posted: April 21st, 2022

updated: May 27, 2022


Island Health recently announced a change to the mandatory requirement for a pre-op history/physical from primary care: As of May 1, 2022, family physicians will no longer be required to complete a pre-op for patients booked for surgery at VGH/RJH/SPH in Victoria. Below is some additional context and what you need to know in this transition.

How we got here: Two years of collaboration

This change results from a two-year collaboration between family physician colleagues, anesthesia/surgical specialties and Island Health in response to increased demands on primary care during the first COVID waves. The collaboration led to an initial change in June 2021, when patients previously booked for an anesthetic consult no longer required an additional pre-op visit from their family physician. The requirement only remained in place for patients who were considered to be healthy enough not to need an anesthetic consult. 

However, after further consultation with surgical services and anesthesia, it became clear that the remaining mandatory pre-op requirement was not sustainable for family physicians in light of the significant burden of limited access to primary care. All involved agreed that the mandatory pre-op history and physical would no longer be required for any surgical patients after May 1, 2022.
 

What you need to know in this transition

Although pre-ops are no longer required, family physicians are welcome to continue to provide this consultation service and send pre-op information using the current form should they wish to do so.

To assist our surgical colleagues in this transition, we strongly encourage all family physicians to follow the College referral guidelines and good collegial medical practice. Please include a relevant past medical history and a medication and allergy list as part of the initial referral to the surgeon. This information will now be submitted as part of the surgical booking and inform the surgical screening process. In other words, “sore knee please see” with no medication list or past medical history is not a great way to return the favour of removing the mandatory pre-op from our primary care workload.

A new streamlined screening portal for surgical patients will be rolled out in the coming year. You may also see a change for ophthalmology patients in the next weeks. The interim process for these patients will be a simple letter to family physicians requesting a “fit for surgery” designation and medication list. This is necessary as these steps are out of scope for optometry who are the initial referral source to opthalmology for many patients. The opthalmology process will be refined over the coming months.

Many thanks to all of our primary care, surgical and anesthesia colleagues and to Island Health for working collaboratively on effecting this change. It will help reduce the burdens on primary care while continuing the safe provision of surgical services for all of our patients.