William Lahey, a professor at Dalhousie University in Halifax, was the first witness to testify at the inquiry Monday into preferential health treatment in the province.
He said it's a concern that some people may have to wait a few months for diagnostic tests, while others can pay to have them done at a private clinic in a day.
Faster results mean patients can get onto waiting lists for surgeries sooner, he said.
Lahey told reporters the inquiry is the first of its kind in the country to delve into the issue of queue jumping in the health-care system. He expects many Canadians will be paying attention.
"There is a perception, perhaps, that there is preferential access happening, but no one has really studied or looked into it in a systematic way."
The issue of queue jumping came into focus in Alberta when Stephen Duckett, former head of Alberta Health Services — which oversees the day-to-day operations of all health delivery in the province — gave a speech in Toronto last year.
He said that when he took over as head of Alberta Health Services in 2009, he had to put a stop to politicians having go-to people in health regions who could facilitate faster care for friends, family and supporters.
The NDP then asked police to look into the matter. The RCMP investigated, but said it found only anecdotes, stories and rumours of queue-jumping.
Duckett is to testify Tuesday.
Premier Alison Redford ordered the inquiry in February after the Alberta Health Quality Council released a scathing report of abuse and mismanagement in the system.
The council heard from many doctors who said that when they complained about poor patient care, they were bullied or even fired.
Redford initially said the inquiry would look into the bullying allegations, but later ordered the inquiry to focus on queue jumping — although she clarified it can follow the evidence where it goes.
John Vertes, a retired senior judge on the Supreme Court of the Northwest Territories, is heading the inquiry. He is to hear from 10 witnesses during its first week in Edmonton. It is scheduled to wrap up Jan. 18 in Calgary.
Vertes pointed out that Alberta's Health Care Protection Act has a queue-jumping provision that prohibits buying or selling spots on waiting lists. But he asked Lahey whether there is anything in provincial or federal laws that spells out how waiting lists are structured and regulated.
Lahey said there's not. And there's also no legal definition of what services are considered "medically necessary" or "medically required" to be publicly funded.
He said it can come down to money, and what each province is willing to pay for.
John Rossall, a lawyer for the Alberta Medical Association, asked Lahey whether politicians and doctors often disagree on what tests and services are necessary.
"There can be that gap, yes," said Lahey. "There can be differences between what individual physicians think need to be done, relative to a particular patient, and what the health-care system has decided.
"That happens. It happens in all health-care systems."
Rossall further questioned Lahey about how private diagnostic tests can give patients a jump start on getting surgery.
"Would you agree that really amounts to systemic queue jumping?" he asked.
Vertes ruled Lahey had been called as an educational witness and could not give his opinion.