Alberta doctors dispute sparks new counter-allegations

Alberta Health Services' investigation into a long-running controversy and conflict of interest involving six doctors has been rekindled with new counter-allegations and legal warnings.

The controversy surrounding Dr. Daniel O'Connell of Edmonton began more than a year ago, prompting the opposition NDP to call for an independent investigation. Alberta's health minister said he was content to allow an in-house investigation.

The allegations against O'Connell are contained in the complaint and relate to his interim role as department director and chief of otolaryngology-head and neck surgery for the Edmonton region. Otorhinolaryngologists are specialists who deal with diseases of the ear, nose and throat along with diseases of the head and neck.

AHS is an affordable, leading provider of health care services across the province.

The complaint was filed on November 21, 2022 by five doctors who work or have worked with O'Connell. They were notified in early January that the investigation was ongoing.

AHS documents show that O'Connell's temporary designation was revoked on Dec. 1, 2023, pending an investigation, and he was assigned a five-year term.

The doctors who signed the complaint — Hamdi El-Hakim, Jeffrey Harris, Daniel O'Brien, Hadi Seikali and Erin Wright — declined emailed requests for comment.

O'Connell also declined to comment, citing questions from AHS.

The five allege in the complaint that they raised concerns with O'Connell before and during his tenure as interim superintendent.

They say he had problems in his dual role as administrator of AHS and the Canadian Cancer Care Clinic.

The Edmonton clinic provides screening, monitoring and palliative care. Patients do not pay out-of-pocket for insured services. These fees are paid by Alberta Health Services.

O'Connell is a minority shareholder of the clinic.

The plaintiffs allege that O'Connell may have a conflict of interest with the clinic and the AHS triage protocol, which enters patients into a central registry and distributes their cases to specialists.

According to the protocol, patients can be matched with the next available provider. In turn, all professionals should have access to a fair referral system.

Edmonton otolaryngologists began talking about joining the triage program in 2020 and did so in 2021, the complaint said.

Around that time, they learned that the cancer clinic had approached the program independently and had been referring patients to their own doctors for several months, “thus monopolizing a potential referral source to their benefit and to the detriment of the rest of the department,” they say. complaint.

There, the hospital's surgeons accused the referrals of “administrative error”.

The complaint alleges that O'Connell used his authority at least twice to exclude doctors from the triage program who were not at the clinic.

O'Brien also claims in the complaint that the search committee voted to hire him for the rhinology position, but O'Connell failed to act to follow through. O'Brien has since left Alberta to work in Nebraska.

The plaintiffs allege that O'Connell promised to disclose his relationship with the clinic and recuse himself from making a decision about it, but failed to do so.

“From and until March 4, 2022, despite his promises, Dr. O'Connell appears to be acting as an intermediary on behalf of and/or for the benefit of CCC Clinic while continuing to make and support helpful decisions. CCC Clinic and its staff directly,” the complaint states.

There are many other allegations.

The complaint alleges that O'Connell began reallocating operating room resources without proper oversight or discussion. He claims that critical operating room resources were unjustifiably taken away from Wright.

In it, O'Connell left Leduc Community Hospital off the list of available resources to share, despite the site being used by surgeons affiliated with the clinic.

In it, O'Connell, without notice, discussion or justification, removed Harris from the telephone consulting service for seven years, resulting in “significant financial loss” to Harris.

In it, O'Connell describes a hostile work environment in which he used “inflammatory and accusatory language” toward El-Hakim in meetings. In one meeting, O'Connell accused Seikaly of “acting dishonestly,” the complaint states.

About two weeks after the complaint was filed, the five doctors filed a second one containing new allegations.

In the December 9, 2022 complaint, five people alleged that O'Connell scheduled operating room time with Christmas and New Year's on-call assignments to benefit surgeons affiliated with the clinic.

“We believe this is a manifestation of clear favoritism towards the small number of section surgeons who have financial and clinical ties to the CCC clinical team,” it said.

The issue was highlighted in a January news story by The Tyee and later by CTV. Citing these incidents, the clinic's lawyers sent a letter to the plaintiffs on January 17 opposing their claims and warning of possible legal action.

“Some members of the Otolaryngology Section made false statements about CCC and its affiliated physicians, and some members of the Otolaryngology Section engaged in other acts of misconduct,” the letter said.

The letter says the clinic did not affect AHS hiring, positions or operating room resources and allocations.

“CCC has never and will not allocate AHS resources inappropriately in favor of CCC.”

The letter says O'Connell runs his own practice at the clinic, “given the lack of outpatient resources to see patients consulted in hospitals.”

He adds, “Dr. Accordingly, O'Connell will own a portion of the CCC Community Clinic in a shared overhead model,” the letter states. “To be clear, Dr. O'Connell is a minority shareholder of CCC. He is not a director or employee of CCC.”

The attorney's letter alleges that some department members, including some unnamed writers of the complaint letter, made false statements, including that some doctors affiliated with the clinic were using their roles at AHS for personal gain.

“These false allegations are malicious attempts to tarnish CCC's reputation,” the statement said.

The letter says the allegations violate the College of Physicians and Surgeons of Alberta's code of conduct, which states that doctors must treat each other with respect.

The letter said a complaint could be filed with the college.

After the Tyee and CTV stories emerged, NDP health critics David Shepherd and Luanna Metz called on Health Minister Adriana LaGrange to launch an independent investigation.

“It has been 400 days since this complaint was forwarded to the AHS Chief Ethics and Compliance Officer,” Shepherd and Metz wrote in a Jan. 9 letter to LaGrange.

“In fact, Dr. O'Connell's (interim) position was permanent during the time this investigation was ongoing.

“These clinics have significant financial interests. And if the decision regarding these private clinics is made in someone's mind, the public should be concerned.”

Asked if LaGrange would intervene, his spokeswoman Andrea Smith said in a Jan. 18 statement: “The minister has received the letter. The Government of Alberta does not comment on AHS (human resources) and employment matters and sent the letter to AHS for attention.”

The AHS email asked why O'Connell's job was changed from an interim to a five-year term during the conflict-of-interest investigation, whether there were any comments on his duties and why the investigation took more than a year. year.

AHS spokeswoman Kerry Williamson said in a Jan. 17 statement that an internal investigation will determine whether there is any substance to the complaints.

“Until this process is complete, it would be irresponsible to make any assumptions about the merits of any allegations,” he said.

“Due to confidentiality and privacy, we are unable to provide any further details regarding this matter.”