The Yukon’s resident orthopedic surgeons aren’t taking new patients for elective orthopedic surgeries because there is no new money or support for the program, they argued in a letter to other doctors.
The Yukon Surgical Clinic has temporarily stopped accepting referrals for elective consultations, according to the letter from Dr. Adam McIntyre and Dr. Scott Westberg.
The Yukon Party provided the letter to reporters on April 8.
“The waitlist for orthopedic surgery in the Yukon has grown exponentially and is well beyond what is manageable with current resources,” reads the letter, which was sent by email on April 4.
The doctors wrote that they have been consulted by and negotiating with the Yukon government for two years.
“But there has been no increase in operational funding or support for the orthopedic surgery program that would help us accommodate the rapidly growing demands of our steadily increasing population,” they wrote.
Per the letter, the doctors are focused on treating active patients and those already in line.
For that reason, the letter notes consultation requests received after April 4 will be rejected until further notice.
Until then, the doctors are recommending that all semi-urgent consultation requests be referred out of territory.
McIntyre and Westberg were not available for interview due to their schedules by press time, but they said by email that their advocacy continues and they hope to secure more operational support.
According to the Yukon government cabinet communications team, as of Jan. 8, the wait time for total knee or hip replacement was between 16 and 21 months, with 284 people on the waitlist.
The health minister was asked about the letter in the legislature during the question period on April 8 and 9.
“Why has the minister of health failed again to support increased funding for hospitals, leading to more cuts of important surgical services here in the Yukon?” health critic Brad Cathers of the Yukon Party asked.
Cathers regularly refers to the governing Yukon Liberal Party’s “chronic underfunding” of the Yukon Hospital Corporation. From his perspective, spending on hospitals is down by $14 million in 2024-25 compared to 2023-24.
He often cites an independent report made public in late 2023 and commissioned by the Yukon government that looked at hospital funding.
“It is clear from the analysis that steps need to be taken collaboratively to address the (Yukon Hospital Corporation’s) chronic cash flow and operating shortfall,” reads the report.
Cathers wondered when the government will inject more funding and what impact will be had on medical travel costs if people are being referred Outside due to the pause at the clinic.
In response, Health and Social Services Minister Tracy-Anne McPhee noted two resident orthopedic surgeons support the territory, plus coverage from locum surgeons.
McPhee referred to an orthopedic agreement that allows for 100 total joint replacement procedures per year. She mentioned that in 2022-23, 104 joint replacement surgeries were completed, and 67 were done by the third quarter of 2023-24.
“This allocation has incrementally increased since the introduction of the program in 2017,” McPhee said. “I think it’s important for Yukoners to recall that prior to 2017, there was no such services available here in the territory.”
That’s when the Yukon government set up a resident orthopedic surgeon program in the territory.
In November 2021, the first full hip-replacement surgery was done at the Whitehorse General Hospital.
“Prior to that, in 2017, no orthopedic surgeons here in the territory also meant that individuals who needed such services for following an accident of some kind or tragedy also had to travel outside the territory,” McPhee said.
About a year ago, the same two surgeons notified that wait times for joint replacement surgery went up from about a year to between 18 and 24 months.
At the time, McPhee admitted that people are waiting longer than they should be for joint replacement surgery.
An April 9 email statement from cabinet communications indicates the Yukon Liberal Party government has been working with resident orthopedic surgeons and the Yukon Hospital Corporation to expand and review the program.
The statement confirms the government’s awareness of the concerns raised by the two surgeons and the potential impact on elective consultations as well as the government’s commitment to mitigating these concerns by working closely with the surgeons and the hospital corporation.
As opposed to Cathers’ claims about cuts to hospital funding, cabinet communications said the budget for the Yukon Hospital Corporation in 2024-25 is up from last year. In 2023-24, $107 million was budgeted for the hospital corporation in the main estimates, while this year’s main estimates have been increased to $115.5 million.
The statement indicates the hospital corporation oversees its budgetary, staffing and surgical capacity forecasts for the year.
“Our government has consistently provided funding to meet those forecasted needs,” cabinet communications said, recognizing the growing and aging population and its evolving demands and needs.
The government and the hospital corporation are looking to identify the needs of health-care providers and Yukoners seeking elective surgeries amid the pause in referrals for elective consultations. They are discussing how to support the program and access to care for Yukoners, per the statement.
An updated memorandum of understanding around the program could come as part of a review of health-care infrastructure, according to cabinet communications. The memorandum of understanding will set surgical volumes. The statement indicates that the government, hospital corporation and Yukon Medical Association are seeking ways to assess and set benchmarks for the “overall surgical services landscape” backed by evidence and data.
“We understand the stress that wait times for orthopedic surgeries can cause, as many of us know someone who is on the waitlist,” cabinet communications said.
Yukon Hospital Corporation spokesperson James Low said by email on April 9 that the hospital corporation “was not involved in and does not support the decision by the orthopedic surgeons.”
“The decision is related to not accepting new elective consults in [the] clinic. The hospital will continue to accept referrals for elective surgery,” he wrote.
Low clarified that the clinic runs independently from the hospital but is located on the hospital campus.
He indicated that the hospital corporation, orthopedic surgeons and government would keep moving forward with their current arrangement.
“The hospital has met or exceeded targets for orthopedic service over the past year” despite creeping pressures, Low wrote.
Data Low provided suggests that 100 hip and knee replacement procedures were targeted for 2023-24, with 107 completed.
“Wait times from the hospital perspective only (from referral/request to surgery) is 15 months for total knee and 12 months for total hip. This does not include the time it may take to see a surgeon for assessment/consult,” Low wrote.
Low said the Yukon has come a long way in a short period of time on this front.
“Together, government, surgeons and hospital have identified needs, set service levels and will remain responsive as needs grow and evolve. This includes looking at service scope and level as well as what resources are required to support these needs,” Low said.
When taking questions from reporters in the Yukon government cabinet office on April 9, Premier Ranj Pillai confirmed work is underway and the memorandum of understanding between involved parties is under review.
Pillai was unable to give a timeline for a solution to the problem.
Contact Dana Hatherly at dana.hatherly@yukon-news.com