Cardiologists and heart surgeons in Quebec have issued a cautionary alert about a workforce shortage, specifically in the field of perfusionists. They emphasize that the insufficient number of these critical healthcare professionals, who assist in maintaining patients’ life functions during heart surgeries, is leading to procedural delays and, in some tragic cases, fatalities.
Dr. Bernard Cantin, president of the Quebec Association of Cardiologists, revealed that over the past year and a half, 80 individuals have lost their lives while awaiting heart surgeries due to the scarcity of perfusionists. The role of perfusionists, although not widely recognized, is pivotal in cardiac surgeries across Canada. They operate the heart-lung machine, also known as the cardiopulmonary bypass, which mimics the functions of the heart and lungs throughout lengthy surgical procedures by redirecting, oxygenating, and returning the patient’s blood supply.
Presently, Canada has approximately 375 perfusionists, with around 40 vacant positions and an estimated 60 retirements anticipated within the next five years, as per the Canadian Society of Clinical Perfusion. In Quebec alone, out of the 92 perfusionist roles, only 70 are presently filled, as highlighted by the associations of cardiologists and cardiovascular and thoracic surgeons in the province. They have been cautioning the government about the staffing shortage and the escalating surgical waitlists since 2019 and are now preparing to file a complaint with the provincial ombudsman.
According to the most recent data available in Quebec, as of August 23, over 1,300 patients were awaiting cardiac surgeries, with nearly 65% surpassing the medically acceptable wait times prescribed by the province. Quebec’s Health Ministry responded to the concerns raised by the medical professionals, indicating that the reported deaths should be cautiously interpreted, citing that patients awaiting cardiac surgeries often have multiple health conditions that might contribute to their demise.
Despite the ministry attributing only one percent of canceled surgeries to the perfusionist shortage, the associations of cardiologists and cardiovascular and thoracic surgeons dispute this claim. They argue that the surge in demand for cardiac surgeries over the past five years has not been met adequately, and the ministry’s cancellation statistics fail to encompass surgeries that were never scheduled due to staffing deficiencies.
Beyond Quebec, various provinces in Canada are grappling with similar staffing challenges in the perfusionist domain. Naresh Tinani, a senior cardiovascular perfusionist in Regina and acting president of the Canadian Society of Clinical Perfusion, noted that the profession remains relatively obscure, making recruitment challenging, compounded by demanding schedules and remuneration discrepancies compared to the U.S. Further exacerbating the predicament are an aging perfusionist workforce and the taxing nature of the job.
Yannick Pinard, a perfusionist in Quebec City and president of the Quebec Perfusionists Association, expressed the escalating difficulty in both recruiting and retaining professionals in the field due to better working conditions outside the province luring practitioners away. Santé Quebec, the government entity overseeing health services, acknowledged the recruitment and retention hurdles and pledged to attract, train, and retain new graduates to ensure seamless service provision.
Efforts are being made in some provinces to bolster the pipeline of perfusionists by enhancing training opportunities. Three institutions in Canada – Université de Montréal, the British Columbia Institute of Technology, and the Michener Institute in Toronto – offer perfusionist training programs. Dr. Michael O’Leary, the principal at Michener, disclosed plans to ramp up student intake from 16 to 38 annually by fall 2027 in collaboration with Ontario’s Health Ministry, recognizing the critical role perfusionists play in the operating room.
The shortage of perfusionists in Quebec has had dire consequences, with patients languishing on waitlists and, tragically, losing their lives while anticipating surgeries. The associations of cardiologists and cardiovascular surgeons in the province have recorded close to 80 deaths among patients awaiting surgery in the past year, partly attributed to the staffing shortages impeding scheduling and leading to cancellations.
In Manitoba, the poignant case of Debbie Fewster underscores the anguish endured by patients on surgical waitlists. Despite being listed for cardiac surgery, the procedure was never scheduled for Fewster, who succumbed to a heart attack after months of anticipation. Her son, Daniel Fewster, has been advocating for “Debbie’s Law” in Manitoba, urging transparency in communicating expected wait times and alternative options to patients facing prolonged delays.
As the healthcare sector grapples with the pressing issue of perfusionist shortages, stakeholders remain hopeful for improvements in working conditions and compensation, while striving to attract and retain talent in the field to address the burgeoning demands of cardiac surgeries.