PEI radiologist shortage highlights national problem

I pitched a story about the long wait times for mammograms and results being experienced by women in PEI. When I began to investigate the story further, I found PEI represented the “tip of the iceberg” in a looming national shortage of radiologists.

PEI radiologist shortage “tip of the iceberg” says national rep

The delays and backlogs in Prince Edward Island’s breast screening program which have raised public concern in the province could eventually be seen across the country, according to an official with the Canadian Association of Radiologists.

“This is just the tip of the iceberg. There is a shortage of radiologists in Canada,” says Dr. Normand Laberge, the CEO of the organization.

Radiologists are physicians with special training in reading X-rays and performing X-ray procedures, and Prince Edward Island has been short two and a half of them for nearly a year. Women there face a nine- to twelve-month wait for the routine breast screening X-rays commonly known as mammograms and there is a backlog of 700 mammograms waiting to be read. The situation led PEI radiologist Dr. Colin Taylor to threaten to temporarily shut down the breast screening program during a radio interview on Oct. 24 unless some help was received.

“We want to make sure we’re practicing the best medicine we can, and I think at this point in time we’re being compromised by the shortage of radiologists,” he commented.

Dr. Laberge echoes Dr. Taylor’s concerns. He says the benefits of a breast screening program are diminished if women in the targeted age group of 50 to 69 do not receive mammograms every two years, as recommended by the Canadian Cancer Society. He explains that mammography, as with any X-ray, carries the risk of causing cancer, but if it is done at the proper interval time, the advantage of catching early cancers outweighs the dangers inherent in the procedure.

“We know that we can reduce death rate from breast cancer by 25 per cent with breast screening programs. [If women are not able to have mammograms at the appropriate time] that reduction will not be possible on the Island . . . The situation is now critical,” he says.

Dr. Richard Wedge of PEI’s Department of Health acknowledges the government is very concerned about the backlog. “There could possibly be one or two women in there (the backlog) whose mammograms will show something. I think it’s in everybody’s best interest to have them read in a timely fashion,” he says.

PEI Health Minister Chester Gillan announced Oct. 25 that a radiologist from Ontario will come to the Island temporarily to read mammograms and would return as often as necessary. Dr. Wedge expects the backlog to quickly decline once that radiologist comes on board. The doctor will focus only on mammograms and will read as many as 500 over a three-day period. Dr. Wedge adds that three more radiologists have agreed to come to PEI to work part-time as soon as they are licenced in the province. “Come December, we should have four people to do locums on a regular basis,” he says.

The sudden flurry of activity when the province has been short radiologists for nearly a year leaves at least one woman suspicious that the provincial government would have done little about the situation if it weren’t for Islanders airing their concerns in the media.

“I just wish the government was proactive. They seem to be reacting. When the backlog reached 50 to 100 mammograms, why didn’t the alarm bells go off? They knew we were short radiologists. If we didn’t rattle their cages would this situation just have gone on?” asks Maureen Garrity, a Charlottetown woman who was diagnosed with breast cancer in June 2005. In a letter to the editor published in The Guardian, Charlottetown’s daily newspaper, on Oct. 31, Mrs. Garrity wrote that “the government must reassess its priorities,” and pushed for the province to “immediately institute a program to attract and hold more radiologists.”

Dr. Laberge agrees that the provincial government could be trying harder to solve the problem. “PEI hasn’t been that aggressive in finding radiologists. An ad placed in the paper every six months isn’t going to do it,” he says. While he doesn’t comment on the effect pay rates may have in attracting this type of specialist to PEI, he does say that Island radiologists are paid “on the low end” of the national scale.

Mr. Gillan says his government has been doing the best it can. It provided a scholarship to a medical student studying radiology with the caveat that the student would relocate to the Island after graduation. However, the student decided to live and work elsewhere, and is now repaying the scholarship funds to the government. The minister says they are now trying the same process with another student with the hopes of better results. In addition, the province is looking into shipping the mammogram films to other radiology clinics in Canada or the U.S. to be read as a short-term solution to the problem, although there are several issues that need to be worked out before this becomes a reality.

With regard to pay rates, Mr. Gillan says the Island is “competitive,” but a small jurisdiction like PEI can’t vie with large Canadian centres when it comes to salaries. He hopes the attractions of living and working in a smaller community will provide a balance. Another attraction, in Mr. Gillan’s opinion, is working with the Island’s six radiologists, who operate a group practice at Charlottetown’s Queen Elizabeth Hospital. “We have a good, strong team. They are professional and cohesive,” he says.

The members of this “strong team” have already put up some of their own salary dollars to pay for the overtime hours caused by the shortage and for the recruitment of new radiologists. As a matter of fact, the doctors themselves found the four radiologists who will be coming to the Island on a locum basis. Dr. Taylor, who is a member of the group, brought the situation in PEI to the attention of radiologists throughout the country at national conference of the Canadian Association of Radiologists held in Montreal a few weeks ago.

However, even with the promise of extra help on the way, there is a very real fear that women on PEI have been discouraged from making appointments for their mammograms because of the long wait times. This is a cause for concern in a province, which, according to statistics from the Canadian Cancer Society, is expected to have 130 new cases of breast cancer diagnosed and 25 deaths occurring from the disease in 2006.

“What should have taken one month has taken 10 months so far and I still don’t know the final results. I am constantly hearing ‘Make sure you get your mammogram,’ and I have to shake my head and wonder what is wrong here,” Sharyn Mitchell wrote in The Guardian on Oct. 17.

Maureen Garrity puts it very simply. “Women may say, ‘what’s the point?’”

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