Perfusionist Shortage Blamed for Heart Surgery Delays in Quebec

Cardiologists and heart surgeons in Quebec are sounding the alarm over a shortage of specialized staff, particularly perfusionists, warning that the crisis is fueling delays in cardiac surgeries and has even led to patient deaths.

Dr. Bernard Cantin, president of the Quebec Association of Cardiologists, said the consequences are devastating: “Eighty people have died in the last year, year and a half, waiting for their surgery. That is awful. It's unbelievable.”

The critical role of perfusionists

Perfusionists are little known to the public but essential in operating rooms. They manage the heart-lung machine, which temporarily takes over the function of a patient’s heart and lungs during lengthy cardiac surgeries. Without them, these procedures cannot go forward.

According to the Canadian Society of Clinical Perfusion, there are only about 375 perfusionists across the country, with around 40 current vacancies and over 60 retirements expected within five years. In Quebec, just 70 of 92 positions are filled.

Growing waitlists, rising deaths

As of August 23, more than 1,300 Quebec patients were waiting for cardiac surgery, and nearly 65% had already exceeded the province’s maximum medically acceptable wait time. The cardiology and surgical associations say they have warned the government repeatedly since 2019, but are now preparing to file a complaint with the provincial ombudsman.

They track deaths among patients on waitlists, recording nearly 80 in Quebec last year alone. Doctors say the shortage of perfusionists directly contributes to surgeries being delayed or canceled.

Government response

Quebec’s Health Ministry responded cautiously, arguing that many patients awaiting surgery have multiple health problems, and deaths cannot always be attributed to cardiac disease. It also maintained that perfusionist shortages account for only about 1% of surgery cancellations.

Santé Québec, the agency overseeing health services, acknowledged recruitment challenges but said it remains committed to attracting and training new graduates to ensure continuity of care.

A nationwide issue

Other provinces are also feeling the strain. Naresh Tinani, acting president of the Canadian Society of Clinical Perfusion, said the profession suffers from being “under the radar,” making recruitment difficult. He cited heavy on-call schedules, burnout, lower wages compared to the U.S., and an aging workforce as key reasons for the staffing crunch.

“Quebec faces the most strain,” Tinani said, noting many perfusionists leave the province for better pay and working conditions elsewhere.

Training efforts underway

Perfusionist training is only available at three Canadian institutions: Université de Montréal, the British Columbia Institute of Technology, and the Michener Institute in Toronto.

Michener’s principal, Dr. Michael O’Leary, said the school is working with Ontario’s Health Ministry to expand its program, aiming to more than double enrollment from 16 students last year to 38 by 2027.

Human cost of delays

For families, the consequences are deeply personal. In Manitoba, 69-year-old Debbie Fewster was placed on a cardiac surgery waitlist in August 2023 for a triple bypass. Two and a half months later, before her surgery was ever scheduled, she died of a heart attack after Thanksgiving dinner.

Her son Daniel Fewster is now pushing for “Debbie’s Law,” which would require full transparency on surgical wait times and available options. “If we’d have known she needed surgery in three weeks but was going to be waiting months, we would have done something about it,” he said.

Calls for reform

Perfusionists in Quebec say improving salaries, work conditions, and recruitment strategies are essential to prevent more tragedies.

“We see more and more people leaving the province for better work conditions outside Quebec,” said Yannick Pinard, president of the Quebec Perfusionists Association. Despite the challenges, he remains hopeful: “I believe in it. I think it's just a matter of time.”