1. Ambulatory Endoscopy in Ontario- Current Practice Patterns
Doug Hemphill MD, FRCP(C)
Barrie Endoscopy
The Royal Victoria Hospital, Barrie, ON

2. Ambulatory Clinics in Ontario
Little known about out of hospital endoscopy activity in Ontario
No requirement to declare site of endoscopic activity with CPSO, OMA, or specialty organizations
No accreditation process or organization
Ministry could be aware (Tray fee E749 or group billing numbers)
Estimate of proportion of Ontario colonoscopies done in out of hospital settings is 20% (Linda Rabeneck- personal communication)

3. Ambulatory Endoscopy in Ontario- Finding the Clinics
Diverse group- Surgeons/Gastros/Other, endoscopists who have and those that don’t have hospital privileges.
Sources of information
Industry
Registration
Word of mouth
We don’t have a complete list

4. Endoscopy Clinics in Ontario
Albany Clinic
Missisauga Colonoscopy
Barrie Endoscopy
North Scarborough Endoscopy
Bluewater Surgical Centre
North Toronto GI Clinic
Bray
North York Endoscopy
Brunswick Clinic
Markham Endoscopy
Byrne
Oakville Endoscopy Centre
Digestive Health
Oshawa Clinic Endoscopy
Desai
Ottawa Endoscopy
Downsview Endoscopy
Patel
Durham Endoscopy Centre
Polyclinic
Elkashab
PES-Rudd Clinics
Endoscopy Clinic of Greater Toronto
SCOPE Clinic
Farmed Endoscopy
Surrey Clinic
Gastroenterology Group
Toronto Clinic
GTA Endoscopy
The Toronto GI Clinic
Holly Street Endoscopy
Upper Canada Lower Bowel
Intestinal Health
Vaughan Endoscopy
Kensington Endoscopy
West GTA Endoscopy
Maple Endoscopy

5. Endoscopy Clinics in Ontario
Albany Clinic
Missisauga Colonoscopy
Barrie Endoscopy
North Scarborough Endoscopy
Bluewater Surgical Centre
North Toronto GI Clinic
Bray
North York Endoscopy
Brunswick Clinic
Markham Endoscopy
Byrne
Oakville Endoscopy Centre
Digestive Health
Oshawa Clinic Endoscopy
Desai
Ottawa Endoscopy
Downsview Endoscopy
Patel
Durham Endoscopy Centre
Polyclinic
Elkashab
PES-Rudd Clinics
Endoscopy Clinic of Greater Toronto
SCOPE Clinic
Farmed Endoscopy
Surrey Clinic
Gastroenterology Group
Toronto Clinic
GTA Endoscopy
The Toronto GI Clinic
Holly Street Endoscopy
Upper Canada Lower Bowel
Intestinal Health
Vaughan Endoscopy
Kensington Endoscopy
West GTA Endoscopy
Maple Endoscopy

6. 1. How many years has your clinic been in operation? (22 responses)
Average 6.86 yrs
Range 3 months to 40 years
11 Clinics 3 yrs or less

7. 2. How many doctors perform endoscopies at your clinic on a regular basis? (22 responses)
General Surgeons 2.9/clinic 58 Total
Gastroenterologists 3.43/clinic 72 Total
Other 1
Number of Clinics GI only
Number of Clinics General Surgery Only

8. 3. What proportion (%) of doctors working regularly at your clinic have active hospital privileges?
100% hospital privileges 10 clinics
0% hospital privileges 6 clinics
20%-90% hospital privileges 6 clinics

9. 4. How many procedures are done in your clinic per year
4. How many procedures are done in your clinic per year? (21 clinics responded)
Total
Average/
Clinic
Range
Median/
Colonoscopies
65,528
3,120
156-22,250
2500
Gastroscopies
13,915
662
0-3,650
400
Sigmoidoscopies
7,948
418
0-6,050 50

10. 5. Can patients be referred for gastroscopy only (not associated with a colonoscopy)?

11. 15 of 19 clinics have unused procedure rooms for future expansion
6. How many procedure rooms at your clinic are used for endoscopy most days?
15 of 19 clinics have unused procedure rooms for future expansion

12. 7. How are your patients referred?

13. 8. Do patients have their procedure performed on the same day as the consultation?

14. 9. Indications for referral for endoscopy at your clinic.

15. 10. What types of co morbidity exclude patients from having procedures at your clinic?

16. 11. What therapeutic procedures do you perform at your clinic?

17. 12. Which colonoscopy prep do you most commonly use?

18. 13. What sedation agents are used at your clinic?

19. 14. What patient monitoring is performed?

20. 15. Nurses- what proportion are RNs vs. RPNs?

21. 16. Scope Reprocessing.

22. 17. What indicators of quality care do you regularly monitor and record?

23. 18. Are you an accredited with any organization?

24. 19. Is your clinic involved in marketing or advertising?

25. 20. Does your clinic charge patients a non-OHIP fee?

26. END