Feb 18, 2026 by Robert W. Marotta
Healthy Debate
The sicker the system gets, the more patients leave, the better our statistics look.
Here’s a magic trick for you: How do you improve emergency department (ED) wait-time metrics while simultaneously seeing fewer patients? Simple. You wait until they leave, then don’t count them.
Recently, I wrote about euphemisms used in health care to downplay systemic failure. Let’s take a closer look at one of those: Left Without Being Seen (LWBS) – the statistical escape hatch that’s become Canadian emergency medicine’s dirtiest little secret.
Let’s start with the raw numbers, because they’re genuinely breathtaking.
In 2018-19, British Columbia recorded 76,157 LWBS patients. By 2024-25? That number hit 141,961 – an 86 per cent increase in just seven years. To put that in perspective, B.C.’s population grew by roughly 11 per cent during the same period, meaning LWBS rates increased nearly eight times faster than population growth.
For context, pre-pandemic LWBS rates varied by hospital type: academic/teaching EDs averaged 3.7 per cent, regional EDs 3.4 per cent, and urban EDs 3.2 per cent. Those rates now look quaint.
Quebec managed an astounding 11.5 per cent LWBS rate in 2024-25, representing 428,676 people who walked out of EDs. Across the country, LWBS rates ranged between 4.9 per cent (Ontario) and 14 per cent (P.E.I).
But here’s where it gets interesting. These patients vanish from our performance metrics entirely. They don’t count against “time to physician initial assessment” targets. They actually improve the statistics.
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