Shooting arrows in the dark: the policies and practices of waitlist management in Canada.

Wait times for medical procedures in Canada are universally thought to be too long, particularly for elective procedures. In this paper we point out the conceptual and practical difficulties surrounding wait list management in Canada. We suggest that while waits need to exist as a distributive allocation policy, the data to make informed decisions about wait times and their impact on patient care is absent. We also show that current waitlist initiatives lack an underlying conceptual model of why waits occur. The paper concludes with a discussion of why operational research (OR) models are not in greater use for wait list management and suggest a program of research to improve knowledge uptake for OR models.