Surgeon perspectives on surgical wait times and the single-entry model: challenges and opportunities for equitable access in a Canadian health care system.

Background: Surgical wait times affect patient outcomes, access to care, and surgeon well-being. The single-entry model (SEM) has been proposed to address these issues, but its implementation raises concerns among surgeons. We sought to explore surgeons' perspectives on surgical wait times, referral processes, and the potential effect of the SEM on improving access to surgical care in a major metropolitan Canadian city.

Methods: We conducted a qualitative descriptive study to explore the perspectives of surgeons at a large community hospital using semi-structured interviews. We used thematic analysis to identify key themes regarding surgical wait times, referral processes, and the SEM.

Results: We interviewed 10 surgeons with different specialties and administrative roles, and a median 16.5 years of experience. Participants expressed frustration with systemic inefficiencies, particularly regarding long wait times for consultations and surgeries. Key issues included overwhelming workloads, limited operating room availability, and nonspecific referrals, which often led to delayed patient care. Surgeons reported burnout from managing these delays. Although many participants viewed the SEM as a promising strategy to improve equitable access to care, others raised concerns about depersonalization of care and reduced surgeon autonomy. Some participants emphasized that, without concurrent reforms to funding models, the SEM could inadvertently reinforce existing disparities, particularly gender-based pay inequities.

Conclusion: Surgical wait times pose substantial challenges for both patient outcomes and surgeon well-being. The SEM holds promise for reducing delays and improving equity in patient access, but its successful implementation requires addressing concerns related to surgeon autonomy and workforce equity.