Absence of Local Vascular Surgeon Puts Sault Renal Patients on the Road

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Caught without a vascular surgeon after Dr. Sam Fratesi suffered a heart attack while on vacation in Europe, some outpatients at Sault Area Hospital are having to travel to Sudbury to have procedures done.
In the case of renal patients being prepped for possible dialysis sometime in the future, this has necessitated at least two and sometimes three trips out of town to complete the process.
And it isn’t as if it is being made easy. The appointments, at least for the first one at Sudbury Vascular Laboratory, are being scheduled for 8 a.m and they want you there 20 minutes early to register.
It is hard to think of anything more ridiculous than such an early appointment for people having to travel 300 kilometres to get there..
In essence, this necessitates travelling to Sudbury the day prior to ensure getting there on time because it could be risky leaving at 4 a.m. with the weather the way it can be at this time of year.
If the appointment time were 1 p.m., patients could easily drive down in the morning and back in the late afternoon.
As it stands, it is not only inconvenient for Sault residents being forced to make such a trip, but it also is a drain on the provincial purse with the added draw from travel grants.
It should also be noted that not everyone has a car. Those who don’t have to make the trip to Sudbury on a Greyhound bus and use cabs within the city.
Dr. Fratesi suffered a heart attack more than a month ago in Vienna, Austria, while on a river cruise. He was transferred to hospital in Ottawa where he is doing his rehab.
His brother, Joe, former chief administrative officer with the city, says he is doing well, that he was very fortunate to get a high level of care almost immediately after suffering the heart attack.
But he said his brother probably won’t decide until after Christmas what kind of medical practice he wants to return to.
“He’s dedicated, he loves what he’s doing, but he’s 68 now and he is going to have to slow down,” he said.
Brandy Sharp Young, Manager Communications & Volunteer Resources at Sault Area Hospital, said in a couple of emails in response to my questions that the Sault Ste. Marie Physician Recruitment & Retention Program is undertaking recruitment efforts as part of succession planning for SAH’s Vascular Surgery Program.
“Currently, all vascular surgeries are being transferred to Health Sciences North or other centres,” she said. “Surgery to repair an abdominal aortic aneurysm, lower extremity bypass surgery, vascular access for dialysis (fistula/graft), or carotid bypass are examples of some of the types of surgeries that would necessitate a transfer.”
She said some of the non-operative vascular surgery services are being covered by other providers at SAH.
She said as far as she was aware in the past six years, SAH has not had more than one vascular specialist and given the volume of vascular surgery in Sault Ste. Marie, has not required the use of a locum.
But she said to support the current care needs of patients, SAH is “completing an application for locum coverage, which includes an application to Health Force Ontario for approval of funding and a demonstration of the need based on patient volumes.
“Unfortunately, at this point, we cannot estimate how long our vascular surgery gap will last,” Sharp Young said. “We are working to improve care for our patients as quickly as possible through these efforts.”
She said SAH has an arrangement with Health Sciences North in Sudbury to provide vascular surgery services that it is not able to provide locally.
“We have always needed to transfer some patients requiring vascular surgery to other centres, sometimes driven by their care needs and sometimes by the availability of the surgeon,” she said.
In any event, there may be some rethinking required by SAH when it comes to recruiting a possible replacement for Fratesi. Not everyone may be willing to carry the excessive workload he did so it may have to become more than a one-person show.
In regard to my comment about the 8 a.m. appointment times that are being given renal patients from the Sault, Sharp Young said SAH encourages them to work directly with the Renal Team to help accommodate their individual needs; the renal team will do their best to help support an accommodated time for the appointments if possible.
“If their concern remains unresolved, our Quality & Risk Department facilitates a formal patient relations process on behalf of the hospital and will be pleased to work to resolve any outstanding concerns,” she said.
I would suggest that rather than wait for a patient to express concerns, that now that SAH has been alerted to the 8 a.m. appointment time being given its patients that it put its Quality & Risk Department to work to negotiate a more reasonable time with Sudbury Vascular Laboratory, one that would allow for travel to and from Sudbury in one day.

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