The Question: Does the Holland Orthopaedic & Arthritic Centre accept referrals from an out-of-province GP? I am a resident of Alberta and I am interested in the Holland Clinic based on its reputation and relatively favorable wait times.
The Answer: In 2004, the federal government’s health accord identified joint replacement as an area to improve timely access to care. Since then, patients have been able to see if their provinces are meeting the target of completing the operation within 26 weeks after seeing the surgeon. Though some provinces do a better job of meeting this target than others, queues still vary by surgeon, hospital and city.
As a patient, it sounds as if you are shopping for a joint replacement based on wait time, availability and reputation. According to Anne Marie MacLeod, operations director of the Holland Orthopaedic & Arthritic Centre at Sunnybrook, our institution has a reciprocal agreement with Alberta, which means that any operation you have here would be funded by your provincial health plan. About 2,200 hip and knee replacements are conducted at the hospital each year, with patients staying an average 4.2 days before they go home.
The Holland Centre has a central registry, which means you will be offered the first available appointment with the first available surgeon. Before seeing the surgeon, you will be assessed by an advanced practice physiotherapist who will help you determine whether a replacement is something you want or need now. That physiotherapist will provide a detailed assessment, which includes a review of x-ray images.
“About 30 per cent of patients don’t go on to the surgeon right away,” Ms. MacLeod said in an interview. “A patient may have arthritis but may not be ready to consider joint replacement.”
Indeed, some patients, after undergoing that assessment decide not to go for the replacement right away, opting instead to manage their condition with other methods. Others opt for the first surgery date.
You should ask whether they can schedule those two visits – the advanced practice physiotherapist and surgical consult – during the time you are here to save yourself a trip. After that visit, a preoperative health assessment by your family physician will need to be done closer to the date or surgery. You will then fly for the operation.
Across the country, the number of hip and knee replacements has increased by 15 per cent from 2010 to 2012, costing more than $100 million to the health care system, with $40 million spent on hip replacements and $61 million spent on knee replacements, according to the Canadian Institute for Health Information. Most – about 80 per cent of patients – received their replacements in 2012 within the benchmark wait time; 79 per cent received their knee surgery within that benchmark.The operations are considered clinically and cost effective, compared to other medical treatments.What you need to do now is request your family physician make a referral to the Holland Centre. Please go to this link for the downloadable referral form. https://sunnybrook.ca/media/item.asp?c=17&i=889&page=33977
I would also suggest you watch this very clever video by Dr. Mike Evans on how to prepare for hip and knee surgery.
http://www.youtube.com/watch?v=xAL_TrQdtTY
