Alberta patients waiting for surgery struggle to access pain clinics

As Judy Wales waited an agonizing 76 weeks for shoulder replacement surgery she sought out relief at an Edmonton chronic pain management clinic, but ended up on another wait list.

Wales' primary-care physician referred her for treatment at the pain clinic in the Edmonton Bone and Joint Centre in late 2015. By the time she got an appointment, her surgery was already done.

Wales kept her appointment anyway, hoping the specialists on site could help alleviate the nagging arthritis pain in her spine.

That's when Wales was told, as a post-operative patient, she was no longer agood candidate for the clinic.

'Big waste of my time'

"They are really overwhelmed and if I walked in the door, which I did, they didn't think I needed help," Wales 69, recalled in an interview with CBC Radio's Edmonton AM.

"It was a big waste of my time."

The system is leaving patients in limbo, Wales said.

"Because of the population that's aging, and the kind of issues that are coming up, I don't think they have services in place for the needs that are starting to surface," Wales said.

"Wait lists aren't health care."

Wales' case is far from unique, said David Swann, a medical doctor and an MLA.

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Pain clinics can help patients cope as they await surgery, but access is limited by overwhelming demand,Swannsaid.

'Not acceptable'

As surgery wait lists grow, pain clinics are also experiencing longer wait times, he said.

"This is part of the knock-on effect of delaying surgery further and further is that we have more and more difficulties with pain management, longer and longer wait times for the pain clinics.

"And that's not acceptable."

Pain management clinics in Alberta are designed to connect patients to psychologists, psychiatrists, physiotherapists, and doctors or nurses who specialize in pain care.

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Alberta Health Services operates a number of clinics across the province including Edmonton's Kaye Clinic and the Chronic Pain Centre at Richmond Road Diagnostic and Treatment Centre in Calgary.

The Edmonton Bone and Joint Centre also provides some pain management resources and referrals, when necessary.

'Asupply and demand issue'

AHS said the majority of patients waiting for a hip, knee or shoulder replacement surgery have their pain managed by their family or primary care physician.

Dr. David Zygun, Edmonton zone medical director, said he was surprised by Wales' experience.

Zygun said the case sounded like a "relatively unique situation," and the apparent wait time issues for pain management clinics had not been brought to his attention.

"Just because I haven't heard of it doesn't mean it doesn't exist," Zygun said.

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AHS did not have statistics on the wait times for chronic pain management services, but an analysis from the Canadian Institute for Health Information (CIHI) shows that wait times for joint replacement procedures continue to grow in Alberta.

"It is a supply and demand issue that we are actively addressing," Zygun said.

"Access to healthcare keeps all healthcare providers and administrators up at night because we don't want to delay access for these needed services."

'It is so counterproductive'

Betty Dean, 72, suffers from osteoarthritis and is on a wait list for knee replacement surgery.

She's been waiting for areplacement since the spring of 2017 when her doctor put in the request, but she wasn't officially put on the list for the surgery until November.

She's been told her surgery should happen by the end of July, more than a year after she first sought a referral.

The Edmonton woman, who takes painkillers daily to deal with chronic nerve pain, was referred to a pain management clinic in the meantime, but decided to stick with her family doctor after hearing about the challenges Wales, afriend,faced.

Dean wrote aletter to the health minister's office aboutthe lack of services for wait list patients.

"As you get more and more desperate, it finally happens," she said. "But it ought to be done as quickly as a physician says it needs to be done ... so that as we as age, our health doesn't deteriorate more quickly because were forced to sit and wait.

"I don't get how decision makers don't see this," she said. "It is so counterproductive to population health."