MAHC adds plastic surgery to its surgical specialties


Main photo: Dr. Oleh Antonyshyn has a cottage in the area and he’s been providing locum plastic surgery services at Huntsville hospital since April. (Photo courtesy of Lindsay Bishop.)

Muskoka Algonquin Healthcare (MAHC) has been providing plastic surgery since April 2018. The addition of the service was prompted by two physicians with cottages in the area who suggested that the service be added.

Natalie Bubela, CEO for both the Huntsville and Bracebridge hospitals, said she was approached by the two physicians about a year ago, inquiring about the possibility of adding the service here.

“Their reason for wanting to do this is to give back to a community that they’ve enjoyed and felt that this was an opportunity to give back, knowing that we didn’t have plastic surgery capability here,” said Bubela. “I was really impressed that the two of them would consider that because of being cottagers here, falling in love with Muskoka and wanting to help out the local community.”

Esther Millar, Chief Nursing Executive & Clinical Services for MAHC, said bringing the idea to the North Simcoe Muskoka Local Health Integration Network (NSMLHIN) was not a hard sell. The NSMLHIN is a regional Crown agency that looks after coordinating and funding health services, including hospitals, in its catchment areawhich includes Muskoka and surrounding communities as well as areas such as Barrie, Orillia and Collingwood.

She said MAHC managed to build a business case for the service and demonstrated that the capacity and volumes were there and that it could be done in a sustainable manner.

“It is very cost efficient for us to do and it’s very good for our surgical program because with the increased volumes, we become even more efficient so that’s very good for a hospital,” she explained. “It hits all the right parts of the funding formula—increased volumes and lower costs.”

One of the two physicians who originally approached the CEO has already started offering the service on a locum basis, twice a month. Once the second physicians begins offering his services, the pair will provide a clinic two days a month each with time reserved in the operating room for them as well, said Millar.

She said MAHC now offers five surgical specialties, which include: urology, ophthalmology, an ear, nose and throat surgeon, gynecology and plastic surgery.

Other services MAHC is hoping to add, although not surgical, involve rehabilitation beds and stroke in-patient beds. “That’s part of the capital plan,” said Bubela. “We’ve actually set aside beds to reflect that, should we be given the nod by the Ministry and the LHIN, to be able to do that,” she added. “So what we’re trying to do here is really match services with the community need and so we absolutely recognized, as Esther said, that we needed plastics to support our Emergency Department and reduce the wait-times and travel for our residents. So we know the same thing is true with rehabilitation and stroke in-patient beds, so we’re going to lobby for those as well.”

Millar clarified that the addition of plastic surgery is not cosmetics per se, but rather procedures that are covered by OHIP. She said the added specialization supports the Emergency Department for patients coming in with, as an example, facial or hand trauma or burns as well as supporting those with skin cancer.

In the past, according to Millar, people from this area had to travel as far away as London, Ontario to get the service. Some procedures had a waiting list of up to 316 days compared to the provincial average of 158 days, she explained. In 2016, there were 192 patients in MAHC’s catchment area who had to travel outside of the NSMLHIN to get the service. In the local LHIN’s catchment area, there were over 600 people who had to travel elsewhere to get the service.

“It was very difficult for the emerg physicians because they would assess the injury and they knew the patients needed to be seen, so they had to phone all over the province trying to find the shortest wait for our patients,” said Millar.

She also said the need for the service has been increasing, not only due to the recreational nature of Muskoka and the associated type of injuries, but also because skin cancer is on the rise.

Millar said the service is being offered at MAHC’s Huntsville hospital site and also supports the Bracebridge hospital. She said since its inception in April, “Our local plastic surgeon has seen 60 patients and he’s performed about half a dozen procedures and we’re very fortunate he’s been here to support our emergency department. So we’ve had some of our hand traumas that have been able to get very quick service, so we’re very pleased with that.”

MAHC said it plans to expand the program and eventually recruit a permanent, full-time plastic surgeon for the organization.

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  1. Jim Jefferies on

    I don’t really understand Esther Millar’s comment: “It is very cost efficient for us to do and it’s very good for our surgical program because with the increased volumes, we become even more efficient so that’s very good for a hospital,” she explained. “It hits all the right parts of the funding formula—increased volumes and lower costs.”
    Centres of excellence will drive costs lower with higher volumes, not MAHC as they don’t even have a full time physician let alone 6 or 7 that would provide the level of care needed for a proper program. Most of the trauma cases will still be outsourced to southern or GTA hospitals, which is likely at least 30% of the 192 cases listed above. This de-centralized approach will not work in the long run to provide quality and efficient care.

    • Len Macdonald on

      So by your estimate, that leaves 70% of the 192 cases who received this plastic surgery in Muskoka – close to their homes, a shorter driving time than going south and by competent surgeons. How is that not a good thing for Muskoka?

  2. Leon Braithwaite on

    Dr Antonyshyn removed some skin cancer from my face in June. He is the best as well very personable. Muskoka is so fortunate to have a doctor with his credentials. He is the best bar none.

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