Ophthalmology services were on the agenda when members of the Prairie North Health Region board met April 27.
CEO David Fan provided information about ophthalmology services in PNHR, in response to a newspaper article. He advised PNHR does not employ, hire or fire the physicians who provide ophthalmology services in the region.
Physicians generally apply for privileges to practice in the health region, he said, and to access the Region's facilities and resources, including operating room time.
As a health region, the fundamental question raised was whether PNHR has the authority to allocate its resources to the best of its ability. Fan said it was necessary for PNHR to go to court to determine if the region has that right. Fan noted two of the largest Saskatchewan health regions - Saskatoon and Regina Qu'Appelle - sided with PNHR by seeking intervenor status in the court proceedings, as the question to be determined has huge implications for all.
Fan explained the process that prompted the court matter and the question of allocation of resources was PNHR's decision in 2007 to support a resident ophthalmologist for the region and reduce the visiting cataract surgery services of two non-resident ophthalmalogists, one each from Edmonton and Saskatoon. The specialists provided only visiting cataract surgical services to Lloydminster and North Battleford.
Fan explained that prior to 2007, PNHR had a full-time resident ophthalmologist in the Battlefords. The specialist did not perform cataract surgeries. The health districts that preceded PNHR had granted privileges to the visiting specialists to do cataract surgeries at Lloydminster and Battlefords Union Hospitals respectively.
When the resident ophthalmologist in PNHR retired in 2007, the Health Region had the opportunity to recruit a Canadian-trained ophthalmologist to provide a full range of eye specialty services to Prairie North. That full range of services includes cataract surgery, after hour on-call services and visiting clinics to other locations in PNHR.
The question was whether to support a full-time, comprehensive ophthalmology service for the region, or split the most lucrative part of the service (cataracts) with visiting specialists. Fan commented that the visiting ophthalmologists provided good services over the years, but that the Region had to weigh the overall benefits of full-service-resident versus single-service-visiting ophthalmology services.
In consultation with medical staff in the Battlefords and Lloydminster, a decision was made to recruit the full-service resident ophthalmologist and reallocate the majority of the surgical time and resources to the resident surgeon. Fan said medical staff members favoured full-time resident ophthalmology services over visiting services.
The visiting ophthalmologists objected to the decision, leading to the eventual court ruling supporting PNHR's position.
Fan added the dilemma over resident versus visiting service applies to any specialty.