This approach places some patients whose treatment requirements fall outside one of the five priority clinical areas in a difficult position as they see their wait time remain overly long and potentially being extended. For their part, provincial/territorial governments can hold regional and local health authorities accountable through performance agreements that include specific wait list reduction targets. Limiting investment in health care, either in the training of physicians, nurses and other health-care professionals or in the construction and maintenance of infrastructure, has long-term consequences. As an example, as Canada and many other nations have learned from experience, resolving a shortage of health-care professionals is not a task that can be accomplished in the short term. If one accepts that the effective management of health-care wait times will be a permanent requirement, then the need to address accountability and liability issues takes on a strong degree of urgency. Should the clinical condition of your patient necessitate an earlier appointment or should the scheduled appointment exceed the wait-time benchmark, attempt to negotiate an earlier appointment. Furthermore, medical professional regulations and guidelines are almost exclusively based on individual patient care. Funding of health care in France. Public education to support system transformation. For example, there are indications in Ontario that, although the time a patient waits for surgery after being put on a waiting list may actually be getting shorter, the total waiting time may not be getting any better due to increased waits to see specialists following referral by a family doctor. It identifies the most salient medico-legal considerations associated with the wait times issue and offers recommendations for policy makers, health-care authorities and institutions, and physicians. For this approach to be viable, such procedures must be in place and be understood and accepted by all involved. While Canadians appear to be generally satisfied with the quality of care provided, they are increasingly expressing concerns about the timely access to care. Physicians and other health-care providers are familiar with these regulations and how they impact care delivery. Average Wait Time to See a Doctor in France Pediatrician or radiologist – three weeks Dentist – one month (average 17 days) Gynecologist – six weeks (average 32 days) Cardiologist – 50 days Dermatologist – two months Ophthalmologist – 80 days In a world in which timely access to care is not a problem, managing the queue of patients waiting for care would be a straightforward issue. This individual responsibility to one's patient is a foundation of medical practice and it is clearly spelled out and well understood by physicians and, within their own scopes of practice, by other health-care professionals. Reversing these effects requires both immediate action and a long-term commitment. Success will not however be based on the actions of one or two of these groups but rather on each taking the necessary actions, both within their own domains and collectively with others. Inform the patient about the signs or symptoms for which he/she should seek additional medical care during the wait time. While there has been an encouraging effort to reduce the length of time a patient has to wait for care, there has been less focus on addressing the real and potential concerns associated with the accountability and liability issues associated with managing wait times. The following recommendations for physicians address medical liability considerations related to treating wait times: All Canadians recognize the potentially negative impact that overly long wait times can have on patient care. It is also important to acknowledge the requirement to wait for access to health care is neither new, nor is it a situation that is restricted to Canada. This creates a real dilemma for physicians. Ongoing research to support benchmarking and operational improvements; Adoption of management practices and innovations in health systems; Accelerated implementation of information technology solutions; Cultural change amongst health professions; Development of regional surge capacity; and. Be aware of the date of the scheduled appointment provided by the consultant and determine if the timing is a cause for significant clinical concern. DISCLAIMER: The information contained in this learning material is for general educational purposes only and is not intended to provide specific professional medical or legal advice, nor to constitute a "standard of care" for Canadian healthcare professionals. It is safe to predict there will always be a gap between the demand for health-care services and the resources available to provide them. Document all actions taken in each of the above circumstances. Governments, health-care authorities, hospitals and health-care providers all have some accountability for providing health-care services, but this accountability needs to be defined in a way that is practical for all involved. As a starting point, it is perhaps instructive that the very definition of wait times is the subject of some debate. Given the physician's responsibility to individual patients, there remains considerable potential for conflict with his/her as-yetundefined responsibilities to other persons on the waiting list for care. Many Canadians, including physicians, have seen first hand that progress in addressing overly long wait times for medical treatment has been inconsistent across both different treatment procedures and different jurisdictions. Given the trend to cross-jurisdictional comparisons, these methodological inconsistencies are coming under increasing attention. For example, patients rightfully expect their physician will act on their behalf to gain timely access to the care needed. On the other hand, the rationing of time and resources to individual patients in order to enhance access for others may lead to negative outcomes. Standardize wait-time calculation methodologies and reporting procedures. This gives rise to a potential situation in which a physician might be held accountable for not advocating strongly enough for a patient faced with overly long wait times. Consider appropriate ongoing care for the patient during the period while he/she is waiting for the appointment. This would result in poor management of valuable health-care resources. This duty of care is guided by the following considerations: Within their particular scope of practice, physicians have a responsibility to direct their patients' care. In the interim, governments, regulatory authorities, regional and local health-care authorities, and health providers, including physicians, must work collectively to resolve the accountability and liability issues associated with wait-times management. Waiting times have been linked to inefficiencies in health care delivery, prolonged patient suffering and dissatisfaction among the public , , , , they have become important policy issues in many OECD countries, where national waiting time statistics are routinely collected in various countries , , .Some studies have compared waiting times between countries. Courts, regulatory colleges and patients can be expected to hold physicians accountable for how they treated individuals — regardless of the pressures to "treat" waiting lists. There are likely to be both positive and negative patient safety implications from efforts to reduce wait times. Any legal action would be further complicated if a patient's condition deteriorated when a wait time exceeded the performance goal. Most discussions regarding wait times for health care use as the basis of measurement the time between attendance at a consulting specialist and the completion of investigations or treatment.