Wait-time benchmarks – Medico-legal
Of interest to all physicians
In September 2004, Canada’s first ministers committed to develop benchmarks for “medically acceptable” wait times in five clinical areas: cancer, cardiac care, diagnostic imaging, joint replacement and vision restoration. A Wait Time Alliance (WTA) involving several stakeholder groups was facilitated by the Canadian Medical Association to respond to the challenge of developing medically acceptable wait times. The final report of the WTA in August 2005 emphasized that wait-time benchmarks were to be considered “health system performance goals” and included the following statement:
Despite this distinction, such goals do, for the first time in Canada, provide a benchmark against which performance may be assessed. This may be significant from a medico-legal standpoint, particularly if an adverse event is considered to have occurred when an actual wait time exceeded the performance goal. In any subsequent legal action, how the courts will respond when an actual wait time exceeds these goals remains to be determined.
As a result, the CMPA provides the following suggestions to physicians whose wait times may be exceeding the benchmarks recommended by the WTA, governments or other authorities.
First, it is important to recognize that the courts, in consideration of the specific facts of the case, may determine the physician owes a duty of care from the moment his/her office accepts a referral, irrespective of whether the patient has been seen by the physician.
Second, again depending on the
facts of the case, it may be argued that the referring
physician continues to have a duty of care beyond the
simple act of referral which may include continued
The following are some medico-legal considerations for physicians related to wait-time benchmarks:
For the referring physician:
Whether the establishment of
performance goals and the monitoring of wait times will