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‘Systemic underfunding’ of surgical services drives surgeon out of Yukon

Upon questioning by the News about the doctor’s exit letter, hospital corporation and health department said a new surgical facility is being planned to add onto Whitehorse hospital
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The sign for the surgeon's clinic outside the Whitehorse General Hospital is pictured on May 7, 2024. Dr. Adam McIntyre is being driven out of the Yukon due to “systemic underfunding” of the territory’s surgical services.

An orthopedic doctor is being driven out of the Yukon due to “systemic underfunding” of the territory’s surgical services. 

“I am sorry to be leaving,” Dr. Adam McIntyre wrote in a letter to his colleagues. 

McIntyre’s exit letter indicates that while his decision was difficult, the territory needs more robust support for patients and health-care workers, more operating rooms and surgical time, and, eventually, a new hospital to meet standards of care for patients in the Yukon, as the population grows. 

Upon being questioned by the News about the doctor’s exit, the Yukon government and the Yukon Hospital Corporation (YHC) said that planning is already underway for a new surgical facility at the Whitehorse General Hospital. 

During an interview by phone, Tiffany Boyd, YHC’s chief executive officer, referred to the “surgical tower” as a new build with multiple floors and new acute beds added onto the Whitehorse hospital. She said work over the next year will involve more detailed planning around how many operating theatres and beds will be added, how will it be organized and how will it best meet the population’s needs. 

An email statement attributed to Health and Social Services Minister Tracy-Anne McPhee also states that funding for total joint procedures is going up to increase access to orthopedic surgeries.  

The health authorities did not provide dollar figures or timelines. 

The news about expanding the hospital to make way for more operating rooms came as a pleasant surprise to McIntyre when the News spoke to him by phone. He said the hospital needs four operating rooms that are bigger in footprint. He supports the work done by doctors before him and a surgical services renewal strategy for the Whitehorse hospital that suggests the expected number of required operating rooms is four, plus one minor treatment room. 

But it’s too late for McIntyre. 

He started working as a physician at the Yukon Surgical Clinic in the territorial capital in July 2022. He is currently one of two local surgeons running the orthopedics program. YHC said the goal is to keep the program alive. Two more local surgeons will likely need to be hired for a total of three to maintain the service, after McIntyre leaves, effective March 31.

McIntyre said three orthopedic surgeons is the bare minimum but four is the ideal number. 

From his perspective, in late 2023, it seemed like things weren’t going to get any better in surgical services. McIntyre said morale was at an all-time low at that point. He said an “impasse” had been hit in talks with the Yukon government. He said there was an announcement to cancel travel nurses and cut back surgical services. 

The duo of orthopedic doctors temporarily stopped taking new consult referrals on April 2, 2024, citing their concern about maintaining standards of care given a lack of adequate resources. McIntyre told the News the orthopedic program’s waitlist was close to 300 patients, or a three-year wait, at its height. He has had to tell patients that he can’t give them the care that he wants to provide. 

McIntyre didn't see “appreciable change” over the year. He made the decision to move on.  

“There's good opportunities going forward, but it's kind of sad that it had to come to this,” he said. 

In his letter, McIntyre informed his colleagues that he will be leaving his practice in the Yukon to take up a new position at the Campbell River Hospital in British Columbia. He said he expects his new job will be less demanding with more resources in terms of infrastructure, personnel and equipment. 

McIntyre writes that he will maintain privileges at the Whitehorse General Hospital for another year after his exit to work remotely with patients and ensure continuity of care.  

However, the two local orthopedic surgeons haven’t resumed new consult referrals. Non-urgent elective patients will continue to be referred out of territory. 

McIntyre’s letter cautions about decreased patient volumes following his departure, until a new surgeon — or more — can be brought on. The program isn’t sustainable in its current form, he said. 

He said some people have left the territory for publicly and privately paid-for orthopedic surgery. 

When McIntyre leaves his position, Dr. Scott Westberg will carry on as the only local doctor in the program.

“It's kind of like we're turning back the clock,” McIntyre said.  

Health leaders commended both doctors' commitment to the territory and their patients.  

Without having enough locals, the program relies on locums, or doctors from outside the territory, filling in. 

YMA president Dr. Derek Bryant told the News that the Yukon needs significant investment in health-care infrastructure to attract and keep surgeons from outside the territory. 

“If the Yukon wants to be able to competitively and consistently recruit and retain surgeons, both in orthopedics and other services, then what we really need to focus on is increasing our operating capacity,” Bryant said. 

Bryant argued there needs to be more beds, expanded operating rooms and more operating rooms available to keep up with local demand and population increases in the Yukon. 

“Yukoners are either having to wait or leave the territory for service,” he said.  

“I don't believe that that's something that's going to be changing in the short term, until the orthopedic service can be stabilized, and what would really be needed to stabilize the orthopedic service is to build local, sustainable capacity for orthopedics, so that the number of procedures that can be performed in a year adequately line up with the demand and wait lists can actually get smaller.” 

Bryant noted the Yukon hasn’t kept up with other jurisdictions. The territory isn’t meeting accepted benchmarks for wait times and maintains longer wait times than B.C. 

Bryant knows recruitment efforts are underway, with the support of the YMA. 

“One person can't reasonably sustain an entire service and be on call 24/7,” he said.  

“It's critically important to recruit either local orthopedic surgeons or locum surgeons that can enable the orthopedic service to continue.” 

The CEO of Yukon hospitals wants Yukoners to feel safe, comfortable and confident in accessing care. 

“I'm so cognizant about the level of fear around access, especially over the last several years, coming through a pandemic and then into an HHR (health human resources) crisis,” Boyd said. 

“I've seen such positive momentum addressing some of these really hard HHR challenges. But I'm very optimistic, and I feel that in in the Yukon, we are so privileged and uniquely positioned in that, because of our size, we have the opportunity to resolve a lot of these issues, because they're not as big as they become in other places.” 

Contact Dana Hatherly at dana.hatherly@yukon-news.com 



Dana Hatherly

About the Author: Dana Hatherly

I’m the legislative reporter for the Yukon News.
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