Quebec cardiologists, surgeons say staff shortage leading to heart surgery delays and deaths

Cardiologists and heart surgeons in Quebec are warning about staffing shortages, particularly perfusionists, saying the shortage of workers who help keep patients alive during heart surgery is contributing to delays and even deaths.

“Eighty people have died in the last year and a half waiting for their surgery,” said Dr. Bernard Cantin, president of the Quebec Association of Cardiologists.

“It’s horrible,” he said. “It’s unbelievable.”

This job is not well-known, but perfusionists play a vital role in the operating room during cardiac surgery across Canada. They run cardiopulmonary bypass, or heart-lung machines, which perform the work of the heart and lungs during hours-long procedures. The machine removes the patient’s blood supply from the heart, oxygenates it, then returns it to the patient during surgery.

According to the Canadian Society of Clinical Perfusion, there are currently approximately 375 perfusionists in Canada, with approximately 40 vacancies and more than 60 retirements expected in the next five years.

Quebec’s associations of cardiologists and cardiovascular and thoracic surgeons said only 70 of the 92 perfusionist positions in that province are currently filled. The associations said they have been warning the government about shortages and growing surgical waitlists since 2019. Now, they plan to file a complaint with the province’s ombudsman.

“We started working with the hope that the government would take action but nothing happened,” Cantin said.

latest data Available in Quebec Show By August 23, more than 1,300 patients were waiting for cardiac surgery. about 65 percent were waiting For longer than is medically acceptable according to the province’s timeline.

Quebec’s health ministry said in a statement to CBC News that the number of deaths noted by cardiologists and surgeons should be “interpreted with caution.”

“Patients awaiting cardiac surgery often have multiple co-morbidities. Therefore the cause of death may be related to a condition other than heart disease.”

The ministry said the perfusionist shortage in particular is responsible for only one per cent of surgeries being canceled in the province.

Staffing issues across Canada

Other provinces are also dealing with staffing challenges.

“We’re in a very under-the-radar profession,” said Naresh Tinani, a senior cardiovascular perfusionist in Regina and executive president of the Canadian Society of Clinical Perfusion. He said this is partly due to on-call schedules and overtime, as well as making it harder to attract new people to the job.

“You’re essentially working on a cardiac surgeon’s schedule,” he said. “It becomes a challenging situation to maintain over time.”

Tinani said the workforce shortage is also linked to wages — perfusionists have moved away because of higher wages and other incentives in the U.S. — an aging workforce, and intensified job demands.

Quebec faces the most stress, Tinani said. “They lose sprinklers to other provinces and the US”

Yannick Pinard, a Quebec City perfusionist and president of the Quebec Perfusionists Association, said it is becoming increasingly difficult to recruit and retain people for the job.

“We are seeing more and more people leaving the province for better working conditions outside the province of Quebec,” he said.

Santé Quebec, the government corporation in charge of health services, said it is aware of recruitment and retention challenges.

“Sainte-Québec is committed to attracting, training and retaining new graduates to ensure continuity of services,” it said in a statement.

Some provinces are trying to increase the number of people receiving training for this position It is offered at three sites in Canada – Université de Montréal, British Columbia Institute of Technology and the Michener Institute in Toronto.

Michener principal Dr. Michael O’Leary said the school is working with the Ontario Ministry of Health to increase the number of students trained each year from 16 last year to 38 by 2027.

“We are concerned about the recruitment of individuals into this profession,” O’Leary said. “The importance of this role within the operating room is significant and we believe there is an opportunity here to meet that demand.”

died on waiting list

In Quebec, cardiologists and heart surgeons said they are worried about putting people on waiting lists and losing patients waiting for surgery. The association tracks the number of deaths on the waiting list of each cardiovascular surgical center in Quebec and found that about 80 people died last year while waiting for surgery. The unions say this is due in part to staffing shortages, leading to surgeries not being scheduled and some having to be cancelled.

In Manitoba, Debbie Fewster was added to that province’s waiting list for cardiac surgery last August. She was 69 and required triple-bypass surgery, but her son Daniel Fewster said it was never scheduled.

He died of a heart attack after Thanksgiving dinner a year earlier. She was on the list for two and a half months.

“When the ambulance came they tried their best to revive her. They threw everything they had at her, but she was gone,” her son said in an interview from his home in Niverville, Maine.

Fewster says he doesn’t know why his mother’s surgery was not scheduled, or whether the delay was related to a shortage of perfusionists or other staff. Still, he has been calling for more transparency about wait times – regardless of the reasons behind it.

She and her family want the Manitoba government to pass “Debbie’s Law” – which would ensure that patients are informed about expected wait times for their surgeries, And what are their other options if the waiting time exceeds the medically recommended time.

“If we had known my mom was going to be on the list for two and a half months and need surgery in three weeks, we would have done something about it,” Fewster said.

Meanwhile, the Manitoba government said in a statement, “The Minister of Health, Seniors and Long-Term Care directed cardiac services to provide all patients with a letter giving the expected time frame (depending on their severity) for their surgery.”

Pinard, a perfusionist in Quebec City, wants Quebec to improve wages and working conditions. He is committed to the work and hopes things will improve.

He said, “I believe in it. I think it’s just a matter of time.”