The Waiting Game
Waiting your turn for health care
By Bacchus Barua
Waiting for treatment has become a defining characteristic of Canadian health care. In order to document the lengthy queues for visits to specialists and for diagnostic and surgical procedures in the country, the Fraser Institute has—for over two decades—surveyed specialist physicians across 12 specialties and 10 provinces.
This edition of Waiting Your Turn indicates that, overall, waiting times for medically necessary treatment have not improved since last year. Specialist physicians surveyed report a median waiting time of 18.3 weeks between referral from a general practitioner and receipt of treatment—slightly longer than the 18.2 week wait reported in 2014. This year’s wait time is 97% longer than in 1993 when it was just 9.3 weeks.
There is a great deal of variation in the total waiting time faced by patients across the provinces. Saskatchewan re-ports the shortest total wait (13.6 weeks), while Prince Edward Island reports the longest (43.1 weeks). Results for the latter province should be interpreted with caution since data is not available for certain specialties because of either a lack of response or an absence of doctors practising some specialties.
Who waits the longest?
There is also a great deal of variation among specialties. Patients wait longest between a GP referral and orthopaedic surgery
(35.7 weeks), while those waiting for radiation oncology begin treatment in 4.1 weeks. The total wait time that patients face can be examined in two consecutive segments.
The first segment occurs from referral by a general practitioner to consultation with a specialist. The waiting time in this segment is 8.5 weeks this year, roughly the same as in 2014. This wait time is 130% longer than in 1993, when it was 3.7 weeks. The shortest waits for specialist consultations are in Saskatchewan (6.7 weeks) while the longest occur in Prince Edward Island (28.3 weeks).
The second segment occurs from the consultation with a specialist to the point at which the patient receives treatment. The waiting time in this segment is roughly the same as last year, 9.8 weeks. This wait time is 76% longer than in 1993 when it was 5.6 weeks, and almost three weeks longer than what physicians consider to be clinically “reasonable”. The shortest specialist-to-treatment waits are found in Saskatchewan (6.9 weeks), while the longest are in Newfoundland & Labrador (20.5 weeks).
It is estimated that, across the 10 provinces, the total number of procedures for which people are waiting in 2015 is 894,449. This means that, assuming that each person waits for only one procedure, 2.5% of Canadians are waiting for treatment in 2015. The proportion of the population waiting for treatment varies from a low of 1.7% in Quebec to a high of 8.4% in Newfoundland & Labrador. It is important to note that physicians report that only about 12.5% of their patients are on a waiting list because they requested a delay or postponement.
Patients also experience significant waiting times for various diagnostic technologies across the provinces. This year, Canadians could expect to wait 4.0 weeks for a computed tomography (CT) scan, 10.4 weeks for a magnetic resonance imaging (MRI) scan, and 4.0 weeks for an ultrasound.
Research has repeatedly indicated that wait times for medically necessary treatment are not benign inconveniences. Wait times can, and do, have serious consequences such as increased pain, suffering, and mental anguish. In certain instances, they can also result in poorer medical outcomes—transforming potentially reversible illnesses or injuries into chronic, irreversible conditions, or even permanent disabilities. In many instances, patients may also have to forgo their wages while they wait for treatment, resulting in an economic cost to the individuals themselves and the economy in general.
The results of this year’s survey indicate that despite provincial strategies to reduce wait times and high levels of health expenditure, it is clear that patients in Canada continue to wait too long to receive medically necessary treatment.
Bacchus Barua, Senior Economist, Health Policy Studies, Fraser Institute. www.fraserinstitute.org