At the Inaugural Diabetes Surgery Summit in Montreal last week, it became apparent that there is significant provincial variation in accessibility to weight loss (bariatric) surgery. As Dr. Nicolas Christou of McGill University pointed out, in Canada in 2008, the number of bariatric surgeries performed in each province was as follows:

– Nova Scotia: 28
– New Brunswick: 17
– Quebec: 802
– Ontario: 579
– Saskatchewan: 23
– Alberta: 272
– BC: 160

The reasons for the provincial variation are complex. One interesting phenomenon that was brought up was that in Ontario, patients had previously been funded by the provincial health care system to have bariatric procedures done in the United States – this was a situation that was unique to Ontarians, as no other province provided funding to do this. Due to the enormous expense of sending patients over the border and the potential savings of having these surgeries done at home, the Ontario government provided funding to build access to the service in their home province, to the tune of many millions of dollars in cost savings. As other provinces never had the situation where patients were funded to go south to have surgery, the same financial pressure does not exist to bring the procedure home.

In the mix of the numbers above, other factors have to of course be considered, including population density and surgical expertise available in each province (though with increased provincial funding for bariatric surgery, the surgical expertise would be likely to follow).

Even in provinces with the most accessibility to surgery, however, there is still an enormous shortage of availability country wide, with an estimated fifteen year backlog of patients who would be appropriate for, and benefit from, the surgery.

What can we do? Get out there and talk about it.

Dr. Sue © 2010