Calgary doctor responds to queue-jumping allegations
By The Canadian Press - Monday, February 25, 2013 - 0 Comments
CALGARY – A high-ranking Calgary doctor at the centre of queue-jumping allegations conceded Monday…
CALGARY – A high-ranking Calgary doctor at the centre of queue-jumping allegations conceded Monday he booked his patients outside the normal routine, but said he didn’t realize that would move them to the front of the line.
Dr. 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.
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 didn’t 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,” said Bridges.
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 didn’t realize that by sending his patient-screening requests through senior brass, those patients were then getting fast-track treatment.
“I’m just trying to help people get into the system,” said Bridges.
But why not simply tell those patients to follow the rules, asked 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 Hollins.
“Many people don’t have family doctors,” replied Bridges.
“What are all of the other people supposed to do? Can anyone without a family physician call you up?” asked 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 Bridges’ 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 Bridges even though he didn’t have any authority out of her respect for him and his title.
Bridges acknowledged that, in a 2011 email to Koch, he directed her to book his low-risk patients “in the coming months” while the wait list as he understood it at the time for those patients was well over a year.
But he testified that at time, the CCSC was short patients and was looking to fill slots. He also said that when he asked 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 Bridges.
“But that is exactly what you say (in the email),” said Hollins. “Please arrange for these colonoscopies in the coming months. That was clearly your expectation.”
“That was a poor choice of words,” allowed 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 emails,” said 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 non-profit and donates $200,000 or more per 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 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 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.
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When it comes to waiting for health care, Canada is last in line
By macleans.ca - Tuesday, February 19, 2013 at 7:00 PM - 0 Comments
A major international survey says Canadians wait longer for health care
Wait for the next available customer service agent. Wait for your boarding call. Wait for the ads to end so the movie finally begins. Waiting is a major component of modern life. And while most of that time spent waiting is simply an inconvenience, sometimes it can be life-threatening.
For decades, wait times have been a consistent and much-lamented component of the Canadian health care system. Within the strictures of medicare, we endure lengthy waits for family doctors, specialists, tests, therapy, beds and on and on. Canadians, in fact, wait longer and more often for health care than citizens in all other developed countries. Why do we consider this acceptable?
Earlier this month, the Organisation for Economic Co-operation and Development (OECD) released a major survey on international health care waiting lists and policies. Canada is at the bottom of the pack in almost every category. One example among many: 25 per cent of Canadian patients waited more than four months for non-emergency, elective surgery, the highest proportion of any country reported. The figure is 18 per cent in Australia and seven per cent in France, Switzerland and the United States.
The OECD also reveals Canada to be one of five countries (out of a survey of 22) that report major wait-time problems in all six possible health care categories—from emergency rooms to long-term care.
Finally, and perhaps most depressing, we’re included in an unhappy group of counties that spend above the OECD per capita average on health care but nonetheless report significant wait times. We pay more but still underperform.
To be fair, Canada has made substantial progress on wait times over the past decade. But this just reflects the depth of our problems. A major federal-provincial agreement in 2004 allocated more money and attention to waiting lists, designating five priority areas for wait-time reductions—cardiac, cancer and cataract care, hip and knee replacements and diagnostic imaging—and setting benchmark times for treatment. It also committed to greater transparency about how long Canadians wait.
Since then, all provinces have put wait-time data online for everyone to see. And measured by the benchmarks, waiting has generally improved across the five priority items. Ninety-nine percent of all cardiac patients, for example, now receive bypass surgery within the specified time frame. (Although anyone with a heart problem might argue that six months is a rather generous benchmark.)
Without question, all this scrutiny has improved health care provision in this country. And with the 10-year 2004 agreement set to expire next year, Canadians are being told a story of great progress. But we still wait much longer than our peers in other countries. We can do better.
Certainly, a broader array of services needs to be included in any new deal, one that covers the more routine aspects of health care, such as emergency-room, rehab and long-term care. According to a survey of 11 developed countries, Canadians make the most use of emergency departments and are most likely to wait longer than four hours to see a doctor.
Canada should apply successful strategies from other countries, regardless of ideology. “High expenditure is not a guarantee of [short] waiting times,” reminds the OECD report; evidence-based innovation is more important than money. That countries with public health insurance and no patient cost-sharing tend to have the longest waiting lists suggests Canada’s sacred medicare system may be one of the biggest obstacles to improving service. Finland, for example, found that a voucher system for certain procedures led to a reduction in wait times. It also established wait-time guarantees (as opposed to benchmarks) enforced by fines.
We need to take note of innovations occurring within our own borders, as well, such as successful pay-for-performance experiments in British Columbia and dedicated nursing-home paramedics in Nova Scotia whose goal is to reduce the number of ambulance trips taken by seniors. St. Mary’s General Hospital in Kitchener, Ont., even posts up-to-the-minute emergency-room wait times on its website (6.5 hours to see a doctor, as of noon on Monday), allowing potential patients to make informed decisions on their best treatment options. From this perspective, the recent news that, for political reasons, Quebec has dropped out of a pan-Canadian committee on health care innovation seems entirely retrograde.
However much progress Canada has made to date on health care wait times, the fact remains that we’re still worst among our peers. A real and permanent solution will require focus, imagination and an end to misplaced ideology. There’s no time to waste.
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'I don't feel qualified to intervene in the debate' (II)
By Aaron Wherry - Tuesday, August 11, 2009 at 12:53 PM - 17 Comments
For those unsatisfied by yesterday’s demurring, here is an excerpt from Stephen Harper’s reply to the Speech from the Throne in October 2002. Possibly the last time he’s allowed himself to say these sorts of things out loud in a public place.
