Cardiologists and heart surgeons in Quebec have raised concerns about a shortage of staff, particularly perfusionists, stating that the insufficient number of workers crucial for supporting patients during heart surgeries is causing delays and fatalities. Dr. Bernard Cantin, the president of the Quebec Association of Cardiologists, expressed dismay over the loss of 80 individuals who passed away while awaiting heart surgeries in the past year and a half.
Perfusionists, though not widely recognized, play a vital role in cardiac surgeries across Canada by managing the heart-lung machine, also known as the cardiopulmonary bypass. This machine takes over the functions of the heart and lungs during lengthy procedures by redirecting the patient’s blood flow, oxygenating it, and returning it throughout the surgery.
Currently, there are approximately 375 perfusionists in Canada, with around 40 vacant positions and an anticipated 60 retirements in the next five years, according to the Canadian Society of Clinical Perfusion. In Quebec, only 70 out of 92 perfusionist positions are filled, leading to warnings from the associations of cardiologists and cardiovascular and thoracic surgeons regarding the shortage and the resulting increase in surgical waitlists since 2019. They intend to escalate the issue by seeking intervention from the province’s ombudsman.
Despite the Quebec Health Ministry downplaying the significance of the reported deaths related to the shortage of perfusionists, the associations contest this stance. They argue that the ministry’s data on cancelled surgeries fails to consider procedures that were never scheduled due to staff shortages.
Staffing challenges are prevalent across Canada, with Naresh Tinani, a senior cardiovascular perfusionist and acting president of the Canadian Society of Clinical Perfusion, highlighting the profession’s obscurity, demanding schedules, and wage differentials with the U.S. as contributing factors. In Quebec, the situation is particularly strained, with perfusionists being drawn away by better opportunities in other provinces and the U.S.
Yannick Pinard, president of the Quebec Perfusionists Association, noted the increasing difficulty in recruiting and retaining perfusionists in the province. Santé Quebec acknowledged the recruitment and retention hurdles and reiterated its commitment to attracting and training new graduates to ensure seamless service delivery.
Efforts are being made in various provinces to address the shortage by expanding training opportunities for perfusionists. Institutions like the Université de Montréal, the British Columbia Institute of Technology, and the Michener Institute in Toronto are ramping up their efforts to meet the rising demand for skilled perfusionists.
The challenges of long waitlists and patient fatalities while awaiting surgeries have prompted calls for more transparency and legislative action, as seen in Manitoba with the proposed “Debbie’s Law.” This legislation aims to inform patients about expected wait times and alternative options in case of extended delays beyond medical recommendations.
Pinard emphasized the need for Quebec to enhance salaries and working conditions to retain perfusionists and improve the overall situation. Despite the current difficulties, he remains optimistic about the future of the profession.