Neurologist shortage leaves Ontario in crisis Dr. Ranjit Singh and Dr. Keith Meloff Windsor Star Saturday, May 03, 2008 Mrs. Smith waits nervously in the neurologist's office to hear the results of her tests. She'd had a bit of a problem with her speech three months ago, and was referred to the neurologist -- a highly trained medical specialist who can diagnose diseases of the nervous system and prescribe treatment -- by her family doctor. Then, just last week, she experienced difficulty when speaking with her daughter on the telephone, forgetting how to make the simplest words. Mrs. Smith is scared and confused, but she is actually one of the lucky ones. These warning signs mark her for a high risk of stroke. Her neurologist will be able to intervene in time and prevent a serious stroke. Mr. Jones wakes up and finds to his dismay that his legs give out from under him as he tries to get out of bed. He cannot walk. He is rushed to the emergency room of the closest hospital. A neurologist is called and diagnoses a slipped disk pressing on the spinal cord, and recommends that emergency neurosurgery be scheduled immediately. Unfortunately, on any given day in Ontario, the emergency room of any hospital is under siege and overwhelmed. Ambulances line up waiting to offload patients. Nurses and doctors try to keep up with the onslaught. After waiting patiently but anxiously for several days, Mr. Jones is finally sent to Buffalo for the urgent surgery that isn't available in Ontario because neurosurgical services here are overloaded. He, too, was one of the lucky ones. Mr. Jones, at least, was treated and can still walk. How ironic, that after having paid a lifetime of taxes and trusting the government, these two patients should be denied timely access to the health care services politicians promise to make available every time an election rolls around. Mrs. Smith and Mr. Jones only escaped serious illness or death, not because they received timely care, but because they were the lucky ones. Not seeing a neurologist in a timely manner might have left Mrs. Smith unable to speak for the rest of her life and Mr. Jones sitting in a wheelchair instead of playing basketball with his son. What else do these patients have in common, besides being lucky to have survived long and dangerous waits here in Ontario? Both were seen by one of only 200 neurologists -- or brain specialists - in Ontario. The problem is that 200 neurologists simply cannot take care of all the patients that need them in a province with a population that exceeds 12 million. That begs the question: Why hasn't the Ministry of Health and Long-Term Care used tax dollars entrusted to them to do something about this growing crisis and provide care for these patients? Clearly, we are facing a crisis in neurology. Ontario's population grew 4.6 per cent from 2002 to 2006, and with this increase, came a significant increase in the numbers of the elderly, who are vulnerable and at risk of succumbing to serious and often disabling conditions. We need at least 40 more neurologists in the province, as well as attractive working conditions, in order to encourage more students to train in this field. These commitments by the government will also have the affect of preventing any more outward migration of neurologists still practicing in Ontario, as well as convincing those who have left the province to return. If you or your family - a wife, a brother, a sister or child - needed neurological care, you would want it now. But Health and Long-Term Care Minister George Smitherman says these demands are just some of the many health care issues the province is facing. "In health care," Minister Smitherman said, "there are many places we can do more and we always have to prioritize those resources." In other words, the Ministry of Health and Long-Term Care considers these problem patients not to be priorities. The Association of Ontario Neurologists thinks the ministry's attitude is the problem. If you were Mrs. Smith or Mr. Jones, we're sure you'd agree. Continuing to talk, walk and lead a productive life is not a privilege in Ontario. It is the right of all of our citizens. We have all paid into this health-care system. It is up to the Ministry of Health and Long-Term Care to use our money to protect our health and our lives. Clearly, the time has come for a dialogue to be initiated between the government of Ontario and the neurologists as soon as possible to help remedy this intolerable situation before it's too late. Our patients expect no less of us. Dr. Ranjit Singh and Dr. Keith Meloff are the pesident and vice-president respectively of the Association of Ontario Neurologists. Its mandate is to ensure the best possible neurological care for the citizens of Ontario and to represent the interests of its members. To learn more, please visit the Association's Web site at www.aoneuro.on.ca. © The Windsor Star 2008