Open Letter to the Public from cSBC President, Dr. Robert Carruthers
January 28, 2025
The Consultant Specialists of British Columbia (cSBC) is reaching out to bring attention to an escalating healthcare crisis that demands immediate action: the growing waitlist for Specialist care in British Columbia. Despite previous discussions with the Ministry of Health, no finalized solutions have been implemented to address this critical issue. As of late 2024, over 1.2 million British Columbians are waiting to see a Specialist, an increase from 1 million in 2022.
Specialist wait times are a vital indicator of the health of our system, and current delays are unacceptable. Patients are enduring uncertainty, pain, and even disability as they wait for care. Cancer care suffers in the Specialist Waitlist Crisis as almost all diagnosis and initial treatment (including surgeries) of new cancers is done by Specialists, such as General Surgeons, Urologists and Gynaecologists. Almost all subsequent referrals to the BC Cancer Agency come from those Specialists. Increasing wait times to see Specialists delays cancer diagnosis and treatment leading to avoidable suffering and deaths. The impact is systemic, leading to overcrowded Emergency Rooms, redundant Specialist referrals, and added strain on Family Doctors. Rural communities face even greater challenges, with higher barriers to care and longer wait times - a gap that must be further measured and addressed.
The Scope of the Problem
Recent survey data from Specialists across BC paints a troubling picture:
- Wait Times: Urgent referrals take approximately one month, while semi-urgent cases average 10 weeks but may extend up to 18 weeks for internal medicine and gastroenterology. Non-urgent referrals are the most alarming, with average wait times of 10 months, climbing to 16 months for neurosurgery.
- Waitlist Sizes: Many Specialists’ waitlists now contain hundreds of patients, with Dermatology averaging 1,166 patients, Orthopaedic Surgery at 556, Allergy and Immunology at 539, and Urology at 365. Alarmingly, many of these patients may never receive care.
- Deteriorating Access: The majority of Specialists report that waitlists and wait times have “increased significantly” over the last two years. A staggering 93% state that BC lacks a sufficient number of Specialists, with certain specialties—including Gastroenterology, Geriatric Medicine, Infectious Disease, Neurosurgery, Plastic Surgery, and Radiology—unanimously reporting inadequate staffing.
- Specialist Concerns: 79% of Specialists believe BC residents lack adequate access to Specialist care, and 86% prioritize reducing wait times as a critical need.
Proposed Solutions to the Waitlist Crisis
cSBC has outlined actionable solutions that can deliver both immediate and long-term impacts:
- Investment in a Comprehensive Waitlist Project: This initiative has already been developed in collaboration with the Ministry of Health and is ready for implementation. It will identify geographical and specialty-specific pressure points, enabling targeted investments. It will also introduce tools for funded waitlist management and new written advice options so that Specialists can better support patients under the care of their Family Doctor.
- Specialist Team Care Expansion: Increasing capacity of our existing Specialist work force by integrating allied healthcare providers into Specialist outpatient clinics.
- Improved Rural Outreach Support: Expanding Specialist services in underserved rural areas so that patients can receive the Specialty care they need in their home communities.
- Increased Residency Training Positions: Substantially increasing residency slots and investing in the education of new trainees is essential to ensuring we have the Specialist workforce we need in the coming decades.
- New Payment Models: Providing Specialists with flexible compensation options tailored to their practice and patient needs. Increased choice in compensation model will attract new Specialist physicians to BC and will help ensure that all Specialist services are available for BC residents when they need them.
- Enhanced Specialist Clinic Resources: Increased point-of-care testing at the time of Specialist consultation to facilitate efficient diagnosis and treatment planning and avoid other, more expensive and time-consuming investigations, which costs the system more and leads to further patients waiting for care.
A Call to Action
British Columbians cannot take access to Specialist care for granted. We urge you to share your experiences waiting for Specialist Doctors with your BC MLA Representative (Members of the Legislative Assembly | Legislative Assembly of BC). Share your experience with us by using the QR code below (https://consultant-specialists-of-bc.kit.com/0180194f6d). Please share on social media using #BCstillwaiting and tag us on X (@SpecialistsBC).
The Ministry of Health needs to return to the table and prioritize funding for meaningful collaborative solutions. These investments are critical to alleviating the burden on our healthcare system and ensuring timely care for all British Columbians.
On behalf of the Consultant Specialists of British Columbia (cSBC), which represents all Specialist physicians in BC, thank you for your attention and support.
Sincerely,
Robert Carruthers, MD, FRCPC
President, cSBC