treat you. That's like threatening Hickman Motors to sell you a car had they refused to do so because you were a beligerent pompous a$$ in their showroom. Now, if you could prove the doctors were discriminating against you personally for some reason, you might be able to go to the Human Rights Commission. Count your lucky stars the doctors had compassion enough not to let you waste your money. They probably sympathized with your pain and plight. Next time when you see a doctor, try not being the beligerent pompus a$$ you sound like in your comment. See what the doctors have to put up with from suffering patients day in and day out ? It's like trying to save a suffering animal which has gone haywire from suffering and pain - very difficult to deal with and provide help to when it's snapping at you. I pity the doctors. br br On another topic, 'All of the rheumatologists are in St. John's which means travel time and expense for patients, besides their long, painful wait times' demonstrates the problem with rural NL and the expectation of people in those areas who will never be satisfied unless their is a rheumatologist in each of their communities. What if the government declared that all fishing boats which take part in the various types of fishing throughout the year in NL MUST be docked at St. John's harbour ? How would you enjoy be told where you have to work ? Would you want a very big incentive to have to travel to St. John's each morning from Lewisporte to get in your bo-at and go fishing ? How would you enjoy the rest of NL giving you the gears about not moving to St. John's to take your boat out to go fishing ? If you choose to live partially isolated, then expect to live partially isolated. Why is this so hard to understand ? I don't pity those whiners. They made their bed, now they can sleep in it.

  • Neil
    July 01, 2010 - 20:24

    Now it's like this....We live on an island in the middle of the North Atlantic with ok weather and an excellent standard of living with excellent salaries for dr's of all kinds....Problem is, St. John's and the province as a whole cannot compete with other major cities and provinces in Canada and states south of the border. We just can't compete. We all know it's the best place in the world to live, but not everyone knows that. Shortages are going to happen and waitlists are going to be bigger and bigger....You can offer $1 million dollar salaries, houses, cars, bonuses etc etc and you'll still have shortages and waitlists. That's life. Unless someone comes up with a time machine that we can go back to the start of the waitlist and do something about it then there is nothing that can be done....reality sucks.

  • Don
    July 01, 2010 - 20:18

    CB if you don't like the health care that is provided here move to Alberta and suffer what these people have to put up with. After the normal wait of 6 to 8 hours a few times and our health care will look a whole lot better!!! Shortages of doctors isn't only for Newfoundland but all across this great country of ours.

  • Manuel
    July 01, 2010 - 20:12

    Not to long ago these men stated on TV that you cant make everyone happy. Yet here they are demanding to be made happy with no give in them at all. Either meet their demands or else we start suffering. br Well as a man who has had 15 surgeries and half his right side replaced with steel i know your lies. br I had to threaten a lawsuit against 2 orthopedic surgeons in order to get proper treatment. Ive started seeking a doctor outside the province. I am now considering a lawsuit against the 2 doctors as the doctor in toronto says what was done was completely unnecessary and over kill. Now i have a steel ankle and knee that i shouldnt have. What are these doctors going to do to fix this. I suppose a huge undeserved salary increase is going to make it all better. With this money the doctors can treat you better. Are all you people that stupid to believe this. Spend the day at the Health Science and watch the doctors there and espically the nurses. If there was ever a waste of money, it is there. How many doctors do you see driving some old car, struggling to keep gas in it as most of the public does. Yet we have to pay them half a million dollars a year and more, plus all kinds of other benefits they enjoy as doctors just to keep them from holding us hostage against the government. They should be ashamed.

  • jaydee
    July 01, 2010 - 20:10

    Jerome Kennedy isn't going to do anything about Health Care, because Sir Danny doesn't see anything wrong with it. This from a man who can hop on a plane and get his medical care from anywhere in the world. So what does he care about the common man. As Dr Kraidshi said we are not a Third world country, even though you would think we are by the long wait lists to see specialists. We are going to be in big trouble if one of the rheumatologists that are still here decide to leave. I suffer from psoriatic arthritis and have been very grateful to be a patient of Dr Kraidshi for 5 years now. I pity the doctors work load. Some will say they are making big bucks so they should work for it. I agree but there is such a thing as overworking too. Burnout is a big problem. Come on Jerome Kennedy...open your eyes and ears and listen to what the doctors are telling you. They know more than anyone how badly the system is frayed.

  • CB
    July 01, 2010 - 20:08

    Ok so just what is the problem with Jerome Kennedy? Why, as an elected representative of the people and Health Minister to boot, does he show such a lack of concern for these major issues facing us. ...he has eyes does he not! I know! It must be that he has not had the grand tour from the other side...the patient's side, cause if he did he may have a different perception.

  • snapping back to reality
    July 01, 2010 - 20:01

    Manuel Clark from St.johns, Newfoundland threatening to sue doctors wouldn't give them any impetus whatsoever to treat you. That's like threatening Hickman Motors to sell you a car had they refused to do so because you were a beligerent pompous a$$ in their showroom. Now, if you could prove the doctors were discriminating against you personally for some reason, you might be able to go to the Human Rights Commission. Count your lucky stars the doctors had compassion enough not to let you waste your money. They probably sympathized with your pain and plight. Next time when you see a doctor, try not being the beligerent pompus a$$ you sound like in your comment. See what the doctors have to put up with from suffering patients day in and day out ? It's like trying to save a suffering animal which has gone haywire from suffering and pain - very difficult to deal with and provide help to when it's snapping at you. I pity the doctors. br br On another topic, 'All of the rheumatologists are in St. John's which means travel time and expense for patients, besides their long, painful wait times' demonstrates the problem with rural NL and the expectation of people in those areas who will never be satisfied unless their is a rheumatologist in each of their communities. What if the government declared that all fishing boats which take part in the various types of fishing throughout the year in NL MUST be docked at St. John's harbour ? How would you enjoy be told where you have to work ? Would you want a very big incentive to have to travel to St. John's each morning from Lewisporte to get in your bo-at and go fishing ? How would you enjoy the rest of NL giving you the gears about not moving to St. John's to take your boat out to go fishing ? If you choose to live partially isolated, then expect to live partially isolated. Why is this so hard to understand ? I don't pity those whiners. They made their bed, now they can sleep in it.