‘There simply aren’t enough people’: Canada’s shortage of anesthesiologists contributing to surgical backlog, group says

Canada’s surgical backlog cannot be cleared without enough anesthesiologists, who are essential for surgeries, according to the former chair of Ontario’s Anesthesiologists, which represents the province’s nearly 1,500 practising anesthesiologists.

Dr. Monica Olsen said the shortage of anesthesiologists is a “cyclical” problem that’s existed for years, but was exacerbated by the COVID-19 pandemic.

The shortage is currently being seen and felt across the country, with operating rooms having to close and surgeries and other medical procedures being delayed, she said.

“We know from surveys and personal experience that operating room closures are starting to happen,” Olsen told CTV’s Your Morning on Friday.

“We know that it’s been challenging to upscale or increase the amount of work done to deal with shortages and wait times because there simply aren’t enough people.”

SHORTAGES ACROSS CANADA

Anesthesiologists cover a critical component of surgical care by evaluating, monitoring and supervising patient care before, during and after surgery, but several provinces are dealing with a shortage, contributing to growing wait lists for nearly all medical procedures.

More than half — or 59 per cent — of Ontario hospital chiefs of anesthesiology reported operating room (OR) closures in the last six months due to anesthesiologist vacancies, with rural and remote areas most impacted, according to a new survey conducted by Ontario’s Anesthesiologists, a section of the Ontario Medical Association.

Eighty-four per cent said they needed to hire more anesthesiologists to properly staff ORs, many of which are open or on standby 24/7.

Earlier this year, Niagara Health warned patients it’s moving after-hours emergency surgeries to its Niagara Falls site, because of a shortage of anesthesiologists in Welland.

In July, the former president of the Alberta Medical Association’s anesthesia executive told CTV News that Edmonton needed 20 to 30 more anesthesiologists while Calgary needed 15 to 20. In Red Deer, Alta., there have been reports of ORs sitting empty without enough workers to staff them.

Alberta is looking to address the shortage by speeding up the accreditation process for international medical graduates and by bringing anesthesia assistants in for low-risk operations.

Furthermore, Canada’s density of anesthesia providers — 12.42 anesthesiologists per 100,000 people — to be lower than that of the United States, United Kingdom and Australia, according to the World Federation of Societies of Anaesthesologists.

By comparison, there are 20.82 anesthesia providers per 100,000 people in the U.S.,17.85 in the U.K., and 23.09 in Australia.

BURNOUT AMONG STAFF

The shortage has forced current practising anesthesiologists to work above and beyond to try and fill in the gaps, while others have reprioritized their values and are choosing to work less, retire early or retire partially, Olsen said.

“We have faced a tremendous workload during the pandemic and that came on top of a workload that was fairly substantial prior, so many people are feeling somewhat tired, lacking in adequate rest and recovery,” she said.

Despite the burnout among staff, Olsen said anesthesiologists “know that it’s vital we remain committed to our patients and patient care” and are now looking for solutions.

“Many of these challenges should galvanize both us as physicians, and our partners to find solutions because where there’s this perfect storm, there are great opportunities to work for a different future,” she said.

POSSIBLE SOLUTIONS

Olsen said there’s “a basket of solutions” to address the shortage of anesthesiologists.

“One of the things that we know needs to happen is a long-term commitment to addressing data collection and analysis so that we can plan our workforce and understand population or patient needs, both here and now, but the future,” she said.

Among other possible solutions, Olsen also recommended expanding the anesthesia care team model to allow anesthesia assistants to assist during surgical procedures and offering more incentives to people pursuing jobs as anesthesiologists.

She further recommended finding “creative efficiency solutions,” which would entail shifting medical staff around to deliver care more efficiently. 

Anesthesiologists cover a critical component of surgical care by evaluating, monitoring and supervising patient care before, during and after surgery, but several provinces are dealing with a shortage, contributing to growing wait lists for nearly all medical procedures.

To watch the full interview, click the video at the top of this article.