CALGARY - The head of Calgary's flagship colon-cancer screening centre is blaming his booking clerks for going rogue and allowing favoured patients to jump the queue by as much as two years.
Dr. Alaa Rostom told Alberta's queue-jumping inquiry Wednesday that the clerks don't have that authority and shouldn't have been doing it.
"It's inappropriate for the clerks to change (treatment) priority based on anything other than the other priority of the patient," Rostom testified.
Rostom is the medical director of the Forzani and MacPhail Colon Cancer Screening Centre, located at the Foothills Hospital.
Opened in 2008, it was the first stand-alone colon treatment clinic, and is run by the province. It has six examination rooms and can handle up to 20,000 patients a year.
On Tuesday, three current or former clerks at Forzani testified that systemic queue-jumping had been going on for years, ending in 2011, with favoured patients being directed to three Forzani doctors, including Rostom.
Many of the patients were coming from the nearby Helios Wellness Centre, an exclusive private care facility.
The inquiry heard that while the wait for regular patients was up to three years or more, the favoured patients were referred, examined, and treated within weeks or months.
All three clerks, including former staffer Samantha Mallyon, said that while urgent cases still kept their priority, routine patients had to wait longer to make way for the favoured ones.
One of those patients was accommodated as quickly as possible, even though he repeatedly missed appointments, the inquiry heard. He missed one because he was at the Calgary Stampede.
The staff testified the queue-jumping orders came from Forzani doctors, nurses or supervisors.
Shown case histories, including the Stampede client, Rostom agreed the turnaround time was unusually short for some non-urgent patients.
He was shown one case where the patient's triage status was moved up from routine to urgent and signed off by Mallyon for no apparent reason.
That was wrong, said Rostom.
"There's absolutely no reason for a clerk to change the priority status," he said.
"Why that would be changed by her specifically, I don't know. I can't understand that."
He disagreed with Mallyon's assertion that her supervisor, Darlene Pontifex, gave her standing instructions to make the changes.
"I work very closely with Darlene Pontifex and I can't imagine she has any direction that would have said that either," he said.
Rostom also said he didn't know why clerks were directing on the forms that some of the favoured patients be seen only by him or two other named doctors.
That prompted an exchange with commission head John Vertes.
"I cannot imagine that the clerk who is just entering data into this database would on his or her own put any particular doctor's name on there without being instructed to do so," Vertes told Rostom.
"Yes," Rostom agreed.
Rostom told the inquiry that he knows very little about Helios and has never met the doctors at the clinic even though at one point Rostom ordered a gift of wine from Helios to the Forzani clinic be returned.
He also told the inquiry that he was once informed by a colleague that one of the Forzani doctors was directing clerks to move patients up in the queue.
"I was told it was rumours. I didn't get a formal letter of complaint," said Rostom.
He testified that given that it was a rumour and he didn't have the resources to investigate, he didn't investigate.
And because he didn't investigate, he said, he didn't feel he had the right to ask the doctor about it directly.
"I didn't feel I had enough information to go to him about that," he said.
He said instead he sent out an email warning staff that queue-jumping was not allowed.
"In all truthfulness, I didn't care whether it (queue-jumping) was happening or not," he said.
"My point was to get it (the email) out there to indicate that it was not acceptable."
Before leaving the witness stand Rostom delivered a quick speech thanking the Forzani clinic staff.
"I just want to show my appreciation for the staff that are really working incredibly hard to have screened the 60,000 patients that we've done, and I hope that they recognize that we appreciate the work that they are doing," he said.