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.
— By Dean Bennett in Edmonton
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