The surprising ways Baby Boomers impact ophthalmologist care

June 19, 2019 | Author: Royal College Staff

Lorne Bellan, MD, FRCSC, knows demand for his services will grow in the years ahead. As the Baby Boomers age, the head of the Department of Ophthalmology at the University of Manitoba says ophthalmologists and other specialists serving seniors will struggle to meet the increased demand.

“I think that what gets lost is that there are a lot of diseases that have a prevalence rate with seniors and with the Baby Boomers coming forward, the demands are soaring.”

Dr. Bellan specializes in oculoplastics — surgery around the eye and any surgery involving the eye socket or tear drainage system. The majority of his patients are seniors. Some are cancer patients, while many others are referred for drooping eyelids or cataracts. And wait times are a growing concern.

Years ago, Dr. Bellan was involved in a national study on wait times for cataract surgery. That resulted in federal and provincial agreement on a benchmark for wait times. But the aging of the population keeps moving the goalposts.

“The rates of achievement of that benchmark just keep getting worse and worse because of that demographic shift,” he says.

“Sometimes people phone and write to the minister of health to complain. A few patients who have been sent to me lately have asked, ‘Why don’t you send me to another province?’” he says.

“But that’s not how the system works.”

Dr. Lorne Bellan

There’s also the challenge of finding the best approach for patients with several medical conditions. For Dr. Bellan, these considerations often involve consultations with other specialists such as dermatologists, cancer-care physicians and neurologists.

Recently, a new senior patient was referred for cataract surgery, but is on a blood thinner for a heart condition, which would make surgery impossible. So Dr. Bellan is liaising with her cardiac doctor to find a solution.

There are also logistical challenges in running a practice that caters primarily to seniors.

“Because their mobility is reduced, it’s harder to get people in and out,” he says. “Patients often arrive with wheelchairs or walkers. It adds to the time it takes to see everybody.”

Occasionally, Dr. Bellan faces a dilemma around medical interventions for patients at very advanced ages.

“I had a woman in this week who is a spry 102-year-old,” he says. “She was sent here for cataract surgery.” With other age groups, there are stats on success rates. But data is not readily available for the over-100 group.

“We had a long discussion about this,” he says. “No doubt, she is more fragile.”


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G Robert La Roche | December 1, 2021
Ophthalmology and its many sub-fields, including strabismus surgery for relief of diplopia, is one but many other specialties that see an increase of their scope of practice in the senior age group. Think of orthopedics, dermatology, gynecology for example. Our residents in training will need help in getting better prepared to deal with an aging population in their practice. More then drops, arthroscopy, laser ablations, they will need to learn about the specific geriatric dimention of the care they provide in all its dimensions; from the physical to the mental health, to the socio-economic reality of their senior patients and their family. An increasing challenge our post-graduate education programs will have to address.