‘You just break down’: The long, agonising wait for surgery in Victoria (2023)

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Phil Muscat constantly feels like his hand has been slammed in a door.

It is a kind of excruciating pain that shoots up through his fingertips, radiates down the right side of his body, and leaves him unable to walk up flights of stairs without clutching onto handrails.

‘You just break down’: The long, agonising wait for surgery in Victoria (1)

“I’m a bit of a tough nut who can handle a lot of pain, but sometimes you just break down,” Muscat said. “You can’t sleep. It’s just pain all day, every day.”

For two years, the 57-year-old has been living in daily agony, while he waits for a discectomy, a procedure to remove a degenerative disc in his neck. He is one of thousands of Victorians who have been left languishing for years on the state’s record-long elective surgery waitlist.

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In a significant pre-election health pitch, the Victorian government promised elective surgery would be cranked up to 125 per cent of pre-pandemic levels, with an extra 40,000 operations to be undertaken this year, building up to 240,000 every year from 2024.

But serious doubts are being cast over the ability of the $1.5 billion plan to clear the massive backlog.

Australian Medical Association Victorian vice president Dr Jill Tomlinson said she is yet to see any evidence the state will be able to perform the additional 40,000 surgeries it promised this year.

“It is going to take years to get on top of this,” she said. “While the investment is extremely welcome, our biggest, biggest issue continues to be workforce. I am not convinced that the new facilities announced will be sufficient.”

‘You just break down’: The long, agonising wait for surgery in Victoria (2)

Leading Victorian orthopaedic surgeon Associate Professor John Cunningham said public patients on his list for spinal surgery were facing delays of more than two years and wait times continued to climb.

“My public elective surgery waiting list is catastrophic,” Cunningham said. “That’s a fair and realistic adjective to use for it.”

Tomlinson said severe shortages of nurses, doctors, surgeons, physiotherapists and even clerical staff were plaguing hospitals, leading to ongoing delays of essential surgery, such as joint replacements and hernia repairs.

Victoria has almost 135,000 patients on the elective surgery waitlist, close to 60,000 more people than the estimated backlog of 77,845 in New South Wales, according to a new analysis by the Australian Medical Association.

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The analysis indicated Victoria makes up 44 per cent of the country’s entire elective surgery backlog, the legacy of 150 days of restrictions on surgery during lockdowns and the battering of hospitals amid continual coronavirus waves.

Victoria’s official surgical waitlist stands at 84,955. The AMA said their analysis included the backlog of people who have not yet been added to the official waitlist as well as those with debilitating and painful chronic conditions who have been waiting more than three years to see a specialist.

Cunningham, who treats both public and private spinal surgery patients, said all major metropolitan hospitals in Melbourne were balancing soaring public surgical waitlists, alongside increasing numbers of trauma patients, who require urgent surgery.

‘You just break down’: The long, agonising wait for surgery in Victoria (3)

“I only get through one elective spinal surgery case a month at the moment and I’m putting two or three patients on the list every fortnight,” Cunningham said.

“I only get through one elective spinal surgery case a month at the moment and I’m putting two or three patients on the list every fortnight.”

John Cunningham, surgeon

Patrick Lo, chair of the Royal Australasian College of Surgeons in Victoria, said the government investment had failed to filter through yet, and he was doubtful the state could realistically churn through an extra 40,000 surgeries this year.

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“It’s not going to be a steep drop, it will be more of a slow burn,” Lo said.

However, the neurosurgeon warned investments into combating elective surgery waiting lists failed to address Australia’s struggling primary healthcare system, including GP shortages.

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Lo said an inability to afford a doctor’s appointment and delays in booking in with overrun GPs had meant extraordinary numbers of Victorians, who had delayed medical care during the pandemic, were now landing in emergency departments seriously ill and requiring urgent surgery or hospital beds.

Lo said pre-pandemic surgical patients could spend more than a week in hospital following surgery, but health services were now completely overwhelmed and there were not enough beds. “These old ways cannot be recovered,” Lo said. “Those days must be gone.”

As part of the $1.5 billion plan, Victorian hospitals will be operating at night and on weekends to try to catch up. Frankston Private Hospital is set to be effectively taken over by the state government, and run as a public surgery centre, in the hope it will handle up to 9000 public patients a year, from this year. The Bellbird Private Hospital in Blackburn will also be transformed into a public surgery centre.

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You would not know it by looking at Muscat, a burly personal trainer, who has spent years weightlifting, but the right side of his body is slowly wasting away.

“One arm is bigger than the other, one pec muscle is bigger than the other,” he said. “I’ve got a wasted calf, wasted quad and hamstring on my right side. All that muscle that takes years of building up just goes in weeks. It has actually robbed me of my personality a little bit.”

