Q&A: The MUHC's chief surgeon on record-level wait lists, overcrowding in Quebec ERs

By all accounts, Quebec's health-care system is under enormous strain. The CAQ government recently passed Bill 15 into law to try to make the system more efficient.

But in the meantime, emergency rooms are dangerously overcrowded and wait times for some surgeries are reaching record highs.

Dr. Liane S. Feldman, the surgeon-in-chief at the McGill University Health Centre (MUHC), spoke to CTV News Montreal anchor Maya Johnson Tuesday about the current situation in Quebec hospitals.

This article has been edited for clarity and length. Watch the video above for the full interview.

CTV: I'd like you to put this into perspective for us if you can. What kinds of surgeries are we talking about? And how bad is it compared to what you've seen in your professional experience in the past?

FEDLMAN: I think we always had wait times in our system. But no doubt that in those situations — the wait times, the waiting lists, the number of patients — is, at least in our institution, higher than it's ever been. And I think that that's a consequence of just not having enough skilled people to work in the operating room, and people in the nursing units as well as the intensive care unit.

CTV: We also have an aging population. Is that something that could be contributing to the problem as well?

FELDMAN: Yes, exactly. As our population ages, there's actually more need for surgery. That's a demographic fact. And actually, as surgery has improved, and the outcomes of surgery have gotten better, it means more people are actually eligible for surgery. So that's another factor that plays into it.

CTV: So what kinds of surgeries are we talking about here?

FELDMAN: We're really talking about all surgeries. We have made a lot of efforts to have more oversight on all the patients that are waiting, We have a much more centralized process to provide the oversight to try to make decisions about how to prioritize these lists. Of course, there are what people call elective surgery — I prefer to use the term scheduled surgery versus emergency surgery or more urgent surgeries. And so we have different pressures on each of those categories of patients who all need surgery.

CTV: Our reporter Kelly Greig spoke to one woman yesterday whose husband was diagnosed with congestive heart failure two years ago and needed an aortic valve replacement at the MUHC. He died waiting for that surgery. Would you say that's an exceptional case? Or is that something that, unfortunately, could become more common with these longer wait lists?

FELDMAN: Yeah, I saw that story. Obviously, it's really devastating to see the pain of that family and my sympathies to that family, especially as we go into the holiday season. I think it's a sad result of the system that we're in, in terms of the pressures that you've described.

CTV: Are you hopeful that Bill 15 will help make Quebec's health-care system more efficient? Obviously, the health minister, Christiane Dubé, is convinced that it will, but there are critics.

FELDMAN: I wouldn't pretend to be an expert on Bill 15. What we try to do in our department, and with all the people who are working so hard every day, completely committed to good outcomes for our surgical patients and all of our patients here, I think our goals are really to maximize the resources that we have, make sure that we are as efficient as possible, as productive as possible, have the best outcomes as possible. We are very committed to using all the resources that we have at our disposal at the various hospital sites that we have, including in the centre médical spécialisé (CMS), or the private centres, that we have agreements with to make sure that we're aligning the patient needs with any resources that we have.

We've also done quite innovative things with decreasing the time that people need to spend at hospital after major surgery through specialized clinical care pathways. We were very happy to just open a new unit dedicated to improving recovery after surgery for patients. Because if people don't need to spend as much time in hospitals, if they're recovering faster, then we can make all those beds more available to people. So I think we're very focused on what we can do in our own purview with the resources that we have.

Watch the video above for the full interview.