Is There a Plastic Surgeon on Call? A Population-Based Cross-Sectional Study on Plastic Surgery Call Coverage in Ontario

Introduction: Plastic surgery consultations are frequently required in emergency department settings; however, some hospitals lack plastic surgery call coverage. This study evaluated the geographic distribution of plastic surgeons providing call coverage within Ontario and the accessibility of emergency plastic services for the population. Methods: Demographic data on practicing plastic surgeons were obtained from the College of Physicians and Surgeons of Ontario database. Call coverage was determined by the number of surgeons by primary practice location and hospital affiliations per surgeon in each region. A survey was sent to switchboard personnel at all hospitals in Ontario to further assess call coverage. Results were reported as absolute counts and surgeons per 100 000 population-ie, population density ratios (PDRs). Results: A total of 289 plastic surgeons reported their primary practice location in Ontario. Most practice within Metropolitan Toronto and Central Ontario (66.8%). Northern Ontario had the lowest PDR compared to Metropolitan Toronto with the highest (PDR = 1.29 vs 3.72, 95% CI: 1.41-3.78, P < .001). For 254 hospitals identified, our survey response rate was 64%. Fifty-eight percent of responding hospitals reported no plastic surgery coverage. Over half of hospitals in Metropolitan Toronto and Central Ontario reported plastic surgery call coverage, compared to only 24% in Northern Ontario. Conclusions: This study demonstrates that 95 (58%) hospitals are without plastic surgery call coverage and highlights the discrepancies in the geographic spread of plastic surgeons in Ontario. Further studies are needed to determine the impact of this discrepancy on patient outcomes.