New Brunswick thoracic patients won't be accepted by Nova Scotia surgeons

Thoracic surgeons in Nova Scotia will not be accepting any patient referrals from New Brunswick, despite comments by Horizon Health Network officials and internal memos suggesting otherwise, says the division head of thoracic surgery at the Queen Elizabeth II Hospital in Halifax.

Dr. Harry Henteleff says Horizon Health Network officials contacted him a few weeks ago to ask if his team could help, since the Saint John region's only thoracic surgeon is on indefinite medical leave and the Moncton region's only thoracic surgeon is also "on leave."

"We reviewed it with our local group and the conclusion was that without extra resources to handle the extra workload, we couldn't take them," said Henteleff.

"The reason was that our patients are waiting about two to three times the national standards for wait times for cancer surgery, so if you added a whole bunch of extra patients in, then that would just make our excessive wait list become even longer."

A thoracic surgeon in Quebec has, however, agreed to take New Brunswick referrals.

Thoracic surgeons are specialists who deal with structures of the chest, such as the esophagus, lungs, and diaphragm muscle, but not the heart.

They treat diseases ranging from cancer to gastroesophageal reflux, remove benign tumours, perform chest reconstruction after major traumas and handle lung transplants.

Internal Horizon emails obtained by CBC News have described the lack of thoracic surgery coverage in Saint John and Moncton regions as a "crisis."

But during a news conference last Friday, Dr. Edouard Hendriks, vice-president of medical, academic and research affairs, downplayed the seriousness of the situation, calling it "difficult," but not a "crisis."

Hendriks said all patients in the region who need thoracic surgery have been successfully referred to other surgeons and none have faced "undue delays."

"We also, of course, got in touch with our colleagues in Halifax and even in the province of Quebec to ensure that if at some point … New Brunswick is not able to meet all the demand that we have quickly and easily, ways to refer these patients elsewhere," Hendriks had said.

Awaiting response to offer to fly to N.B.

Similarly, an internal Horizon email from the chief of surgery Dr. David Tees to physicians dated March 14 states: "Please find enclosed a list of surgeons that may be called upon to see a patient in consultation."

It lists nine surgeons, including Henteleff and his three thoracic surgeon colleagues in Halifax, who together serve all of Nova Scotia.

Henteleff contends the email is incorrect and the Halifax surgeons will not be seeing New Brunswick patients.

"I can tell you what my conversation was with Dr. Tees, I said, 'I regret to say that we can't take the patients,'" said Henteleff.

Cancer patients in Nova Scotia are already waiting an estimated eight to 12 weeks for thoracic surgery instead of the recommended four, he said.

The Halifax surgeons did offer to take turns flying to Saint John and Moncton to perform surgeries, but have not yet received a response from Horizon, said Henteleff.

The proposal was for two surgeons to make multiple trips, performing as many operations as possible during each visit, roughly three in 12 hours, with local physicians handling the patient follow-ups, he said.

Dr. Rosaire Vaillancourt, of the Quebec Heart and Lung Institute in Montreal, said he is "quite happy to help" with New Brunswick's "unfortunate" and unusual situation.

"It's real bad luck that your two main thoracic surgeons in the province are sick at the same time," said Vaillancourt, who used to work in New Brunswick at the Dr. Georges-L.-Dumont University Hospital Centre in Moncton from 1992 until 2000, practising cardiovascular and thoracic surgery before specializing further.

He considers it his "duty" to assist his New Brunswick colleagues and the patients, who require the "specialized care."

He's only had one referral so far, and he expects to see her "soon," he said.

"I'm basically just waiting that she has her PET scan in Saint John and then I will see the patient."

The other four physicians listed in the Horizon email as possible consults include general surgeons in Fredericton, Moncton and Edmundston, and an internal and respiratory medicine specialist in Moncton, according to the provincial College of Physicians and Surgeons registry.

The general surgeon in Fredericton, however, has an asterisk beside his name in the memo, indicating "presently full and would prefer no more for now."