Ophthalmologist stymied by lack of OR time

Dwight Silvera went to school for 13 years to be an ophthalmologist, specializing in corneal transplants.

He wants to use his skills at home. But the only place he can operate right now is abroad, on humanitarian missions to places like Colombia, Jamaica and Bolivia.

Silvera, 35, was born and raised in Oshawa. He studied at McMaster University’s medical school, was awarded one of two coveted spots in ophthalmology at Queen’s University, then, his top pick, a one-year corneal fellowship at the University of Iowa.

For four years, the father of two has been trying to get regular operating room time at a hospital in the GTA, with no success. He’s talked with nine hospitals in Toronto, Mississauga, Brampton, Oakville and Hamilton.

“They look at me and say ‘Given our budget, we’re not expanding, we’re not taking on new ophthalmologists right now,’” Silvera said Friday, adding that the process of allocating OR time at the hospital level doesn’t always seem equal. Some surgeons have a lot of time, some have none.

Silvera has even reluctantly played down his specialty in corneal transplants, in an attempt to convince hospitals taking him on wouldn’t cost as much money.

He wants to stay in Canada. “I do love our country,” he said. “The world is here in terms of ethnicity and culture and I think that’s very enriching in terms of raising our kids.”

But if he can’t get some time to do surgery this year, the largely Canadian-trained physician said he will be forced to uproot his family and take one of many job offers coming from the United States.

This week, the Star ran a series of articles on the provinces flawed corneal transplant system. Ontarians are literally going blind as they languish on wait lists for transplants while some corneas are shipped to developing countries, like Kenya, because of a lack of operating room time here.

On Friday, the Kensington Eye Institute, a government funded eye clinic in Toronto, offered to help with the cornea surgery backlog. The clinic is currently operating at 60 per cent capacity and has three working ORs.

Silvera — who works out of Lasik MD in the GTA doing laser eye surgery, as well as in two clinics, one in Mississauga, the other in Brampton doing minor procedures and dealing with medical conditions like glaucoma — has more than 150 patients in need of a cornea transplant on his wait list.

He has to forward those who need the elective procedure to doctors with OR time downtown. But “it’s not a fast track to anything,” he adds, because those surgeons have wait-lists between 18 months and three years.

Silvera adds that in the Halton and Peel region, no one is doing cornea transplants even though hundreds of people need the surgery locally.

In 2008, about 30 of his patients wrote letters to the Ministry of Health, expressing their frustration with cornea transplant wait times. They received a form letter back, he said, adding he’s been largely ignored by the province as well.

What appears to be happening is a “game of tennis” between the government and the hospitals, he said, with the government saying hospitals are given a chunk of money to do with what they see fit and hospitals saying they have finite and competing resources.

A spokeswoman from the ministry, Neala Barton, said hospital funding has risen 50 per cent in the last eight years and that the government doesn’t get directly involved in specific relationships between doctors and hospitals.

Silvera, who just returned from a volunteer mission to Mexico where he performed cataract surgeries, said he doesn’t want to be antagonistic.

He just wants to do surgery.