‘You just break down’: The long, agonising wait for surgery in Victoria (4)

An MRI recently detected that as well as a compressed nerve in his neck, Muscat also now has spinal stenosis, caused by the narrowing of the cervical spinal canal. The severe pain in his back is being intensified by one of his discs pushing onto his spinal cord, which he requires spinal surgery for.

“I went back to my GP and basically just broke down in his office,” Muscat said.

“I told him ‘I can’t do this anymore’ and he went into bat for me. He’s ringing up the hospital saying ‘this needs to be done now’.”

Muscat said having his surgery booked in and then cancelled during the pandemic was akin to psychological torture. He is still waiting for an official date to be confirmed for both his surgeries.

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“You build up all your hopes, and you think I’m finally going to get fixed and then somebody says ‘you’re not getting your surgery mate’ and the depression sort of starts to come into it,” Muscat said.

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Both Muscat’s neck and back procedures have been deemed category-two surgery, which means under existing guidelines, the procedures should be undertaken within 90 days, due to significant pain and disability.

Years of being employed in manual labor in his younger years as bricklayer, landscaper and then concreter, have taken a punishing toll on Muscat’s body.

“I went back to my GP and basically just broke down in his office.”

Phil Muscat

On top of healthcare workforce constraints there remains a dire shortage of surgical theatres for an ageing and growing population, Cunningham said.

While government investments, including a new campus for the Royal Melbourne Hospital at the Arden precinct, will create space for 10,500 additional elective surgeries annually, he said, these projects were years off completion.

Cunningham is concerned by the increasing number of people dipping into their savings or raiding their superannuation to pay for their surgery. He urged Victorians to seriously consider private health insurance if they could afford it.

“My heart just goes out to these people who have no choice but to rely on the public system,” Cunningham said.

“It is absolutely miserable, particularly among younger people of working age, who have a young family and are often self-employed. They are really, really suffering.”

A Victorian government spokesman said more than 4500 healthcare workers have been hired and trained in the past year.

(Video) The first 6 weeks after Hip Surgery: Rapid Recovery Hip Replacement

Recent state government estimates suggest there has been a 64 per cent rise since the COVID-19 catch-up plan was announced last year.

Editor’s note: The journalist who wrote this article has no relation to orthopedic surgeon Associate Professor John Cunningham.

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FAQs

What makes a surgery urgent? ›

Urgent or emergency surgery

This type of surgery is done because of an urgent medical condition. The condition may even be life threatening. Examples are acute appendicitis and trauma.

How long is the wait for surgery in Australia? ›

State
StateMedian elective surgery waiting times (2010–11)Median elective surgery waiting times (2018–19)
NSW47 days56 days
NT33 days29 days
QLD28 days41 days
SA38 days41 days
4 more rows

What is Category 3 surgery Victoria? ›

When a patient in Victoria is assessed by a surgeon as requiring elective surgery, they are categorised as urgent (Category 1: treatment within 30 days), semi-urgent (Category 2: treatment within 90 days) or non-urgent (Category 3: treatment within 12 months). They are then placed on a hospital-based wait list.

Why are surgeries being delayed? ›

The pandemic delayed millions of surgeries

Throughout the pandemic, many hospitals have had to delay elective surgeries and other non-urgent procedures amid overwhelming caseloads from Covid-19 surges, including the most recent omicron surge.

How quickly can surgery be scheduled? ›

Having surgery within about 2-4wks from the time of your consult can be accomplished. You have to also consider your recovery time and follow-up appointments before moving. The best thing to do is start with a consultation and come up with a plan and timeline that meets your needs.

How do you cope waiting for surgery? ›

People might cope with pre-surgery anxiety in very different ways: Some try to prevent anxiety or stress by getting information early on and talking with other people about their concerns. Others distract themselves by reading, or use exercise or relaxation techniques like slow and deep breathing.

What is the longest time for a surgery? ›

The most protracted operation reported lasted for 96 hours and was performed on 4-8 February 1951 in Chicago, Illinois, USA on Mrs Gertrude Levandowski (USA) for the removal of an ovarian cyst. During the operation her weight fell 280 kg (616 lb / 44 st) to 140 kg (308 lb / 22 st).

What is the best time to get surgery? ›

Time of Day Matters

When considering the time of day to schedule your surgery, it's often recommended that anytime between 9 AM and noon work best. Bright and early allows every party to feel ready, and it's best to get it done sooner rather than later. This way, you'll have all day to recover.

What requires immediate surgery? ›

Emergencies that require surgery

Severe trauma to the head, chest, abdomen, or extremities. Severe burns. Cardiac events, such as heart attacks, cardiac shock and cardiac arrhythmia. Aneurysms.

