With waiting times for cataract surgery now stretching longer than a year, it appears there's no immediate help on the horizon to clear that list of patients more quickly.
A lack of surgical time at University Hospital of Northern B.C. is the biggest factor in creating the backlog, according to ophthalmologist Dr. John Konkal, who adds the lack of access to operating rooms is also hurting the ability to recruit new eye surgeons to Prince George.
"Over the last few years, I've had two or three people who have expressed interest in coming up here, and when they find out about the surgical time they don't even
bother coming," said Konkal.
"One fellow, from London, Ont., is now down in Abbotsford and he gets two full surgical days a week. I've been looking at the situation for a little while and we've constantly complained about not getting enough OR time. Twenty years ago we had two full days of ocular surgery between three ophthalmologists. Now we have four ophthalmologists and we're only getting one half-day."
Konkal, 72, is preparing for retirement and had a locum, Dr. Peter Lee, take over his practice for three months this year while he was off work on medical leave. Lee had the option to stay in Prince George but instead chose Richmond. Konkal says the limitation on operating room time at UHNBC was one of the deciding factors that prompted Lee to leave.
"With the situation in the OR, he decided to head south," said Konkal. "When I announced [to Northern Health] that I would possibly have Peter take over my practice, they said we can't have him come in unless we do an impact study.
"Well the impact's going to be when I quit. There's going to be 20,000 people looking for another ophthalmologist. It seems there's a great resistance to do anything. It's gotten worse in the last four or five years."
Konkal, who established his practice in the city in 1969, and the other three ophthalmologists in Prince George, serve a population of about 340,000 in the northern Interior region. One of that group, Andrew Lukaris, is a retinal surgeon who sees patients from as far away as Vancouver and Edmonton.
Cataract surgery accounts for about 80 per cent of all eye surgeries. Konkal stopped performing that operation in June, after more than 5,000 cataract surgeries, while Lukaris, the head of ophthalmology at UHNBC, limits most of his surgery to retinal procedures. One other local eye specialist, Dr. Aleksandra Veselinovic, stopped taking new patients almost three years ago.
"We do have problems because a lot of the people who have been seeing optometrists are being referred to Vancouver to get their cataracts done because the waiting list is so long up here," said Konkal.
Private surgical suites are not the solution, said Konkal. Kelowna once had three private clinics but is now down to just one. "They're just not feasible, they're expensive to run and people are desiring something a bit better in the OR," Konkal said.
But the public sector in that city is taking up the slack. In April, Kelowna General Hospital will open a 50,000 square-foot facility for eye surgeries that will significantly
increase surgical capacity.
UHNBC ophthalmologist Marian Roesch said the reduction of shared surgical time from full days to half-days, introduced four years ago to cut costs and make room for more trauma surgery, fails to serve the needs of the community.
"Doing half-days makes things inefficient and there is less surgery being performed," Roesch said. "We also don't have access to general anesthetic time. Only one of our members who does retinal surgery [Lukaris] gets a half a day a week of anesthesia time and the rest of ours are put on a wait list. I just did a list last week and they all waited nine to 13 months, and some of them are very visually
impaired.
"I see patients all the time, they're a new patient referred for a cataract, and some of them are quite dismayed they have to wait a year. Some of them can't afford to travel to other centres for cataract surgery. It's all a matter of funding and nursing resources."
