Shirley and Dr. Paul Brown | Submitted photo
Shirley and Paul Brown share how the CRH pathologist shortage impacted their lives
Ever since the Vancouver Island Health Authority started reducing pathologist services at Comox Valley and Campbell River hospitals in 2013, North Island citizens have endured longer wait times for their biopsy and other lab results.
Many have complained. And health care professionals and some local government officials have added their voices to the need to restore full laboratory services to the North Island hospitals.
But VIHA, sometimes called Island Health, has denied that reduced pathologist services have created delays in test results.
Now, a well-known Campbell River physician and his wife have come forward with their personal story about how Island Health’s policies have impacted their lives.
Dr. Paul Brown, a Campbell River family doctor for 40 years, has launched a series of complaints to Island Health, the College of Physicians and Surgeons, the BC Health Ministry and local officials regarding a significant delay in a cancer diagnosis that caused his wife anxiety and altered her cancer treatment plan.
Brown told Decafnation this week that his wife, Shirley, had a routine surgical procedure on Dec. 9 at CRH to remove an ovarian cyst.
Five weeks later, the pathology report was still unavailable. Shirley was anxious to learn the outcome of her surgery.
Because Brown knew the system, he called the pathology department at Campbell River Hospital and discovered the problem. There was only one pathologist working during the time that Shirley’s samples were being processed.
The pathologist had not yet reviewed the slides and had not made a diagnosis. He was prompted to review her slides and consult with his colleague who had just returned from holiday.
Two days later, Shirley learned that she had cancer.
It took another 10 days for a specialist pathologist in Victoria to confirm the diagnosis. Shirley saw an oncologist at the Victoria Cancer Clinic two months after her surgery.
The hospital has two full-time pathologists, but when Island Health unilaterally transferred all clinical pathologist services to a private corporation in Victoria, called the Vancouver Island Clinical Pathology Consulting Corporation, CRH lost funding to hire a needed third pathologist.
Currently, CRH’s two pathologists must cover each other’s shifts, vacation time, sick time and other required absences. That means that for a third of the year, up to 18 weeks, CRH may have only one pathologist on duty.
The delay in receiving the confirmed diagnosis moved the oncologists to start chemotherapy before the recommended surgery to stage the cancer and remove any visible tumour. Shirley completed chemotherapy in June.
At the end of July, she had surgery to complete staging and to remove visible cancer. A small deposit of cancer was found at her second surgery and more chemotherapy has been prescribed.
If the pathology report had been delivered in the recommended time frame, she would likely have had surgery first, followed by chemotherapy a couple of weeks later.
It is impossible to predict the outcome of that scenario but the treatment plan would have been completed much sooner, and Shirley would have experienced much less anxiety by knowing the stage of her cancer.
DISINGENUOUS REPLY FROM ISLAND HEALTH
Seven months ago, Brown initially complained to Island Health’s Patient Care Quality Office and he’s still waiting for a response. Every 20 days or so, he receives an email saying they are still working on the file.
He has also contacted North Island MLA Claire Trevena, Health Minister Adrian Dix and his deputy minister. He has not received a reply from any of them.
It’s an understatement to say the Browns are “frustrated by the lack of engagement by elected officials.”
Brown did get a reply to a letter he sent to Dr. Robertson, Island Health’s executive director of lab and pathology, on March 16 of this year. In this letter, Brown described what he considered were the troubling aspects of his wife’s case, including the delay in getting a diagnosis.
“I cannot express the anguish that this delay in diagnosis has caused us … (and it has) left me with concerns regarding the safety of the current delivery of lab and pathology services at CRG,” Brown wrote to Robertson.
In a reply dated May 20, Robertson denied any knowledge that having one pathologist on duty presented a problem.
Brown replied to Robertson on May 25 to refute this claim.
“The fact that you, as you have asserted in your letter, were unaware of concern regarding delays in surgical turnaround times when one of the pathologists was on holiday is incorrect,” Brown wrote.
Brown’s reply refers to several meetings that Roberston attended where the concerns were openly discussed, including the July 22, 2019 Campbell River City Council meeting and the April 11, 2019 meeting of the Comox Strathcona Regional Hospital Board.
Brown told Robertson that to profess no knowledge of the concerns was “disingenuous to say the least.”
INFO TO KNOW ABOUT OVARIAN CANCER
Early-stage ovarian cancer rarely causes any symptoms. Advanced-stage ovarian cancer may cause few and nonspecific symptoms that are often mistaken for more common benign conditions.
Signs and symptoms of ovarian cancer may include:
Abdominal bloating or swelling
Quickly feeling full when eating
Discomfort in the pelvis area
Changes in bowel habits, such as constipation
A frequent need to urinate
When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you.
If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. Your doctor may refer you to a genetic counsellor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers.
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