What is a Category 2 surgery? ›

A definition of elective surgery
CategoryClinical descriptionMeaning
Category 2 - Semi urgentCauses pain, dysfunction or disability. Unlikely to deteriorate quickly. Unlikely to become an emergency.Procedures that are clinically indicated within 90 days*
2 more rows
Oct 22, 2020

What is Tier 2 surgery? ›

The ESAS scale divides elective surgeries into 3 tiers, low acuity (tier 1) defined as “nonlife-threatening illness,” intermediate acuity (tier 2) defined as “nonlife-threatening but with potential for future morbidity and mortality,” and high acuity (tier 3).

What is a Category 2 operation? ›

Triage category 2

People who need to have treatment within 10 minutes are categorised as having an imminently life-threatening condition. People in this category are suffering from a critical illness or in very severe pain.

Why Do doctors deny surgery? ›

Physicians can refuse to treat a patient when the treatment request is beyond the physician's competence or the specific treatment is incompatible with the physician's personal, religious, or moral beliefs.

Why would a surgeon cancels surgery? ›

Cancellations may occur due to scheduling errors, inadequate preoperative evaluation, inadequate patient preparation, lack of surgical linen, equipment shortage, non-availability of the trained staff etc.

Why would an anesthesiologist cancel surgery? ›

Surgery cancellations after induction of general anesthesia are difficult to prevent, as the main reason for such cancellations is sudden and unexpected changes in the patient's condition, such as anaphylactic shock or arrhythmia.

How do they wake you up from anesthesia? ›

The process of waking up from anesthesia is known as emergence. During emergence, the anesthesiologist will slowly reduce the amount of anesthetic drugs in the body. This helps to reduce the intensity of the effects of anesthesia and allows the patient to regain consciousness.

How many hours can you be under general anesthesia? ›

The amount of time a person can remain under anesthesia depends on the type of anesthesia used and the individual's medical history. Most general anesthetics will last between 1-2 hours. However, some procedures may require longer periods of anesthesia.

How long is hospital stay for day surgery? ›

You should expect to be in hospital for between three and six hours if you are having your operation under local anaesthetic, or between five and eight hours if you having your operation under general anaesthetic, depending how quickly you recover from the anaesthetic.

How can I stop being nervous when waiting? ›

5 tips to reduce anxiety while waiting
  1. Develop awareness and self-compassion. ...
  2. Introduce sensory support. ...
  3. Breathe deeply. ...
  4. Redirect your focus. ...
  5. Try different techniques.
Oct 10, 2022

How can hospitals solve long waiting time? ›

How to Reduce Patient Waiting Time: 8 Tips
  1. Gather patient information before their scheduled appointment. ...
  2. Delegate documentation to other trained staff. ...
  3. Use secure messaging. ...
  4. Create a policy for no-shows and late arrivals and stick to it. ...
  5. Design a survey to identify bottlenecks. ...
  6. Implement a mobile queue solution.
May 11, 2017

How can hospitals reduce waiting time? ›

Ten ways to reduce patient wait times
  1. Gather patient information before the appointment. ...
  2. Adopt a patient portal. ...
  3. Streamline clinical workflow. ...
  4. Use secure messaging. ...
  5. Stick to a policy for no-shows and late arrivals. ...
  6. Identify bottlenecks with a survey. ...
  7. Use a mobile queue. ...
  8. Embrace telemedicine.
Jan 13, 2022

What is the riskiest surgery ever? ›

Most dangerous emergency surgeries

Partial colon removal. Small bowel resection (removal of all or part of a small bowel). Gallbladder removal. Peptic ulcer surgery to repair ulcers in the stomach or first part of small intestine.

Which is the most complicated surgery? ›

Thoracic aortic dissection repair

Like any form of open-heart surgery, this procedure is difficult and risky because of its delicate nature. An aortic dissection (a split or tear in your body's main artery) is a life-threatening condition which requires thoracic aortic dissection repair, a risky emergency surgery.

What surgeries take the longest to recover? ›

These procedures below do take the longest to recover.
  • Liposuction (up to three months) ...
  • Tummy Tuck (2-3 months) ...
  • Facelift (two months) ...
  • Breast Reduction (two months) ...
  • Breast Augmentation (six weeks) ...
  • Rhinoplasty (six weeks)

When should you not have surgery? ›

Examples of Conditions that May Delay Surgery Include:

Fever. Asthma attack or wheezing within two weeks before surgery. Chest pain which is worse than usual. Shortness of breath which is worse than usual.

Why do they cover your face during surgery? ›

Surgeons and nurses performing clean surgery wear disposable face masks. The purpose of face masks is thought to be two-fold: to prevent the passage of germs from the surgeon's nose and mouth into the patient's wound and to protect the surgeon's face from sprays and splashes from the patient.

