Doug Ford has a plan to outsource surgeries. This clinic shows how it might work
OHIP #OHIP
The eyes have it.
A Windsor laser clinic has emerged as a model for Premier Doug Ford’s controversial plan to shorten wait-lists by performing more operations outside hospitals — all thanks to COVID-19 and innovative local thinking.
With Ontario government checks and approvals, the doctor-owned Windsor Surgery Centre added OHIP-funded cataract surgeries that had to be severely curbed at Windsor Regional Hospital under early pandemic protocols.
The experience provides insights into how the new system can work amid concerns about independent health facilities poaching doctors, nurses and other medical personnel from hospitals already struggling with staff shortages.
“I get that people are skeptical,” Windsor Regional Hospital chief executive David Musyj told the Star in an interview Tuesday. “But it’s worked in Windsor.”
He said the key is collaboration and co-operation between hospitals and clinics on patients and staffing based on mutual interest — something that will have to be carefully monitored across the province as the government’s plan rolls out.
“Because we have this very close relationship, every single ophthalmologist and anesthesiologist must also work at the hospital,” said Musyj.
The Windsor Surgery Centre is now part of a solution that includes an extra 14,000 people in Ontario scheduled to get cataract operations this year, months sooner than planned and something that will shorten the province’s surgical waiting list by 25 per cent.
“It’s a win-win for everybody,” said Dr. Wassim Saad, chief of staff at the hospital, which works closely with the surgery centre located in a former gym along an east-end suburban strip clustered with car dealerships.
On Monday, Ford announced that the province would move thousands more surgeries and diagnostic procedures out of hospitals and into specialized community clinics to ease the pandemic backlog — now at 206,000 — starting with cataracts and building toward hip and knee replacements next year.
On Tuesday, Ford’s office took a shot at opponents of the plan who have pledged to fight it over concerns about hospital staffing and further privatization of the health-care system.
“A simple question to the NDP and their new leader Marit Stiles: are they OK with telling 14,000 Ontarians waiting for cataract surgery that they should continue to wait?”
Stiles issued a statement maintaining “private, for-profit clinics will result in more health-care workers leaving the public system.”
She called for “bold action, and serious investment, in our existing public system to protect our public health care, and ensure everyone has equal access to health care, no matter how much money they have.”
When COVID-19 hit with full force in the spring of 2020, Windsor Regional Hospital was performing cataract surgeries in cramped quarters in a single basement operating room at its downtown campus. There was little space for distancing and the number of daily operations had to be cut by 80 per cent for patient safety.
Hospital officials approached the doctors who own the Windsor Surgery Centre, asking if they’d be willing take on cataract operations for patients on the hospital waiting list if OHIP would pay.
The answer was yes.
“It’s time for somebody to think outside of the box,” said Dr. Fouad Tayfour, chief of ophthalmology at the hospital and co-owner of the surgery centre.
Once the ministry of health approved, the clinic began taking in the hospital patients and quickly outgrew its two operating rooms, moving last October to the former gym that was renovated to include four operating rooms.
Because the ORs are dedicated to cataract and eye surgery, Musyj said more patients can be handled in a day than at the hospital, and the local waiting list is down to three or four months.
There’s another benefit: free parking at the clinic. It performs about 6,000 surgeries a year with capacity to increase that, potentially adding procedures like knee and shoulder scopes or endoscopies.
Tayfour said the surgical centre specifically trains nurses and therefore cannot easily poach them from the hospital roster — and pays less than the hospital, for shorter day-surgery shifts.
“It’s still more attractive to work at the hospital, financially,” said Tayfour.
The other advantage to the clinic is cataract patients no longer have to be in a busy general hospital, potentially exposing themselves to “risks they don’t need” in the COVID era, Musyj said.
“These procedures do not need to be taking place in a hospital.”
Moving cataract surgeries frees up operating room time for more urgent surgeries, said Musyj, noting that while operating rooms are more available in the evenings, studies have shown patient outcomes for non-emergency surgeries after 5 p.m. are not as good as for daytime procedures.
“That’s why stand-alone surgical centres are operating during the day.”
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