Patients receiving joint replacement surgery through a public-private partnership at Riverside Hospital fared just as well as those treated at The Ottawa Hospital. That’s according to new research examining patient outcomes. The findings emerge as Ontario moves toward more private surgical clinics.
Dr. Paul Beaulé led the research. He serves as medical director of Academic Orthopedic Surgical Associates of Ottawa. This private group began performing weekend joint replacements at Riverside in 2023. They used operating rooms that had been closed.
The study appeared in the Canadian Journal of Surgery. It looked at a pilot program many viewed as a test case. Ontario now plans to expand private delivery of surgeries at standalone centers.
Critics worry this shift weakens public healthcare. They say it drains money and staff from hospitals already struggling. Beaulé acknowledged his competing interests but called the model safe and effective. He said it improves access for patients needing joint replacements.
AOAO now has a license for one of Ontario’s first private surgical clinics. No opening date has been announced yet. The group also reported attracting healthcare workers who had left the field. Burnout and workload likely drove many of those departures.
International evidence shows publicly funded private surgeries can reduce wait times. Canadian experiences have been mixed though. A 2023 Canadian Medical Association Journal article noted unintended consequences. These include extra billing and more complex cases staying in public hospitals.
The research compared 234 patients who had weekend surgeries at Riverside through AOAO. It matched them with similar patients at The Ottawa Hospital. Researchers looked at hip, knee, and shoulder replacements. They matched patients by age, body mass index, and sex.
Results showed no significant differences between groups. Emergency room visits were similar. So were hospital readmissions within 90 days. Follow-up surgeries occurred at comparable rates.
Out of 600 total patients, only two couldn’t go home the same day. One experienced a sudden blood pressure drop. Another developed an irregular heartbeat. Both needed admission to the public hospital. Private centers can’t provide overnight care.
One patient required surgery within 90 days for a prosthetic joint infection. Another needed a wound procedure at the hospital. The study called these outcomes acceptable for the model.
Staffing drew particular scrutiny. Many fear private clinics will pull workers from understaffed public hospitals. AOAO employed 46 nurses, split evenly between full-time and part-time. They also hired 19 registered practical nurses. Ten worked full-time.
The clinic employed 11 other allied health professionals. Administrative and support staff rounded out the team. More than 65 percent came from hospitals other than The Ottawa Hospital. This suggests the program expanded the workforce rather than simply relocating it.
The authors acknowledged concerns about workforce stress. They argued proper implementation can improve wait times while expanding healthcare capacity. They called for better coordination matching supply with demand across Ontario.
Wait times for joint replacements vary widely throughout the province. The researchers cited the Ontario Medical Association. They said new care models must integrate with existing hospitals while boosting efficiency.
Patients in the pilot used the same centralized intake as everyone else. This maintained equity in access according to the study. All patients entered through the regional system regardless of where surgery occurred.
Alberta offers a different perspective. That province has used private surgical facilities for decades. A 2025 Parkland Institute study found outsourced surgeries cost significantly more than public hospital procedures. Wait times for many surgeries actually increased.
The Ontario Health Coalition has raised alarms about private cataract surgery expansion. Some patients pay thousands for procedures OHIP covers. Such practices violate provincial rules.
Ontario has established guardrails for its private clinic expansion. Clinics cannot charge patients for faster care. They must demonstrate plans to avoid draining public hospital staff. OHIP covers surgeries at private clinics.
The province does allow clinics to offer upgrades patients can pay for. Critics call this upselling. They worry it creates pressure on vulnerable patients. It may also blur lines between public and private care.
I’ve covered healthcare debates in Ottawa for years. The tension between access and system integrity never disappears. Everyone wants shorter wait times. Nobody wants public hospitals weakened further.
The Riverside pilot operated in a controlled environment. Weekend surgeries used rooms sitting empty otherwise. Staff came largely from outside The Ottawa Hospital. These conditions may not hold at standalone clinics.
Operating rooms in public hospitals often sit unused. Funding structures and staffing constraints cause this. Some argue better public hospital funding could increase surgical volumes. That might reduce wait times without shifting money to private companies.
The debate ultimately centers on resource allocation. Ontario faces a healthcare workforce shortage. Money flowing to private clinics means less for public hospitals. Whether this improves overall access remains contested.
Dr. Beaulé’s research provides important data about patient safety. It doesn’t resolve larger questions about system sustainability. Short-term outcomes looked good for Riverside patients. Long-term effects on the broader system remain uncertain.
Alberta’s experience suggests caution. Decades of private surgical clinics produced higher costs and longer waits. Ontario may avoid these pitfalls with proper oversight. Or it may replicate Alberta’s problems.
The provincial government emphasizes its protective measures. Private clinics must follow strict rules. OHIP coverage ensures patients don’t pay. Staffing plans prevent public hospital drain.
Critics remain skeptical about enforcement. They point to existing problems with private cataract clinics. Rules already exist but violations continue. Adding more private facilities could multiply these issues.
Joint replacements improve quality of life dramatically. Patients waiting months or years suffer unnecessary pain. Any model reducing those waits deserves consideration. But not at the cost of system-wide deterioration.
The coming months will reveal much. AOAO’s standalone clinic will open eventually. Other private surgical centers will follow. Patient outcomes and wait times will tell the real story.
I’ll be watching how this unfolds. Ottawa residents deserve excellent healthcare. They also deserve a sustainable public system. Whether private clinics advance both goals remains the crucial question.
