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Pathologist shortage in Outaouais has patients waiting months for biopsy results

Hundreds of patients could be waiting months for biopsy results as a backlog of samples plagues the Outaouais region.

4,000 tissue samples were waiting to be analyzed when the Gatineau and Hull hospitals were inspected in March

A shortage of pathologists in Gatineau has created a backlog of biopsies in the Outaouais health region. (Michel Aspirot/Radio-Canada)

Hundreds of patients could be waiting months for biopsy results as a backlog of samples plagues the Outaouais region.

Documents obtained by Radio-Canada show there was a backlog of 4,000 tissue samples at the end of March.

Those 4,000 samples could represent between 200 and 300 patients, said Guy Morissette, director of professional services at the integrated health centre and social services of the Outaouais region.

He said part of the problem was a lack of pathologists who work out of the Hull hospital, which receives samples from seven other hospitals and private clinics across the region.

Guy Morissette, director of professional services at the integrated health centre and social services of the Outaouais region, said the backlog has decreased since March, but it's still higher than ministry guidelines. (Hugo Bélanger/ Radio-Canada)

Not enough pathologists

At the time of the inspection the lab had five pathologists. That number has since increased to six when another pathologist was hired in July and he said a seventh has also been hired and is expected to start sometime between November and January. An eighth pathologist is expected to be hired within the next year.

That months-long delay is a problem as test results should be sent to a doctor within days, not months, he said.

Urgent samples are usually processed within three days and non-urgent samples by two weeks. But as of March, some non-urgent patients were waiting up to four months to have their tissue analyzed and the results sent to their physician.

That wait has since decreased to about two months, Morissette said. But that`s still double the one-month timeline that's stipulated in guidelines from the Quebec Ministry of Health and Social Services.

Patients suffer psychological, if not physical, problems

That wait can cause undue distress for a patient, said Louis-Philippe Mayrand, commissioner of complaints and service quality in the Outaouais health region. He said his office has received more than a dozen complaints since April.

Aside from the psychological aspect of the delay, he said there could also be physical impacts if a sample is processed too late for a procedure to be done. Although he said his office hasn't been notified that a patient's health was put at risk by the backlog.

Louis-Philippe Mayrand, commissioner of complaints and service quality in the Outaouais health region said delays in testing can cause undue stress on patients. (Hugo Bélanger/ Radio-Canada)

Morissette acknowledged the stress on patients. He also said mistakes can happen where a sample marked as non-urgent returns as cancerous.

"It's possible. We're taking means to reduce the possibility of having those cases that will pop up that we don't expect there's a cancer and then there is one."

He said controls are in place to help minimize mistakes. Those controls include doctors visually inspecting the tissue for malignant markers before sending it off for testing.

"We encourage our physicians to call the pathologist and the pathologist will never refuse to… [read] the case within days when it's asked by a surgeon or dermatologist who says 'I have a high suspicion of cancer'," he said.

He said it also depends on where tissue is removed from.

We know there may be some surprises with those samples. But usually, there's not many surprises that we get.- Guy Morissette, director of professional services at the integrated health centre and social services of the Outaouais region.

"When it's a wart, it's rare that you will have [cancerous cells]… but other times there are other lesions that we try to prioritize because we know there may be some surprises with those samples. But usually, there's not many surprises that we get."

Even as the lab deals with the current backlog, another 50 to 100 new tissue samples arrive for testing every day. But Morissette said he's been told eight pathologists should be enough to get rid of the backlog.

With files from Radio-Canada

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