Good morning. Emergency rooms across Canada are bogged down by lengthy wait times – more on that below, along with the latest from the ground in Israel and lessons about puberty from Palaeolithic teens. But first:
Today’s headlines
- Canada’s Geoffrey Hinton, AI pioneer, co-wins the Nobel Prize in Physics with American John Hopfield
- Israel expands its ground incursion to southwest Lebanon as Iran warns of retaliation
- Hurricane Milton becomes a Category 5 storm as Florida orders massive evacuations and rushes to clear the debris from Helene
Outside the ER at Toronto's Mount Sinai Hospital.Ian Willms/The Globe and Mail
Secret Canada
The ER waiting game
If you’re in downtown Toronto and start to suffer a medical crisis – weird heart palpitations, maybe, or trouble breathing, or the worst headache of your life – you might choose to head to the emergency department of Toronto General Hospital. Makes sense, since earlier this year, Newsweek magazine named it the top publicly funded hospital in the world.
But be prepared to settle in: On average, patients waited nearly 21 hours in the ER at Toronto General in July. Had you gone across the street to Mount Sinai instead, you could’ve shaved three hours off that wait. And the gap is even more pronounced in a city like Saskatoon. At Royal University Hospital last March, patients spent more than 26 hours stuck in the ER – which is still a vast improvement on Saskatoon City Hospital, just a six-minute drive away. There, the average wait time clocked in at 62.7 hours.
How do I know that? It wasn’t easy: There’s no dashboard or database that provides wait times at individual hospitals for emergency care. To cobble together this information, The Globe’s Tu Thanh Ha and Yang Sun contacted every single health administration in the country and filed 13 freedom of information requests. Some jurisdictions said they didn’t bother tracking wait times. Others stopped responding altogether. So the picture might be incomplete, but it’s nevertheless pretty grim: According to The Globe’s new analysis, ER wait times stubbornly refuse to come down to pre-pandemic levels.
Missing pieces
Canada does have a clearing house for health care statistics, called the Canadian Institute for Health Information, or CIHI. It has data for about 85 per cent of national ER visits – more than 15 million trips in the past year alone – but there are some notable omissions. What are wait times like in New Brunswick, or Newfoundland and Labrador, or the Northwest Territories, or Nunavut? Great questions, and very hard to say: They don’t send their stats to CIHI. Another five provinces only provide partial data, including Manitoba and B.C.
But even when provinces do pass along complete information, CIHI’s online portal makes it impossible to compare individual hospitals in major cities. Instead, they’re grouped by hospital networks (in Ontario, for example) or by regional health authorities (in Quebec). As a result, Montrealers can’t distinguish average wait times at the Children’s Hospital – roughly eight hours – from the Royal Victoria Hospital, where they’ll hang around for nearly 30 hours before they’re seen.
The right diagnosis
Attempting to game hospital admissions, tempting as it may be during an emergency, isn’t a solution to Canada’s ballooning wait times. Neither is blaming the shortage of primary care physicians: CIHI’s own research found only 20 per cent of ER patients come in with a condition that could have been managed by their family doctor. Instead, the main culprit is the chronic dearth of hospital beds, which forces emergency patients to be “boarded.” That’s a bloodless term that means they spend hours and hours, even days, on a stretcher in the hall.
Hospitals know that insufficient bed capacity drives longer wait times. Governments know it too, Alan Drummond, a veteran ER physician in Perth, Ont., told The Globe. “Yet the response, consistently, has been to blame and shame the public for overusing the ER for minor non-urgent complaints,” he said. It’s essential to document and investigate the impact of these delays on Canadian patients. It begins by actually getting the data to show how bad the problem has become.
The Shot
‘This is not a way to live’
Emergency personnel respond in Kfar Chabad, Israel.Oded Balilty/The Associated Press
Rockets from Hezbollah and Hamas disrupted Oct. 7 memorials in Tel Aviv and the religious community of Kfar Chabad yesterday, while Israel continued to pound southern Lebanon with air strikes. Read more from The Globe’s Mark MacKinnon, on the ground in Israel, here.
The Wrap
What else we’re following
At home: Canada’s telecommunications regulator says Rogers, Bell and Telus must all take steps to make their international roaming fees more affordable.
Abroad: For a decade, Tunisia was the only Arab Spring country to transform into a democracy – but President Kais Saied has tightened his grip, suspending the constitution, jailing opponents and now winning re-election with 90 per cent of the vote.
Lame: Scientists studying the skeletons of ice age teenagers found that the stages of puberty – including the start of voice-cracking and periods – haven’t budged much in 40,000 years.
Changed: LinkedIn used to be a perfectly pleasant place for networking or sharing professional news. Now it’s getting toxic.