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Pricey tummy tucks performed in public hospitals
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Kathy Tomlinson, CTV News
Date: Wed. Nov. 1 2006 9:22 AM ET
He's a cosmetic surgeon with his own private clinic in Montreal, and wants Canadian taxpayers to know how many strictly cosmetic surgeries are now being done in public hospitals.
"Cosmetic procedures are being subsidized by the taxpayer," Dr. Clifford Albert of the Canadian Academy of Cosmetic Surgery (CACS) told CTV News.
Some of Canada's plastic surgeons are making a lucrative profit on the side, by doing the procedures, a CTV Whistleblower investigation has found. Sometimes, doctors say, the cosmetic surgeries even delay other surgeons from getting patients in for necessary operations.
Across the country, Canadian hospitals are allowing patients to get their tummy tucks, breast augmentations and other strictly cosmetic surgeries in hospital, for a nominal fee to the facility.
Patients pay anywhere from $500 to $2,500 to the hospital for the operating room time and the anesthetist, and between $5,000 to $10,000 to the surgeon. A survey of plastic surgeons fees found it's cheaper for patients to have their cosmetic surgery in the hospital than it would be at a private clinic.
Dr. Albert claimed, "There's no question if you do a procedure in hospital, your costs can be off-loaded to the health care system."
The procedures are done during the hospital's off-hours. But, doctors say, when a tummy tuck or facelift goes longer than anticipated, patients whose operations are next on the schedule often get moved to another date.
"I have heard of many physicians who have had necessary surgery bumped as a result of a cosmetic procedure going on," said Dr. Albert.
Albert said guidelines issued by the CACS in 2004 say cosmetic surgery should be avoided in hospitals, specifically to avoid taking up operating room time. Not only are the operating rooms being tied up -- so are the anesthetists.
Neurosurgeon Dr. Alan Hudson once ran a major Canadian hospital -- and banned cosmetic procedures in his hospital -- except for teaching purposes. Hudson is now in charge of cutting Ontario's wait times. He told CTV News invasive cosmetic surgeries can cause delays -- and the practice should be exposed to public debate.
"I don't want wait times going up for hips and knees because cosmetic surgery is occupying the operating room," said Dr. Hudson.
Federal Health Minister Tony Clement, whose party has promised to reduce wait times, has so far avoided the issue, arguing it would be the responsibility of provincial health care ministers.
When asked by CTV News if he planned to address the problem, he replied: "I am going to certainly wait for the provincial health ministers to respond to your excellent story."
Dr. Albert said there is a double-standard when it comes to allowing cosmetic surgery in hospitals. Patients can pay for the procedures, but can't pay for necessary surgery to avoid long wait times.
"We know that people are paying for procedures now, so why not let them pay for medically necessary procedures as well and open the field?" he said.
Last year, about 180,000 Canadians underwent invasive cosmetic surgeries. If just a quarter of those operations were performed in Canada's public hospitals, that would mean than an estimated 135,000 operating room hours used up for procedures like breast augmentations and tummy tucks.
"It's a lot of (operating room) time. It's a lot of things being used," said Dr. Albert.
CTV News contacted 104 plastic surgeons offices across the country - from Halifax to Victoria -- and 56 of them -- more than half -- said they do the procedures in hospital. Some doctors believe hospitals allow the practice because it's a way to keep plastic surgeons from leaving to make a better living elsewhere.
In fact, it's the surgeons, not the hospitals, making money from these procedures. A review of hospital costs for other procedures illustrates this point.
Here is a comparison:
- A tummy tuck would require three hours in an operating room, and several hours of recovery time, sometimes including an overnight stay. The hospital fee: $500 to $2,500.
- Cataract surgery usually involves two hours in the operating room, but rarely an overnight stay. The cost to the hospital -- for the operating room time in Ontario: $753.45.
The Canadian Healthcare Association confirmed that hospitals don't make a big profit from allowing plastic surgeons to do cosmetic procedures. A spokesperson said they do it primarily to train and keep the physicians, who can give other patients quality care by remaining on staff.
Dr. Albert said he hopes, by exposing the practice, he might help make the system better.
"My mother in law right now is going through cancer treatment for stomach cancer and had to sit in the ER for several hours before she was ever admitted to the floor, because there was a shortage of bed space," said Dr. Albert.
"So you know when I say that we've had medicare for the last 30-odd years, and we know it's impossible to contain costs and we know there are problems in the system. I'm trying to alleviate (that) in whatever way I can to allow patients better access."
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I applaud the budget, even though Health Care and education may stay unscathed. Sadly this cannot last and I worry to later this year where cuts will become enviable. If anything, this provides the Wildrose Alliance plenty of ammo when an election is called.


