Queue-jumping can pit doc's compassion against community responsibility: expert

CALGARY - Queue-jumping is not a black-and-white issue in Canada's health system because it often pits personal compassion against community responsibility, a bioethics expert told an Alberta panel Tuesday.

"Wherever you have wait lists — however fair or not fair those wait lists may be — people may feel the call of loyalty to do something for someone," testified Lynette Reid of Dalhousie University.

"That's what we do in life. We try to get the best for ourselves and for the people around us.

"(But) if you're conscious that seeking advantage for someone close to you also means disadvantaging someone not close to you — that brings out the ethical dimension and the necessity of addressing it."

Reid was part of an expert panel giving commission head John Vertes perspectives for a report he will deliver to the province this spring on problems, if any, with queue-jumping in Alberta's health system.

Vertes' Preferential Access Inquiry is wrapping up testimony this week following three months of hearings from doctors, nurses, politicians and administrators on whether patients are systematically butting ahead in line for help.

The inquiry has so far found isolated cases of queue-jumping, along with a culture of bureaucrats in the old Edmonton and Calgary health regions directing medical staff to seek out VIP patients to make sure those patients were happy in care.

Reid's answers underscored testimony from doctors or nurses often giving a helping hand to family, friends or associates.

There have been many examples dating back to testimony last December when Raj Sherman, the leader of Alberta's opposition Liberals and an emergency room doctor, told the inquiry he would treat colleagues in the legislature for rashes or prescriptions as a "professional courtesy."

Jim Thorne, the doctor for the Calgary Flames, later testified he called up a colleague in the health system who in turn arranged private H1N1 flu shots for the NHL team.

Don Christensen, the supervisor of Calgary's Sheldon Chumir clinic, testified there have been times when doctors would try to push their family and favourites to the head of the line.

Dr. Nicholas Mohtadi, a knee surgeon, testified he feels conflicted when friends or associates ask for treatment but said, like many other doctors, he will see that person after hours to avoid bumping out anyone else in line.

Mohtadi said it's unfair that it's left to doctors to make difficult moral decisions because of long waits for medical care. But he agreed that even seeing someone after hours moves them faster up the queue for any subsequent treatment.

"I think it's inevitable that that's going to occur," he testified in January.

"Would you be opposed to anyone trying to impose restrictions on your decision to extend those types of professional courtesies?" Alberta government lawyer Vivian Stevenson asked him.

"Yes," he replied.

Dr. Trevor Theman, registrar of the College of Physicians and Surgeons of Alberta, testified last month that regardless of problems in the system, "it then behooves the profession, in fact all professionals, not just physicians, to work together to recognize there is a broader societal need here."

The only case of alleged systematic queue-jumping raised at the inquiry has come from Calgary's Forzani and MacPhail Colon Cancer Screening Centre.

The publicly funded centre rents space from the University of Calgary, as does the private Helios Wellness Centre.

The inquiry has heard testimony that Helios donates more than $200,000 a year to the university, and that Helios patients were moved to the head of the line at the colon cancer clinic for four years ending in 2012.

Helios patients, the inquiry has heard, were treated in weeks while all other patients waited years.

— By Dean Bennett in Edmonton