EDMONTON - Calgary Dr. Ron Bridges, cited by his peers as possibly being behind a queue-jumping scheme at a colon cancer-screening clinic, will get a chance to tell his side of the story at a public inquiry in Alberta this week.
But he has already, at least once, made his feelings known on the issue of preferential access.
"People are triaged on the basis of risk," Bridges wrote in letter to The Calgary Herald to clarify some points on a news story nearly two years ago.
"Those who have no significant risks for colorectal cancer … are accommodated for colonosocpy screening as resources allow.
"Talk to your doctor and get screened regularly. It could save your life."
The letter was dated May 27, 2011 — the same time that doctors and staff at the Forzani and MacPhail Colon Cancer Screening Centre have testified Bridges was possibly at the centre of a scheme to reward deep-pocket donors of the University of Calgary by moving them to the front of the line for routine testing.
Witnesses told Alberta's Health Services Preferential Access Inquiry last month that while all other patients waited three years or more for help at the publicly funded clinic, the favoured few were being seen and treated in a matter of months, sometimes weeks.
The man at the centre of it, they allege, was Bridges, the senior associate dean of faculty affairs at the University of Calgary and the man in charge of the faculty's fund development programs.
He is a man who, in the last decade, has forged a resume of distinguished public service while serving at the highest levels in his field and mentoring many grateful and distinguished protégés.
He has declined to be interviewed prior to his testimony, but his accomplishments are on the public record.
A graduate of the University of Calgary, Bridges was head of gastroenterology for the entire Calgary region from 2003 to 2007 before joining the university's faculty of medicine.
He gained national profile in 2008, when he became president of the Canadian Association of Gastroenterology. The organization's mission statement is to foster research and innovation in the field along with "promoting and maintaining the highest ethical standards."
At the University of Calgary, Bridges currently sits on the second rank of the faculty of medicine organizational chart, behind only the dean, Dr. Jon Meddings.
His philanthropy includes charity fundraising work for Reach! — a joint faculty-health department campaign that announced in 2009 it had raised more than $312 million from 700 donors.
In 2007, when used endoscopic equipment was about to be sold off at as discount as new machines came in, Bridges intervened to have the desperately needed equipment donated to medical facilities in South America.
Bridges' greatest legacy is considered to be the Forzani and MacPhail Colon Cancer Screening Centre, also known as CCSC.
The idea for it was spawned in 2003 when the now-defunct Calgary health region realized it had a problem on its hands. The population was booming and aging, and the existing hospitals could not handle the colon cancer tests. A stand-alone clinic was needed.
Bridges recalled brainstorming with Meddings on an idea to have the University of Calgary run such a clinic with the province as a partner.
"We talked and decided to jointly put in a proposal," said Bridges in an interview published in the July 1, 2011, issue of UCalgary Medicine magazine.
They needed funds, so Bridges sat down for lunch with local businessmen John Forzani and Keith MacPhail and explained how backlogs in colon cancer screening were putting patients' lives at risk.
MacPhail's mother had suffered through colon cancer and both men were looking to make a difference. Through Reach! the pair donated $2.7 million.
"This wasn't about betting on a long shot. This was about curing people," said Forzani in an article in the university's 2007-2008 Donor Impact Report.
In January 2008, the CCSC opened on the sixth floor of the Teaching, Research and Wellness building at the Foothills Medical Centre.
Dr. Alaa Rostom was recruited by Bridges to run the clinic as medical director while Bridges was one of many doctors who performed colon cancer tests there.
Dr. Valerie Boswell was hired in 2009 to pre-screen patients in 2009. She testified last month that weird things started to happen in early 2010. Patients from the private Helios Wellness Centre, located two floors down from the CCSC, were getting fast-tracked to the front of the queue for routine tests that usually had three-year waits, she testified.
Helios offers a range of services for clients willing to pay $10,000 a year. It was founded by University of Calgary professor of radiology Dr. Chen Fong, who worked with Bridges on the Reach! campaign.
CCSC clerk Samantha Mallyon told the inquiry she was directed by supervisors to fast-track Helios patients to three doctors that included Rostom and Bridges.
Clerk David Beninger testified the clerks coined a name for them: "Dr. Bridges' private patients."
Soon, the Helios cases began spilling over into the Foothills Hospital.
In November of 2010, Dr. Jonathan Love, site chief for gastroenterology at the Foothills, testified he was directed via a Bridges note to urgently check a Helios patient for colon cancer. The woman's case, Love later testified, was routine or moderate risk at best. So why the rush?
Love paid a visit to Helios and testified that Helios Dr. Doug Caine told him Helios was set up to reward deep-pocket donors from the University of Calgary.
Both Caine and Fong are scheduled to testify at the inquiry Tuesday.
Doctors Love, Boswell and Mark Swain, who is currently in charge of all gastroenterology in Calgary, have testified they voiced their concerns about Bridges possibly running his own private queue-jumping list of Helios patients. Rostom has testified that all he ever heard was rumours and there was nothing to substantiate them.
The one constant from the testimony — no one confronted Bridges directly.
There was a reason for that, said Swain.
Bridges, Swain testified, is a key fundraiser and manager, runs the clinics and decides which doctors practise at the CCSC.
"He would be one of the most powerful and significant people in the faculty of medicine," Swain testified. "That is a person that I think you'd have to have a lot of self-confidence to raise a concern about."
Love testified he didn't confront Bridges. He agreed with Swain's assessment, adding, "It has been my personal experience that legitimate differences of opinion don't really go well with (Bridges) and so I limit those."
