Review of cancer patient’s death prompts call for changes

CALGARY – Alberta’s health minister says patient care needs to improve following a damning report from the Health Quality Council. The report follows the case of Greg Price, a 31-year-old cancer patient who was unable to access timely care and ultimately died a short time after his diagnosis.

“Greg’s journey included at least four complete breaks in his continuity of care,” explains Dr. Ward Flemons, HQCA medical advisor and the study’s author.

A doctor first identified a suspicious lump near Price’s testicle during a routine check up at a walk-in clinic. He was referred to a surgeon but waited over three months for a response. Price also had to wait several weeks for a CT scan, even though it was marked urgent. Then, when the results came back, Price wasn’t contacted because the doctor he had originally seen had left to join another practice. After the scan revealed cancer, Price was referred to a specialist but again, his care was delayed.

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“He was referred to an urologist who, as it turned out, was out of the country for an extended period of time, unknown to either the patient or the referring physician,” Flemons says.

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Price eventually had surgery but two days later he experienced severe swelling. He tried to reach his oncologist and when he could not, he went to the emergency department. He died the following day.

“He was a young, athletic, professional engineer,” his father, David Price says. “We knew he was having some pain but we didn’t know until six days prior to his death the was trying to manage everything himself.”

The HQCA has made 13 recommendations to address the continuity of care problems. The recommendations are directed at Alberta Health Services, The Alberta Medical Association, The Alberta College of Physicians and Surgeons, The Alberta Society of Radiologists and the Office of the Chief Medical Examiner.

“It really is an indictment of the health care system in many respects,” says Alberta Health Minister, Fred Horne, “Physicians need to take responsibility for the care they’re providing to patients and that’s not only at a time when they’re seeing a patient in their office, it is in between.”

In a letter to its members today, the AMA President promised to take action.

“We will carefully review the complete study report and are fully prepared to work with others to implement the recommendations,” Dr. Allan Garbutt wrote.

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An Alberta Health Services official promised prompt attention, as well.

“We’re going to quickly move on this,” Calgary zone medical director, Dr. Francois Belanger says, “I think the family would expect, and rightfully so, that we make changes right away.”

The College of Physicians and Surgeons plans to begin by educating their members. Registrar Dr. Trevor Thiman says doctors may not fully realize all of their responsibilities.

“We have a number of standards of practice that applies to our members and one of them is about after hours care. We recognize that there are many members that are either unaware or not compliant with the standard so we’re happy to take that on.”

The minister says he has asked all parties to submit a plan about how the relevant changes will be made.

Greg’s father says he will watching closely, “We are anticipating change, we just know it’s a big job.”

The full report can be viewed online.

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