Doctor ‘made to feel guilty’ for asking patient be treated sooner, as wait list worsens

Sally McShane with her daughter.
Sally McShane says her shoulder injury has made it increasingly hard to care for her daughter Willow.(Supplied: Sally McShane)

Key points:

  • Sally McShane, who was hurt in a car accident in 2014, says she has been told to expect to wait another three years before she can have elective surgery
  • A doctor who requested a patient be moved up the list was told in writing “other unfortunate patients will have to be cancelled to make space”
  • The Tasmanian Health Department declined to specify whether the contents of the letter were official hospital policy

Sally McShane injured her left shoulder in a car accident in 2014, and has been living in pain since.

“I got a level-four slap tear, so pretty much all the ligaments have come off that ball joint in my shoulder,” she said.

After five years of waiting on Tasmania’s outpatients list for a specialist appointment, last month Ms McShane finally saw an orthopaedic surgeon at the Royal Hobart Hospital (RHH), and was put on the elective surgery waiting list as a category-three patient.

Clinically, she should be treated within 365 days, but Ms McShane was told that because of the pressures on the health system, she would have to wait up to three years for surgery.

“The surgeon said to me: ‘You’re not going to die’,” Ms McShane said.

The latest Tasmanian Health Service Plan shows funding for elective surgery has been cut by about $14 million, and surgeons have been told to slash the number of surgeries by 15 per cent.

The state’s outpatients waiting list, which is the list you need to be on before getting on the elective surgery waiting list, has grown to 33,488, up from 28,649 in June last year.

The state’s elective surgery waiting list numbers 9,601 people.

The pain is affecting Ms McShane’s ability to care for her 10-year-old daughter, who has multiple complex disabilities, and relies on a wheelchair.

“I have to lift a wheelchair in and out of a car, I have to lift her in and out of the bath, it just makes it even more tiring and difficult,” she said.

Ms McShane said the years of waiting, had left her feeling helpless.

“I am so broken now by it, what can I do? You feel like the system is broken,” she said.

“I don’t want to be bumped up the list. the Government just needs to deal with it.”

GPs made to ‘feel guilty’, doctor says

Earlier this month, Dr Bastian Seidel wrote to the RHH — after his patient, a man in his 80s at risk of a hernia obstruction, did not receive his surgery within the recommended 90 days — asking for him to be reassessed.

Dr Bastian Seidel
Dr Bastian Seidel says the letter’s intent was to make doctors’ “feel guilty for advocating for a patient”.(Supplied)

The reply he received from the hospital on October 9 shocked him.

It said the surgeon had made a “very unusual request” to see if the patient could be moved up from a category-two to a category-one.

“This will mean of course that some other unfortunate patients will have to be cancelled to make space for him,” the letter states.

Dr Seidel, who is the immediate past national president of the Royal Australian College of General Practitioners, said he had never received such a letter.

“To be frank, I think it is inappropriate … the patient should have been seen in the 90 days anyway,” he said.

“But then to make a referrer feel guilty for advocating for a patient who clearly is in need of medical care, it is disappointing.”

The letter also struck him as a cry for help in the face of cuts to funding for elective surgery, and the well-documented capacity issues at the RHH.

“People are obviously under pressure, the hospital administration is under pressure, the clinicians are stressed, and once you put the pressure on, this is what happens,” Dr Seidel said.

Dr Seidel said patients should receive appropriate treatment in a timely way, and if more funding was needed it should be delivered.

“If we can’t do that, we need to question how the health system is set up, and currently it is not working in the way it should,” he said.

A spokesman for the Tasmanian Health Service did not say whether the contents of the letter were official hospital policy.

In a statement, clinical associate professor Marcus Skinner, Clinical Director, Surgical and Perioperative Services, said surgeons used well-established clinical processes to categorise patients for elective surgery.

“This is underpinned by national standards which ensure that people who are most in need of surgery are prioritised,” he said.