According to Waiting Your Turn: Wait Times for Health Care in Canada 2023, released in December by the British Columbia-based Fraser Institute think tank, nationwide wait times for medically necessary treatment were 198 per cent higher in 2023 than they were 30 years ago – a median 27.7 weeks. That’s up from 27.4 in 2022 and the highest ever recorded. But patients in Nova Scotia, Prince Edward Island and New Brunswick could expect to wait twice as long to get the treatment that they need. In the estimation of the report’s authors – Mackenzie Moir, policy analyst at the Fraser Institute and Baccus Barua, director of the Fraser’s Centre for Health Policy Studies – “Despite provincial strategies to reduce wait times and high levels of expenditure on health care, it is clear that patients in Canada are waiting too long to receive treatment.” Waiting Your Turn, which has been tracking Canada’s wait-time status since 1993 when the median wait was 9.3 weeks, is based on data from survey questionnaires completed by physicians across 12 specialties. It is designed to estimate median wait times at two levels of the treatment process: 1) from a general practitioner’s or family physician’s referral to a consulting specialist, and 2) from the specialist’s consultation to the receipt of treatment. It does not cover emergency room or urgent care services, only medically necessary emergent or elective care services. As in prior years, the survey reveals significant wait-time differences (from province to province) in the referral time from general practitioner (or family physician) to a specialist, and the completion of treatment by the specialist: a 21.6 week median in Ontario; 25.8 in British Columbia; 27.6 in Quebec; 29.1 in Manitoba; 31 in Saskatchewan, and 33.3 weeks in Alberta. The median is calculated by ranking specialists’ responses in either ascending or descending order and determining the middle value. And then there’s Atlantic Canada Reflecting Nova Scotia’s chronic physician shortage, residents of that province had no choice but to buckle up for a 28.3-week ride from their GP/family physician to a specialist consultation, and then another 28.4 weeks (a total of 56.7 weeks) to finally receive treatment from that specialist. And the situation was not much different for residents of neighbouring provinces: Prince Edward Island and New Brunswick faced similar marathon waits of 55.2 and 52.6 weeks, respectively, to get from GP consult to final treatment. However, patients in Newfoundland and Labrador got from family physician to specialist referral and into treatment in a comparatively short 33.3 weeks. Moir and Barua • Waiting Your Turn: 2023 Report • 5 fraserinstitute.org Waiting by specialty Among the various specialties, the shortest total waits exist for radiation oncology (4.4 weeks), medical oncology (4.8 weeks), and elective cardiovascular surgery (13.1 weeks). Conversely, patients wait longest between a referral by a GP and plastic surgery (52.4 weeks), orthopaedic surgery (44.3 weeks), and neurosurgery (43.5 weeks) (table 2; chart 4). The largest increases in waits between 2022 and 2023 have been for urology (+11.9 weeks), otolaryngology (+6.5 weeks), internal medicine (+5.7 weeks), and gynaecology (+5.3 weeks). Such increases are partially offset by decreases in wait times for patients receiving treatment in fields like neurosurgery (−15.4 weeks), ophthalmology (−7.6 weeks), and plastic surgery (−5.8 weeks). Weighted Median Medical Oncology Radiation Oncology Internal Medicine Urology Cardiovascular (Elec.) Orthopaedic Surgery Neurosurgery General Surgery Otolaryngology Ophthalmology Gynaecology Plastic Surgery Wait from specialist to treatment Wait from GP to specialist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Weeks waited Note: Totals may not equal the sum of subtotals because of rounding. Source: The Fraser Institute’s national waiting list survey, 2023. Chart 4: Median wait by specialty in 2023—weeks waited from referral by GP to treatment . . . . . . . Within this overall framework, study analysts found that the overall wait from GP referral to completion of specialist treatment across Canada had risen from 9.3 weeks in 1993 to 27.7 weeks in 2023. In addition to geographical variations in wait times, Waiting Your Turn showed large disparities in wait times for diagnostic as well as treatment procedures. For example: The wait for a computed tomography (CT) scan increased from 5.4 weeks in 2022 to 6.6 weeks in 2023; for magnetic resonance imaging (MRI) from 10.6 weeks in 2022 to 12.9 in 2023, and for ultrasound from 4.9 to 5.3 weeks. Ontario and Quebec had the shortest waits for CT scans – 4.0 weeks; Nova Scotia the longest – 14 weeks. As for specific treatment procedures in 2023, the shortest waits (nationally) were for radiation oncology (4.4 weeks) and for medical oncology (4.8 weeks), while elective cardiovascular surgery weights rose to 13.1 weeks. The longest waits in 2023 were for plastic surgery (52.4 weeks); orthopedic surgery (44.3 weeks); and gynaecology (37.4 weeks). Health Milan Korcok has been writing about Canadian health care since the inception of Medicare. He can be reached at mkorcok@aol.com Canada’s Atlantic Provinces Burdened Most by Growing Medical Wait Times As Canada’s health-care wait times grow to record lengths, patients in the Atlantic provinces carry the heaviest burden of unmet medical-services need 34 | www.snowbirds.org
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