New program cuts wait times to see gastrointestinal specialists by 98%

Alberta doctors applaud a new initiative that cut the wait list to see gastrointestinal specialists from 2,742 patients to just 30.

New triage system could help cut wait times for other medical specialists

Dr. Jessica Orr says her patients have benefited from the new initiative that links primary care providers and specialists. (Francois Joly/Radio-Canada)

Alberta doctors are lauding a new initiative that has essentially eliminated the wait to see gastrointestinal specialists.

The Enhanced Primary Care Pathways program links family doctors with specialists to both eliminate unnecessary referrals, and help patients with non-urgent concerns receive the specialist-level care they need from their primary physician.

The program cut wait times for non-urgent gastrointestinal patients by 98 per cent between January 2016 and February 2018, with the wait list decreasing from 2,742 patients to just 30.

"That is unbelievably empowering to a primary care physician," said Dr. Mark Swain, the section head of gastroenterology and hepatology in Alberta Health Services' Calgary zone. "Everyone is secure their patient is not being lost in the system."

Dr. Jessica Orr, Health Minister Sarah Hoffman, Dr. Mark Swain, Dr. Linda Slocombe and patient Hayley Clarke announce the decrease in wait times for gastrointestinal patients on Thursday. (Francois Joly/Radio-Canada)

Swain said that historically, access to gastrointestinal care has been challenging. Doctors have to deal with a spectrum of complaints that are often referred to specialists, everything from bloating and heartburn to irritable bowel syndrome.

Often, the concerns are chronic, which saw patients waiting months on end to see a specialist for a follow up appointment, leading to a progressively growing wait list for treatment.

The program found that 84 per cent of patients who would normally have to wait to see a specialist to receive care were unnecessarily referred. 

Family doctors can assess, triage patients

The new model sees family doctors given a document that allows them to assess and triage patients just like a specialist would, and gives the doctors access to a phone line so they can receive direct advice from specialists in their care.

Dr. Linda Slocombe — medical director of the Calgary Foothills Primary Care Network — said the project's success has other specialties and regions following in its footsteps, with five other specialties in Calgary implementing similar programs. 

"The gastrointestinal model is a template we're using for integrated healthcare," Slocombe said. 

"It's rapidly expanding and we're hoping to continue to expand so that the family physician in their office is well supported for whatever specialty they need to talk to in the Calgary zone … It really does improve patient care."

The number of patients waiting for routine gastrointestinal procedures in Calgary dropped from 2,742 in January 2016 to 30 in February 2018. (Francois Joly/Radio-Canada)

Family physician Dr. Jessica Orr said she uses the new system approximately once per week.

"How it has impacted my patients has been amazing," she said.

Hayley Clarke is a gastrointestinal patient who was looking at a six-month wait to see a specialist before surgery, until her family doctor tried the new pathways program. It took just one week to get her in to a specialist.

"I left the doctor's office feeling great that my wait time was done, stress was gone," she said. 

With files from CBC's Dave Will and Radio-Canada's Francois Joly