Dr. Justin French is disappointed he and the province’s health minister don’t see eye to eye on a way to improve vision care in western Newfoundland.
The Corner Brook ophthalmologist described the volume of wait times for surgery at his practice as an uncontrollable freight train constantly bearing down on his clinic.
He is considering packing up the practice because the provincial government is rejecting his plan to offer what he believes would be a more sustainable approach to eye care in the western region.
French’s plan is to personally finance the construction of a surgical centre for ophthalmic excellence in Corner Brook, to the tune of around $3.5 million.
While he would pay for the building, along with its maintenance and the equipment required for the practice, the services offered would remain publicly funded and universally accessible, just as they currently are in the public health care system.
“Right now, we are constrained within the efficiencies of a publicly run system,” French said in an interview Tuesday.
French said it might be possible one or two jobs could get lost in making the operation more efficient, but confirmed the centre would still involve a unionized environment and any job losses would come in the context of government saving money and offering a better service.
Health and Community Services Minister John Haggie, also in an interview Tuesday, said government could not accept French’s proposal for a couple of reasons. Firstly, the minister said government did not agree that there would be cost-savings, as suggested by French.
In fact, Haggie said French’s plan would actually cost government more than it currently spends on eye care.
“There was a cost per case cost either to (Western Health) or the government, however it was done, which would effectively amount to a significant subsidy for his clinic, given the volume of procedures he’s talking about — probably in the order of $1 million to $1.5 million per year,” commented the minister.
Haggie said the Corner Brook doctor’s plan, if implemented, would force government to have to shut down eye surgeries at Western Memorial Regional Hospital in Corner Brook and likely at Sir Tomas Roddick Hospital in Stephenville too.
French maintains his proposal not only offers a 65 per cent reduction in the cost per case, but his centre would indeed be designed to eliminate the need for any cataract surgeries to be conducted in Corner Brook or Stephenville.
“My proposal was never to maintain what we have … We wouldn’t be running a parallel system,” said French. “This would be a replacement system. There wouldn’t be an increase in volume, except for increasing the volume to meet the wait times.”
Haggie said his department is in disagreement with the volume of patients French says he has on his wait lists. French said there are between 800 and 1,000 people waiting for eye surgery at his clinic.
“Up until the end of last year, his wait list, as far as the data he had provided to Western Memorial, showed him to be well within the national benchmarks,” said the minister. “In actual fact, Western Memorial’s wait time had improved over 2016-17.”
French disputed the data Haggie was quoting, saying it only shows the number of patients he has booked for eye surgeries. What it doesn’t show, noted French, is the number of other people who have been referred to him by optometrists.
“Most of the people I operated on last week were sent to see me with significant cataracts in 2016,” he said. “The system only measures from when I say they need surgery to when they have it, not from when the optometrist – who is also an eye physician- diagnoses them and sends them to me for surgery.”
He said booking more surgeries than he already does would mean not attending to all of his other patients whose vision is at risk because of other eye-related pathologies.
French will soon be leaving for British Columbia and will be checking out his practice options while there. He will return to practice in Corner Brook in June, but is not sure if his stay will be for six months, maybe a year, or possibly longer.
“I don’t know how long I would be back after that,” he said. “My decision to leave indefinitely has not been made, but this is a temporary departure to look at my options.”
If he goes for good, French said it’s not simply because government didn’t give him what he wanted.
“I’m leaving, if I leave, because the current capacity and volume is not sustainable, unless we do something to fix it,” he said. “I’m trying very hard to fix eye care on the west coast to make it better for the people, better for the physicians and make the sustainability long term. If we can’t do that, then I can’t carry on the way I am.”
Haggie acknowledged French is an important asset to the western region’s health care system, but said the decision on where he will practice is up to him.
“I cannot control, nor can I advise him, what his career path should be,” said the minister.