When Mr Stanley tracked down Dr Livingstone on the shores of Lake Tanganyika he greeted the doctor with the now famous phrase “Dr Livingstone, I presume?” Dr Livingstone replied “Yes, I feel thankful that I am here to welcome you”. Dr Livingstone was thankful but very ill; still he refused to leave Africa until he found the source of the Nile. Unfortunately he died before achieving his goal.
As I plowed through the transcripts of the Preferential Access (Queue Jumping) Inquiry, I was struck by the testimony of two intrepid physicians—Drs Love and Boswell—who like Dr Livingstone refused to give up their search for justice until they’d reached their goal. Unlike the unfortunate Dr Livingston, Drs Love and Boswell were successful.
Note to reader: from this point forward you’re going to meet a lot of doctors…stay with me.
Dr Love is a gastroenterologist and site chief at Foothills Medical Centre. He sees patients at the University of Calgary Medical Centre and the Forzani & MacPhail Colon Cancer Screening Centre (CCSC).
Dr Boswell is a general practitioner who performs pre-assessments at CCSC. She’s married to Dr Love.
In 2010 Dr Love heard rumours that patients from the Helios clinic, a private facility providing concierge medical service to well heeled patients, were being treated differently than the 14,000 people on the CCSC waiting list (2454)*
He was troubled that a patient rated “moderate priority” had been booked for a colonoscopy four days after referral. The usual wait time for a “moderate priority” case is 10 months. Other than her file being tagged “as per Dr Bridges” (2444), there was nothing to indicate an urgent priority, other than perhaps a referral letter from her Helios physician, Dr Caine, that indicated a relationship between him and Dr Bridges (remember Dr Bridges, he figures prominently in this story) and the fact that the patient was leaving for her winter home in Mexico in two weeks (2463).
Dr Love paid a visit to the Helios clinic and was treated to a tour by Dr Caine, who described Helios as a “reward for the philanthropic community of the University of Calgary”. Dr Love’s reaction: “it’s not really charity if you get a reward” (2450). He tightened CCSC procedures and asked Ms Barbara Kathol, an executive at Foothills Hospital, to speak to Dr Rostom, the medical director and boss of CCSC.
The Kathol/Rostom conversation had an impact and the rumours of queue jumping died down…only to resurface in 2011. This time the concern was raised by Dr Love’s wife, Dr Boswell, who noticed that the Helios patients were moving through the queue more quickly than the rest. After investigating she learned that the Helios charts were colour coded and booked through a special booking clerk (Olga).
Dr Boswell raised her concerns at a meeting with Dr Rostom, CCSC boss, and his colleague Dr Hilsden. They “kind of looked at each other and Dr Rostom said ‘This is not a hill we want to die on’”(2485).
At that point the intrepid Dr Boswell took matters into her own hands. She called the Helios clinic from her home phone and asked how to get a patient into the clinic. She was “grilled” by the receptionist and was so “spooked” that she hung up (2487).
Drs Love and Boswell took their concerns to Dr Swain, the head of gastroenterology at the University of Calgary and Foothills Hospital. Dr Swain is a quirky fellow who describes himself as a “clinical scientist…80 percent of my time, I spend with mice” (2385)
While the practice of flagging a Helios file had subsided, there was still a major problem at CCSC. It appeared that Dr Bridges (remember him, the “as per Dr Bridges” note on the file of the patient going to Mexico?) was booking patients on to his own list. This gave Dr Bridges an opportunity to accelerate his own Helios patients at the expense of CCSC patients.
Dr Swain took the concern to Ms Kathol (she’s the executive that Dr Love sought out originally—clearly a woman with ethics and courage). Ms Kathol took the matter up with Dr Rostom, the CCSC boss, who issued a strongly worded memo warning against this practice.
So why didn’t anyone confront Dr Bridges directly? Dr Swain sums it up in a nutshell: Dr Bridges is a very powerful man and one of the most significant people in the Faculty of Medicine (2397).
He’s the head negotiator for the alternate funding plan (AFP) between the University, the government and Alberta Health Services—AFP pays the salaries of all of the academic physicians (2398).
He has friends in high places and is a director of CCSC with a voice in who gets reaccredited each year. The loss of accredition would result in a “significant financial loss” to doctors who would no longer be allowed to perform colonoscopies at CCSC (2399).
And as if that wasn’t enough, Dr Bridges was Dr Rostom’s first boss at CCSC. Their friendship dates back to their medical school days.
So in the words of Dr Swain, you’d need a lot of self-confidence to complain to Dr Bridges about Dr Bridges.
Aren’t we lucky that Drs Love and Boswell have the courage to “die on this hill” by fighting the Helios expedited list and testifying about it at the Inquiry instead of staying silent? It’s the only way we’ll ever get to the front of the line.
* All references are to page numbers from the Preferential Access Transcript.