A high-ranking Calgary doctor at the centre of queue-jumping allegations has conceded he booked his patients outside the normal routine, but said he did not realize that would move them to the front of the line.
Ron Bridges told Alberta's preferential access inquiry Monday that he was not clear on the rules for booking patients into the publicly funded Colon Cancer Screening Centre, which he founded in 2008.
Dr. Bridges, a gastroenterologist, said he booked referrals through senior managers at the centre rather than faxing the referrals through the booking clerks, as per normal procedure, because he did not know the booking clerks.
"In five years you've never taken the time to find out who the booking clerks are at the clinic that you founded?" asked inquiry lawyer Michele Hollins.
"I don't know who the booking clerks are, no," Dr. Bridges said.
Dr. Bridges is an associate dean of medicine at the University of Calgary and the inquiry has already heard he holds considerable stature in the medical community.
But he said he did not realize that by sending his patient-screening requests through senior brass, those patients were then getting fast-tracked treatment.
"I'm just trying to help people get into the system," said Dr. Bridges.
But why not simply tell those patients to follow the rules, asked Ms. Hollins.
"What prevents [those patients] from going to their family doctor like anybody else has to, faxing in a referral, and waiting the appropriate time?" asked Ms. Hollins.
"Many people don't have family doctors," replied Dr. Bridges.
"What are all of the other people supposed to do? Can anyone without a family physician call you up?" asked Ms. Hollins.
"If they phone me I will try and help them access the system."
Clerks at the colon cancer clinic, better known as the CCSC, have testified that from 2008 to 2012, at the direction of senior management, they slotted in Dr. Bridges's low-risk patients for colon-cancer screening within weeks, while the normal wait for everyone else was three years.
CCSC assistant manager Olga Koch has testified she booked the fast-track slots for Dr. Bridges even though he didn't have any authority out of her respect for him and his title.
Dr. Bridges acknowledged that, in a 2011 e-mail to Ms. Koch, he directed her to book his low-risk patients "in the coming months" while the waiting list as he understood it at the time for those patients was well over a year.
But he testified that, at the time, the CCSC was short on patients and was looking to fill slots. He also said that when he asked that his patients be seen within months, he didn't realize that they would be.
"Certainly it was not my expectation that the average-risk people would be seen in the course of a few weeks or months," said Dr. Bridges.
"But that is exactly what you say [in the e-mail]," said Ms. Hollins. "'Please arrange for these colonoscopies in the coming months.' That was clearly your expectation."
"That was a poor choice of words," allowed Dr. Bridges. "My expectation was not that they be seen in the next two or three months at all."
"A poor choice of words that we've seen repeatedly in these e-mails," said Ms. Hollins.
Clerks and doctors have testified that many of the patients moved to the head of the line at the CCSC were from the Helios Wellness Centre. Helios is a private clinic that dispenses yoga, exercise, and diet advice to patients for $10,000 a year.
Both Helios and the CCSC rent space from the University of Calgary at the Foothills Medical Centre.
Helios founder Dr. Chen Fong has testified Helios is a non-profit and donates $200,000 or more a year to the University of Calgary's faculty of medicine to fund scholarships and other projects.
Helios staff have already testified that they bypassed the normal booking procedures to go through Dr. Bridges. But they said it was done to get their patient names into what they labelled a dysfunctional CCSC database – not to get preferential access to cancer tests.
But Dr. Bridges testified he was not aware that Helios patients were being sent to the front on the line. He also said he wasn't aware that staff at the publicly funded clinic had a special file for private Helios patients.