Dr. Nicholas Mohtadi told a preferential access inquiry Thursday that he and a "majority" of surgeons are pressured by friends and colleagues for fast-track examinations that then allow patients to get on wait lists for surgery.
Mohtadi testified that doctors see those patients, but always outside office hours so that no one who is on the regular list gets bumped.
"Isn't this circumventing the wait time that ordinary patients like myself would have to undergo?" commission head John Vertes asked Mohtadi.
"Yes, absolutely," the Calgary surgeon replied.
Mohtadi said he and other doctors often debate the ethics of fast-track consultations.
"It's a very frustrating process," he said.
"(But) because of (wait-list bottlenecks) this is always going to occur. People are going to try and get in and see people like me any way they can."
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He suggested it's unfair to force doctors to have to turn their backs on people they know personally or professionally because the system doesn't function properly between 9 a.m. and 5 p.m.
"The appropriate response is that that patient should be able to demand as an Albertan a standard of care that is acceptable to anybody in this room," Mohtadi told lead commission counsel Michele Hollins.
"As a taxpayer, it's not acceptable that you have to pick up the phone and use influence to get through the system.
"We should have standards (of care) that we agree upon that will allow us to solve some of these problems."
Mohtadi said MRIs are one example of uneven standards. Some doctors, he said, refuse to see a patient for a knee injury without an MRI being done first, even though the test may not be necessary for an accurate diagnosis.
The result, he said, is patients waiting longer for care and needlessly gumming up wait lists.
He said consequences for patients can be profound. A ruptured knee tendon, for example, needs to be operated on within a matter of weeks at the most or the joint will develop arthritis "and be damaged irreparably for life."
Mohtadi told the inquiry he is not interested in a solution that would see prevent doctors from seeing people not on the regular wait list. He said he has opened a clinic in Calgary focusing on knee repairs for athletes and other patients as one way to clear up wait-list bottlenecks.
Mohtadi is the second doctor to testify at the inquiry that he treated patients outside regular hours.
Last month, Raj Sherman — leader of Alberta's Liberals and an emergency room doctor — told Hollins that he would treat fellow politicians in his legislature office for minor ailments such as rashes.
That led Hollins to challenge Sherman, a sharp critic of government queue-jumping, of being culpable of similar out-of-bounds behaviour. Sherman called it "professional courtesy."
Sherman later told reporters he didn't mind the grilling but said the inquiry had a double standard, asking hard questions or soft ones depending on the witness.
On Thursday, Hollins did not rigorously challenge Mohtadi when he told her about seeing favoured patients out of turn.
And when Mohtadi — in response to Vertes's questions — later admitted he considered his actions queue-jumping, Hollins was again on her feet, but only to tell the inquiry she was finished.
"Those are all my questions," she said.
The $10-million inquiry was called by Alberta Premier Alison Redford but operates independently of her government.
— By Dean Bennett in Edmonton