12-05-2025
How Sault Ste. Marie is reconstructing plastic surgery care
When most people hear 'plastic surgery,' they think of facelifts and nose jobs. But on the fourth floor of Sault Area Hospital, it's hand burns, skin cancers, breast reconstructions and trauma injuries that fill the surgical slate.
For the past two years, Dr. Cory Goldberg has been bringing his reconstructive expertise north from Toronto, helping bridge a significant gap in specialized care.
At one point, Sault Area Hospital had three plastic surgeons. Two have since left for more lucrative opportunities in the United States, leaving Dr. Timothy Best as the sole full-time plastic surgeon in the region since 2023. At this time, most patients requiring plastic surgery had to travel to have access to care.
By that time, Dr. Goldberg had already been travelling to Sault Ste. Marie for over a decade, offering consultations through Laser Advantage. When he learned of the shortage in care, he arranged a locum position at the hospital. Now, he works in tandem with Dr. Best and the SAH staff to provide consistent and reliable care.
Through the locum program, Dr. Goldberg travels to Sault Ste. Marie once a quarter, staying for a week at a time. While in the city, he provides on-call coverage for trauma and burn cases and runs hospital-based clinics primarily focused on skin cancer, hand injuries and breast surgeries.
'When I come up to the Sault, it's kind of like a community service, but it's one that I enjoy a lot, because I enjoy contributing to the community, and I also really like applying my skill,' said Goldberg. 'I never really intended to be purely a cosmetic surgeon. It just so happened that way, and the healthcare resources have sort of pushed me to do that because things were just so hard in the hospital.'
Goldberg left his hospital job in Toronto due to deteriorating healthcare resources and long wait times, which were exacerbated by the COVID-19 pandemic and made providing comprehensive reconstructive care increasingly difficult.
During a recent locum visit, he saw about 10 hand injuries requiring care from a plastic surgeon in just one day.
'Things like burns, tendon repairs, nerve reconstruction — these are procedures people don't realize fall under the scope of plastic surgery,' he said.
Plastic surgeons, he explained, handle 90 per cent of hand surgeries in Canada. Without timely access to care, patients may face serious consequences, from delayed healing to permanent impairments and costly secondary procedures.
'A fracture that doesn't heal properly may need to be rebroken, and scarred tissue may need to be released. The longer the wait, the worse the outcome,' said Goldberg.
In Sault Ste. Marie, where access to specialty care is limited, these delays are a real concern. Recent visits have included complex procedures, such as immediate breast reconstruction following mastectomy — a service rarely available in smaller communities due to logistical challenges.
'That kind of coordination is hard to pull off, and I don't think it's been happening here very often, if at all,' he said.
Working closely with Dr. Best, Goldberg helps ensure continuity of care between visits.
'It's a very well-coordinated system. I'm confident my patients won't fall through the cracks while I'm away.'
Despite the clear need, attracting and retaining full-time plastic surgeons in northern communities remains difficult. Financial pressures, lifestyle preferences, and a lack of infrastructure all play a role.
'I know the two plastic surgeons who used to be here both left for the U.S.,' Goldberg said. 'The compensation system here can't compete, and many physicians trained in urban centres aren't eager to relocate.'
He adds that locum coverage can be one of the most practical strategies to ensure continuity in rural and remote communities. 'I think that this kind of rotation is, you know, suits the community ideally, because for me, it would be hard to move up here full time and give up my own my own practice, but at the same time coming up here intermittently and being able to enjoy it and practice here works well, but I think that this is one of the reasons why plastic surgery is, you know, short staffed in a lot of rural places, because there's not a lot of places that can really support a plastic surgeon in a full time practice'
He said that the SAH makes the experience to Sault Ste. Marie worthwhile.
'The staff are spectacular. They're so good to work with. They really make it easy for me to get things done,' said Goldberg. 'And the patients also are really, you know, laid back, and they're very appreciative, because, you know, I recognize that many of them, otherwise, either wouldn't get care or they would have to travel a long distance to get it. So they're just very grateful, appreciative people.'
'This is kind of my outlet to use my skills where otherwise I would sort of have the skill set that I wouldn't be using. So this is, this is kind of fun for me. I really enjoy it.'
Programs like Ontario's Northern and Rural Recruitment and Retention Initiative (NRRRI) and the Northern Specialist Locum Program (NSLP) have been vital in bringing physicians like Dr. Goldberg to remote and underserved communities. Still, the broader issue persists: a shortage of specialists and insufficient infrastructure to support them.
For surgeons, the ability to provide care hinges not just on skill but also on hospital resources — operating room time, anesthesiology coverage, and adequate staffing.
'Your entire practice is tied to the hospital,' said Goldberg. 'If those supports aren't in place, it's hard to do your job effectively. That's why so many rural hospitals struggle to attract surgeons.'
The implications for patients are significant. Delayed treatment can result in prolonged disability, increased healthcare costs, and long-term effects on mental health and productivity.
'It's dramatic and very under-recognized,' Goldberg said. 'It's not just about fixing a hand. It's about helping someone return to work, avoid chronic pain, and live a full life.'
As Sault Ste. Marie continues to grow, so too does the need for sustainable solutions to its healthcare challenges. Until then, the dedication of visiting specialists like Dr. Goldberg is helping to fill critical gaps.
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