Manitoba issuing letters to hip, knee patients about free out-of-province option for care

Hundreds of Manitobans waiting for a hip or knee replacement will be getting a letter in the mail encouraging them to consider leaving the province for their operation.

The provincial task force focused on reducing Manitoba's surgery wait list wants to drum up interest among eligible people who are willing to travel to get their procedure more quickly. The province will cover all costs, including travel and accommodations. 

Uptake for these surgeries — completed in northwestern Ontario, North Dakota and Ohio, under agreements the province reached earlier this year — is rising but has fallen short of initial estimates, the executive director of Manitoba's diagnostic and surgical recovery task force says.

"We want to give everybody the opportunity to consider the option, and I perhaps don't think it's as widely broadcast as we would want it to be," Dr. David Matear said in a Tuesday interview.

He expects a first batch of 500 letters to be issued later this week. Up to this point, patients were either informed of the out-of-province program by their health-care provider or applied to the program themselves. 

The task force, which is also working to build up local surgical capacity, is consulting with physicians and surgeons to ensure the letter's wording is right, Matear said.

Patients must meet medical criteria

Not all Manitobans waiting for a hip or knee surgery will meet the criteria. Eligible patients must be of normal weight and have no problems with their heart, liver, kidney or blood vessels, among other conditions. They must also have at least two doses of a COVID-19 vaccine.

Up to 750 people will be eligible to get hip or knee surgeries within the next two years or so under the agreements the province announced in August with Big Thunder Orthopedic Associates in northwestern Ontario, Sanford Health in Fargo, N.D., and Cleveland Clinic in Ohio.

There was also a pledge to help spinal surgery patients get their operations in Fargo, but no estimate on the number of procedures was provided when that agreement was announced last January. 

As of this week, 140 people have left Manitoba to go under the knife for one of these operations.

While those numbers are growing, initial targets have not been reached. An August news release, for example, said 125 hip and knee surgeries could be completed in Fargo this year, although only 13 operations had been done by mid-December.

Matear said getting arrangements up and running has taken a lot of time. Each facility starts with a limited number of patients, to ensure the logistics are handled appropriately.

"I think what we have to do is to build in the processes, build up the partnerships, the opportunities, and then of course communicate that effectively to those people who may be eligible to take up these options out of province." 

Matear said he expects the number of patients travelling for procedures will increase as awareness grows.

He said another 140 procedures are in the queue, including 50 more people booked for spinal surgery and 47 more for hip or knee replacement surgeries in Fargo, but the task force has the capacity to accept more patients.

'Very narrow eligibility': Doctors Manitoba

Kim Kurylo, the first Manitoba patient to get surgery in Ohio, urged anyone who is healthy enough to sign up for an out-of-province operation.

The task force had told her there were many openings. 

"Our backlog could go down a lot faster if people would sign up for out-of-province [procedures], but it seems like some people are scared," Kurylo said in an interview with CBC earlier this week.

She only became aware of the option herself after a friend showed her a news story, she said.

Doctors Manitoba, which advocates for physicians in the province, said a lower than hoped for uptake for operations beyond Manitoba's borders shouldn't come as a surprise to anyone.

Out-of-province travel can be difficult for patients, especially those waiting for joint replacements who may be experiencing mobility issues or in constant pain, spokesperson Keir Johnson said in an email.

"There are also very narrow eligibility criteria, with 15 specific criteria that must be met to qualify for out-of-province surgery."

While out-of-province surgery may be a temporary solution to reduce the backlog, "the primary focus should be adding capacity right here in Manitoba," Doctors Manitoba said.

Critics, including the Opposition NDP and Liberals, have said the Progressive Conservative government should be ashamed the health-care system has been strained to the point that patients must be sent away.

The Tories, however, say they're getting patients care as quickly as possible. 

As of October, the pandemic backlog for hip or knee replacement surgery was 1,140 people. That tally does not count those individuals who were waiting before COVID-19 arrived.

Hip and knee surgery patients encouraged to consider surgery out-of-province

2 years ago

Duration 1:58

Hundreds of Manitoba patients waiting for hip and knee surgery will get a letter encouraging them to travel to the U.S. or Ontario for their procedure. The head of the province's diagnostic and surgical recovery task force says many patients have already taken up the offer.