Horizon Health scrambles to cope with thoracic surgery 'crisis' in Saint John region

Horizon Health network officials are scrambling to deal with the Saint John region's thoracic surgery coverage "crisis," coming up with alternative plans to diagnose and treat patients.

Zone 2, which stretches from Sussex to St. Stephen, currently has no thoracic surgery coverage because the only thoracic surgeon on staff is "unavailable," Horizon officials have said.

"This situation is likely to continue for at least another four weeks," states an internal Horizon memo, dated March 14 and marked "CONFIDENTIAL." 

An internal Horizon Health Network email obtained by CBC News earlier in March described the lack of thoracic surgery coverage in Moncton and Saint John as a "crisis."

Thoracic surgeons are specialists who deal with all structures of the chest, with the exception of the heart, including the esophagus, lungs, chest muscle and diaphragm muscle.

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

The March 14 internal memo, signed by chief of surgery Dr. David Tees, instructs doctors to refer their patients to oncology, respirology or GI for now, "depending on the clinical situation for initial workup and tissue diagnosis."

A "thoracic disposition" group has also been established to review cases and refer to a surgeon "if indicated," according to the memo, obtained by CBC News.

The group plans to meet twice monthly, starting on March 22, it states.

"It is our hope that this system will provide patients with timely access and diagnosis," wrote Tees.

Biweekly teleconferencing with an unidentified thoracic surgeon is also expected to start on March 22 and Tees lists nine surgeons in New Brunswick, Nova Scotia and Quebec who "may be called upon to see a patient in consultation."

Three of the four listed for New Brunswick are general surgeons located in Fredericton, Moncton and Edmundston, according to the provincial College of Physicians and Surgeons registry, while the fourth is an internal and respiratory medicine specialist in Moncton.

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."

Earlier this week, a 65-year-old Saint John woman with esophageal cancer told CBC News her gastroenterologist referred her to four different surgeons in New Brunswick and Nova Scotia and she was turned away by all of them.

"It's really scary," said Eileen Shaw, who is having difficulty getting food past the growing tumour in her throat.

"I'm thinking, 'Oh my goodness, where am I going to go? Am I going to die?'

Tees says Horizon's general surgeons are also providing after-hour coverage "as they have in the past when we have been without a thoracic surgeon."

"Let me know if you have any problems with this temporary solution to triaging patients," he wrote.

A Horizon Health official is expected to provide an update on the situation to the media on Friday at 11 a.m. in Fredericton.