Rostom testified since there was never any hard evidence to go on, he never asked Bridges if the rumours were true.
Barb Kathol, an executive director at the Foothills Hospital responsible for the CCSC, said when she heard about the Bridges rumours, she didn't go to Bridges but followed the chain of command and went to Rostom, who told her there was nothing to worry about.
When Rostom's boss, Dr. Francois Belanger — head of the Calgary health region for Alberta Health Services — heard the rumours in early 2012 he, too, followed the chain of command. He testified that Rostom told him there was no problem.
If nothing else on Wednesday, after three years of whispers and behind-the-back accusations, it seems Bridges will finally be asked direct questions.
Jan. 22, 2008: Colon Cancer Screening Centre, or CCSC, officially opens at the Foothills Medical Centre as a joint initiative of University of Calgary and Calgary Health Region. It is Canada's first free-standing colon cancer screening clinic designed to assume 30 per cent of the colon-cancer tests in the region to take pressure off hospitals. CCSC medical director Dr. Alaa Rostom is hired by clinic founder and University of Calgary associate dean Dr. Ron Bridges. Rostom testified in order to change colon cancer testing from individual patient lists to one common queue at CCSC, doctors are allowed to fill half their slots with their own patients during the transition.
2009: Samantha Mallyon joins CCSC as a booking clerk. Mallyon testified she was soon directed to take all patient files coming from the private Helios Wellness Centre and book them within week or two, while regular patients waited three years or more. She testified CCSC administrator Darlene Pontifex directed her to do it and came by her desk once a week to make sure Helios patients were indeed fast-tracked.
April 2009: All Alberta health regions are folded into one superboard titled Alberta Health Services under new president Stephen Duckett. Duckett issues a memo a month later to health leaders saying that he had heard queue-jumping was going on and would not be tolerated. Around this time Alberta Health Services begins the process to take full control of CCSC.
Early 2010: Patients from the Helios Wellness Centre are being systematically seen much sooner than the normal three-year waiting period for routine tests, according to the testimony of Dr. Valerie Boswell, a general physician hired to pre-screen patients at CCSC. Boswell said she made a phone call to Helios to learn more, but was berated by the person at the other end of the line, who demanded to know why she wanted the information.
March 2010: Boswell brings up concerns about Helios patients jumping the queue to Rostom, Pontifex, CCSC research director Dr. Robert Hilsden, nurse Heather Stubley and Pontifex assistant Olga Koch. Boswell testified she got a frosty reception and no response. She wrote "Yikes" on her meeting notes.
Nov. 1, 2010: Dr. Jonathan Love — site chief for gastroenterology at Foothills Hospital — checks a patient for a colon cancer on expedited basis on referral from Helios doctor Doug Caine and Bridges. The patient was marked urgent but Love testified case appeared routine. Love visited Caine at Helios clinic. Caine gives him a tour and, according to Love, told him the clinic was set up to reward deep-pocket donors at the University of Calgary. Love said he raised the issue of possible queue-jumping involving Bridges and Helios at subsequent meetings of gastronintestinal doctors from Foothills and CCSC, including Rostom, but nothing was done. Rostom testified he doesn't remember such comments. Around the same time, CCSC policy is changed to forbid doctors from booking their own patients because CCSC is moving to one common patient queue.
December 2010: Two boxes of wine with a bow are delivered to CCSC from Helios. Rostom testified he ordered the wine sent back, but didn't explore the issue further. Rostom denied testimony from Barb Kathol, an executive director at the Foothills Hospital who works with the CCSC, that he didn't send the wine back until she ordered him to do so two months later.
Early 2011: David Beninger begins working as booking clerk at CCSC. He testified he saw Helios patients being fast-tracked, with many of them tied to Bridges. He testified he mentioned it to Boswell and was told the practice was supposed to have stopped. He told her it was still happening. Dr. Mark Swain, the head of gastroenterology for the Calgary region but with no authority over CCSC, is told by Love and Boswell about possible queue-jumping involving Bridges' patients.
Alison Redford 2012
Oct. 2, 2011: Alison Redford voted Alberta PC party leader and premier after campaigning on promise to hold a public inquiry into health system problems including queue-jumping.
November 2011: Boswell has second meeting with Rostom, Pontifex, and Hilsden over queue jumping involving Helios. She testified Rostom told her: "This is not a hill we want to die on."
Early 2012: Love asks CCSC clerks if queue-jumping is going on. He testified they replied: "Sure it's going on. Like, duh."
Feb. 28, 2012: Health Minister Fred Horne announces he has asked Health Quality Council to strike an independent panel to examine any queue-jumping in Alberta's health system.
March 16, 2012: After Swain tells Kathol she needs to again look into queue-jumping allegations, Kathol phones Rostom to advise him a second time of concerns that Bridges is directly booking patients at CCSC. This time, Rostom tells her he'll look into it, but testified that he didn't because he didn't have the time or resources.
March 19, 2012: Instead, Rostom sends out an email warning to senior staff reminding them that queue jumping in endoscopy procedures is not allowed. This catches the attention of his boss Dr. Francois Belanger, the head of the Calgary medical zone.
March 21, 2012: Belanger talks to Rostom. He said Rostom confirmed to him there had been charts flagged with him, but told him it was largely the result of organizational confusion and had been fixed. Belanger let the matter drop.
All parties agree any queue-jumping stopped after this point.