Hundreds of thousands of people waiting for medical imaging in British Columbia: radiologists

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Radiologists are the latest group of specialists to sound the alarm with the province as an estimated one million patients wait to see a specialist in British Columbia

Radiologists are the latest group of specialists to sound the alarm with the province about long waiting lists.

According to a Sept. 26 letter from the BC Radiology Society to Health Minister Adrian Dix, shared with the Times Colonist this week.

“We fear for the tsunami of cancer cases – including those initially detected at Stage II and above – that may arrive in British Columbia due to delayed access to medical imaging,” the letter from the agency reads. company president, Dr. Charlotte Yong-Hing.

The letter followed a Sept. 21 open letter to Dix, signed by 26 specialists and supported by hundreds, calling on the province to take urgent action as “patients get sicker and dying on our lists.” of waiting”.

Specialists pointed to a ‘crisis’ in wait times across all specialties, from cardiology to dermatology, neurology and oncology, citing examples of patients in the Lower Mainland and Vancouver Island with “new cancer diagnoses waiting 2-3 months for their first visit with an oncologist.

Doctors of BC said it shares the specialists’ concerns. “Patients who wait – sometimes for years – for specialist care often see their condition worsen while experiencing unbearable pain,” President Ramneek Dosanjh said in a statement.

Dosanjh called the situation “unacceptable” and said doctors are facing “huge moral distress” because they are unable to help.

At a press conference on Wednesday, Dix said there has been an increase in demand for diagnostic tests and test response, including for cancer, and “we’re working hard to meet that.” We are facing a challenge now, absolutely, and our goal is to meet that challenge in the midst of so many demand challenges…that are meeting the health care system,” he said.

In her letter, Yong-Hing cites wait times for breast biopsies and additional imaging like digital breast tomosynthesis — 3D mammography — for patients with higher risks, including dense breasts and a family history.

Tomosynthesis technology, which can detect cancer earlier, has become the standard of care at most imaging sites in Canada, she said, but a new fee code for tomosynthesis is at the Department of Health for more than two years without action.

The codes would provide clinics with monetary compensation for each exam and help recover the costs of operating, maintaining and replacing the technology.

Bob Rauscher, CEO of the BC Radiology Society, said the province’s use of tomosynthesis software is “sporadic” in the absence of sustainable capital planning and budgets for the technology.

“Foundations in British Columbia remain the primary source of capital funding — that’s problematic,” he said.

Delays in medical imaging can lead to delays in diagnoses, specialist referrals, surgeries, medical treatments and cancer care.

The BC Radiology Society is calling on the province to address four key areas, including the shortage of medical imaging technologists, “outdated” equipment, additional imaging for patients at higher risk of breast cancer, and maintaining open community imaging clinics that are threatened with closure. .

Yong-Hing applauded the province for its recent investments in MRIs and CT scans.

On Wednesday, Dix noted a “significant increase” in positron emission tomography/computed tomography scans in the cancer system. In 2019-20, two PET/CT suites were added, one at the BC Cancer Center in Victoria and the other in Kelowna. Together they produce around 5,000 scans per year.

However, Yong-Hing said there was a significant need for new equipment: “The current approach of relying on foundations for funding medical imaging equipment is not working.”

Community imaging clinics — private clinics that provide publicly funded services — are struggling with overhead costs and are under the same threat of closure as family doctor offices, she said.

Imaging clinics perform approximately one million imaging exams per year, including at least 60% of all breast imaging exams, and are funded on a pay-per-exam basis.

Clinics are responsible for the purchase and maintenance of medical imaging equipment and the payment of technologists, administrative staff and rental fees.

If some clinics are forced to close, “it would have a catastrophic impact on wait times for medical imaging,” Yong-Hing said, because diagnostic testing would fall on the acute care system.

Rauscher said that while training new radiologists and creating sustainable investment plans for equipment are longer-term strategies, new pricing codes for breast imaging technologies such as tomosynthesis and support at community imaging clinics are easy problems to solve.

In response to the letter, the Department of Health released a statement indicating that the province has added 17 “net new” MRI units across British Columbia since August 2017, including four in the Island Health Region. , which has reduced wait times for diagnostic imaging in British Columbia.

For MRI wait times, British Columbia fell from fifth in the country in 2018 to second best in 2021, according to the Canadian Institute for Health Information, a ministry spokesperson said.

For CT scan wait times, British Columbia fell from sixth in the country in 2018 to third in 2021, according to CIHI.

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