What should you avoid before surgery? ›

Do not eat or drink anything for at least eight hours before your scheduled surgery. Do not chew gum or use any tobacco products. Leave jewelry and other valuables at home. Take out removable teeth prior to transfer to the operating room and do not wear glasses or contact lenses in the OR.

What are the three rules of surgery? ›

The three “rules” of surgical training, often jokingly repeated by surgery residents to each other, are:
  • Eat when you can.
  • Sleep when you can.
  • Don't mess with the pancreas.
Jul 7, 2022

What's considered a major surgery? ›

Major surgery – such as surgery to the organs of the head, chest and abdomen. Examples of major surgery include organ transplant, removal of a brain tumour, removal of a damaged kidney or open-heart surgery.

What is the most common surgery to have? ›

Some of the most common surgical operations done in the United States include the following:
  • Appendectomy. ...
  • Breast biopsy. ...
  • Carotid endarterectomy. ...
  • Cataract surgery. ...
  • Cesarean section (also called a c-section). ...
  • Cholecystectomy. ...
  • Coronary artery bypass. ...
  • Debridement of wound, burn, or infection.

What is Level 3 surgery? ›

Level 3. • Moderate to significantly invasive procedure. • Blood loss potential 500-1,500 cc. • Moderate risk to patient independent of anesthesia. Includes: hysterectomy, myomectomy, cholecstectomy, laminectomy, hip/knee.

What is Category 2 elective surgery Victoria? ›

Category 2 – Semi-Urgent – People who require less urgent surgery. While all health services endeavour to treat these people within 90 days, this is not always possible. Category 3- Non Urgent – People requiring non-urgent surgery.

What are the 4 classifications of surgery? ›

There are different types of surgery and surgeries can be classified according to surgical urgency. The terms used by National Confidential Enquiry into Patient Outcome and Death (NCEPOD) to classify the types of surgery were Emergency, Urgent, Scheduled and Elective.

Who should not have surgery? ›

A patient under the influence of mood-altering drugs or alcohol. A patient who has attempted suicide who is refusing life-saving care. A patient who has sustained a significant head injury and is not able to understand their current situation. A patient under the age of 18.

Is Tier 1 better or worse than tier 2? ›

Tier 2 capital is considered less reliable than Tier 1 capital because it is more difficult to accurately calculate and more difficult to liquidate.

What type of surgery that is not a medical emergency? ›

Elective surgery

It means that the surgery isn't an emergency and can be scheduled in advance. It may be a surgery you choose to have for a better quality of life, but not for a life-threatening condition. But in some cases it may be for a serious condition, such as cancer.

What is a cat 3 in hospital? ›

Urgent (triage category 3) is for serious but stable conditions, such as wounds or abdominal pain. Patients in this category should be seen within 30 minutes of presenting to the emergency department.

What is a code C in a hospital? ›

for Hearts. • Code 5- Public or Employee Emergency. Response Team. • Code C- ED Closure. • Trauma ( Air or Land )on the way–

What is an optional surgery called? ›

Elective surgeries can include cosmetic procedures like removing a mole or a wart. But they can also include more serious conditions like hernia surgery; removing kidney stones or an appendix; and hip replacements. “Elective surgeries are vital to a patient's health and well-being,” Dr.

Do surgeons try to hide their mistakes? ›

However, when a doctor makes an error on the job, people can suffer serious injuries or death. Unfortunately, surveys show that some doctors are willing to cover up their mistakes in an effort to preserve their reputations and avoid legal consequences.

At what age do doctors stop doing surgery? ›

Although the ACS doesn't favor a mandatory retirement age for surgeons, the association's paper recognizes that physical and cognitive skills decline with age, particularly after age 65, and therefore suggests that an objective assessment of surgeons' abilities should be performed beginning between the ages of 65 and ...

Why you should avoid surgery? ›

There might be several reasons why you want to avoid it; the thought of someone going in and “cutting you” (surgery is really a controlled injury), the risks associated with being put under anesthesia, the long recovery time and disruption to your life routine post surgery, you know someone that had surgery and months ...

What are the 4 categories in the surgical procedure according to urgency? ›

The urgency in the hospital is planned in a four-step scale: an extremely urgent (E) patient should be taken immediately to the operating theater. Class I urgency surgery should start within 3 h (180 min), class II within 8 h (480 min), and class III within 24 h (1440 min).

What are the three levels of urgency related to surgical procedures? ›

Surgery is a broad area of care and involves many different techniques.
...
The urgency of surgery is often described by three categories:
  • Emergency.
  • Urgent.
  • Elective.

What is the difference between urgent surgery and emergency surgery? ›

By contrast, an urgent surgery is one that can wait until the patient is medically stable, but should generally be done within 2 days, and an emergency surgery is one that must be performed without delay; the patient has no choice other than immediate surgery if permanent disability or death is to be avoided.

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