Eye doctors see red over deal

Eye doctors see red over deal
By Dan Hilborn, Burnaby Now assistant editor
Published Aug. 6, 20303


Plans to open a Centre of Excellence in eye care at Saint Mary's Hospital in New Westminster hit a roadblock this week when a group of ophthalmologists from Burnaby announced their intention to withdraw from the negotiations as a protest against the Fraser Health Authority.

The eight Burnaby eye doctors said despite more than three months of discussion, their concerns and recommendations have been virtually ignored by Dr. Peter J. Hill, chief medical director for the Fraser North region of the FHA.

"The Burnaby ophthalmic group has reached an impasse with Dr. Hill and clearly, there is no benefit to be had with us meeting with him again," the doctors said in a July 25 letter to the health authority.

The pronouncement comes after the Burnaby NOW was provided with a series of letters that indicate a growing level of distrust between the Burnaby eye doctors and the FHA.

"It is up to us whether we will co-operate with this scheme or withdraw from it completely," the doctors said in a July 11 letter to Hill. "We are not prepared to be 'managed' without meaningful consultation and if need be we will withdraw services from the region."

At issue are Burnaby doctors' claims that Saint Mary's lacks the equipment, facilities and other support to make the Centre for Excellence a practical or financial success.

The doctors also alleged the move is a misguided attempt to ration the amount of eye surgery done in the region, by moving the eye care surgery into a facility that only recently quelled rumours that it was about to close down.

Dr. Larry Daitz, one of the eight Burnaby eye doctors, said he and his colleagues may simply stop performing eye surgeries if they are forced to relocate.

"What's been going on in the background is a political thing between the region and Saint Mary's," Daitz said in a July 28 interview.

Earlier this year, the government-appointed FHA board drastically reduced its funding for Saint Mary's. In making that announcement, the FHA said it would move a variety of services around the region, including opening a new Centre of Excellence for eye care in the 89- year-old New Westminster facility, forcing the relocation of many of the services currently offered by the Burnaby eye doctor group.

Larry Odegard, chief executive officer at Saint Mary's, was hesitant to speculate what might happen if the doctors follow through with their threats, however, he said more discussion is definitely needed to ensure the centre opens smoothly.

"I know it is very disruptive to them and their practices and their patients, obviously," Odegard said Tuesday. "What we're intending to do is arrange a meeting of the leaders of their ophthalmology groups and their counterparts here at Saint Mary's.

"But my understanding is the decision is final and it part of a new agreement with Fraser Health. We expect, as the eye centre for Fraser North, we'll be able to address patient needs, and hopefully we'll be able to resolve their concerns.

"We'd prefer to have them (the Burnaby doctors) here, and that they'd bring their patients. That's the desire and the intention."

Helen Carkner, chief spokesperson for the Fraser Health Authority, said the authority is still hopeful of obtaining the co- operation of the Burnaby eye doctors.

"I think we're hoping that we can gain that support," Carkner said Tuesday. "That's why the discussions are continuing with them. The plan is to develop a quality program from all facets and avoid duplication of equipment at all sites.

"Change is not always universally welcome, but we do have a responsibility to the whole health authority."

But the doctors said the move could result in higher costs, particularly for the 'ancillary services' they provide at their two private offices in Metrotown and on Hastings Street.

"Rather than taking the region's money by doing testing in the hospital - as they would have us do at Saint Mary's - we currently provide those services in our office, and we don't charge the region a cent for it," Daitz said. "So this is not going to save them a lot of money."

Daitz also believes the move could result in a rationing of eye- care surgery in the region. "The real objective is to contract service. They want to pay for 50,000 operations and that's it.

"It makes no financial sense to consolidate all this at one facility," Daitz said. "We have the full range of services in Burnaby, which they really don't have in New Westminster."

Another complaint is that Saint Mary's fails to meet seismic, earthquake protection standards, and it would be unsafe to use the ceiling-mounted microscope currently used at Burnaby Hospital for many of the most delicate laser surgery operations.

"You don't want your microscope shaking around while you're doing surgery," Daitz said.

That allegation was dismissed by Odegard. "I think they are misled, and I think there are some areas where they have services we do not and vice versa," said the CEO of Saint Mary's.

Meanwhile, in a July 18 letter to Burnaby North MLA Richard T. Lee, the Burnaby doctors alleged that they were completely ignored in the planning process.

"Despite Dr. Hill's assurances, we recently received a letter from him indicating that the amalgamation is a 'done deal.' Many platitudes are expressed, but they are unrealistic, ill-conceived and, in today's budgetary situation, totally impractical fantasies," said the letter. "Despite being the health-care professionals with the most knowledge of the practical aspects of eye-care delivery, and willing to help if asked, we have been completely left out of the entire process and the administrators have decided what is best for everyone."

In the letter, the Burnaby doctors also claim the move could result in the closure of Burnaby Hospital. "If our fears about the true reason for amalgamation - decreased access to care leading to decreased costs - are realized, then neither community will benefit, and waiting lists will lengthen considerably. If other services are similarly organized, the case to downgrade (Burnaby Hospital) from acute care will be easy."

Daitz also does not believe the move will result in the opening of the desired centre for excellence in New Westminster.

"The promises made by Dr. Hill of turning this facility (Saint Mary's) into a top-notch eye-care centre to rival the eye-care centre downtown, to have research and students and all this, is a pipe dream," he said. "If you look at the budget and how much they're in the red in that eye-care centre in Vancouver, there's no way it's going to happen twice," Daitz said.

"This plan is hopelessly ambitious and seriously flawed."

If the proposal does go ahead, Daitz admits that many of the younger eye doctors will likely make the move. However, he also said that most of the more experienced doctors who have already established their careers, such as himself, will likely just retire, resulting in a net loss for the public.

"If they move tomorrow, I'll tell them to shove it. I just won't do it," he said. "I'm 57 years old and I don't need it from a financial point of view."