The Southern District Health Board wants to cut the numbers of patients sitting on "active review" - those with an expectation, but no certainty, of receiving surgery.
These patients fall below the commitment of receiving surgery within six months, and are monitored by their GP with the aim of surgery within 18 months.
Numbers have grown in some specialties, such as in orthopaedics, where 266 patients were on active review in September, up 36% on the corresponding time last year.
Patient services executive director Lexie O'Shea told Wednesday's hospital advisory committee orthopaedics was the first area staff were targeting. A special "joint clinic", which started in Dunedin this year to help osteoarthritis patients find alternatives to surgery, was a first step.
But she warned: "It won't be an overnight fix."
The process would take several months to produce reductions, which the board hoped would be significant.
Chief medical officer Dr David Tulloch said too many patients were admitted to active review, which needed to be reserved for those just below the threshold for the next category.
Doctors should not assume surgery was the only fix for pain or other symptoms, he said.
Sometimes the remedy was simple, like supplying a person with a different walking stick, he said.
A change in mindset was needed from doctors, he said.
"Give us a bit of credit," member Dr Branko Sijnja, a GP, retorted.
Dr Tulloch indicated his comments were more concerned with hospital-level doctors.
Board member Richard Thomson said it was important the active review category was correctly applied, otherwise it "creates false expectations about the likelihood of treatment and that's not a good thing".
• At yesterday's full board meeting, chairman Joe Butterfield sought and received an assurance from management that Southern would meet its 2012-13 elective surgery target, on which it is 3% behind so far this year.