Shirley and Dr. Paul Brown share their story about how the shortage of pathologist services at Campbell River Hospital delayed a cancer diagnosis, causing unnecessary anxiety and altering the medical treatment plan
Dr. Chris Bellamy, a well-known pathologist who practiced in the Comox Valley for 31 years | submitted photo
Last two CVH pathologists resign angry and exasperated by Island Health tactics
For the past 31 years, Dr. Chris Bellamy has been a stabilizing figure in the Comox Valley hospitals’ medical laboratories. The mild-mannered pathologist earned the respect of his colleagues by working days and often nights to provide timely and accurate diagnoses for physicians and patients.
His stellar reputation extended beyond the Comox Valley. His peers around the province recruited him to serve on professional boards and committees, including one that revisited pathologist workload models and studied how they should be used in pathologists contracts provincially.
He mentored a wide array of medical technicians and laboratory assistants and provided them with the real-life education that can only be learned on the job.
When Bellamy first came to St. Joseph’s General Hospital in 1989, he was the Comox Valley’s only pathologist. As a general pathologist he did both the clinical and anatomical streams of the medical specialty.
As the community’s population grew and the hospital’s workload increased, Bellamy was joined by Dr. Wayne Donn in 1999 and Dr. Stefania Giobbe in 2015, also general pathologists. The three doctors covered for each other’s vacation time and shared the after-hours calls and weekend work.
But this rosy scenario took a dark turn about seven years ago when the Vancouver Island Health Authority (sometimes called Island Health) unilaterally started to implement a plan to eliminate general pathologists on the North Island.
MORE: The issue in a nutshell
In the future, VIHA planned to provide only anatomical pathology services on-site and turn all clinical pathology over to a private corporation of doctors in Victoria, called the Vancouver Island Clinical Pathology Consulting Corporation.
Island Health started this change in 2013, but only at the Campbell River Hospital, where complaints of long wait times for results — some as long as six weeks for a cancer diagnosis — began almost immediately.
The Comox Valley pathologists who worked at St. Joseph’s General Hospital, which was not under Island Health’s control, had different contracts that allowed them to practice general pathology and that remained in place through the opening of the new Comox Valley Hospital.
Island Health couldn’t take clinical pathology away from Bellamy, Donn and Giobbe, but it could encourage and pressure them to leave.
And it could refuse, after Dr. Giobbe went on extended medical leave in 2018, to provide any support to ease the workload. In response to requests from Bellamy and Donn for help, Island Health’s answer was to send the work to Victoria.
So it all came to an acrimonious end on June 21 when Bellamy and Donn jointly resigned. They gave two months notice.
“I was just exasperated and angry,” Bellamy told Decafnation. “I really felt forced out. VIHA was relentless in their pressure.”
“Politicians need to have their feet held to the fire”
According to sources within the Comox Valley Hospital, the Island Health announcement of Bellamy’s and Donn’s resignations did not thank the doctors for their years of service.
“And it was sent to the smallest audience possible,” the source said.
Bellamy said he feels sad for patients and staff, “who are bearing the brunt of what’s happening here.”
Their absence for the past two months has caused chaos at the CVH laboratory where most laboratory work is now shipped to Victoria. This has created longer wait times and has provoked some emotional patients to turn up at the lab, desperate for their biopsy results.
Since the pathologists resigned in August, Island Health has been unable to recruit any doctors willing to practice only anatomical pathology at the Comox Valley Hospital. The jobs remain vacant.
VICTORIA WAVES OFF CONCERNS
Dr. Chris Bellamy has been warning Island Health executives and North Island politicians about the dangers of shipping biopsy samples to Victoria to no avail. Now, he’s joining the call for a full external review of the situation.
Bellamy, Giobbe and Dr. Aref Tabarsi, a Campbell River general pathologist, met with Comox Valley MLA Ronna-Rae Leonard on Aug. 11, 2017, just prior to the opening of the new Comox Valley Hospital. North Island MLA Claire Trevena was also invited but did not attend.
The doctors’ goal was to save microbiology and other lab services from being moved from CVH to Victoria. They explained how even minutes counted in making a diagnosis. For example, they said in serious infections, such as meningitis, mortality rates nearly double if the diagnosis takes longer than an hour.
But Leonard said she would not interfere in what she perceived as an Island Health operational issue.
“If politicians don’t want to interfere in the daily operations of VIHA that can impact patient care and safety, then who is accountable?” Bellamy told Decafnation.
Bellamy now believes that an independent review is necessary because there is no accountability within Island Health for the delivery of lab services.
“You can’t point to any one person and say they are responsible,” he said. “It’s a matrix organizational structure, a latticework of managers who all point the finger of responsibility in another direction.”
Bellamy made further attempts to retain lab services on the North Island at meetings with Island Health and VICPCC doctors in 2019 and as late as March of this year. None were successful.
By summer, “it was game over,” for Bellamy and Donn. “From then on, it was just a matter of how to extricate ourselves from the situation,” he said.
BEYOND PATIENT CONCERNS
With Bellamy and Donn gone, the North Island now has no on-site clinical pathologist services. All of that work is now shipped to Victoria, mostly by courier.
That change has raised more concerns than long wait times and impacts on patient treatment plans. There are allegations of conflict of interest within Island Health.
Island Health signed it’s first multi-million dollar two-year contract with VICPCC in 2014. It signed a second two-year contract in 2017 under a non-disclosure agreement.
In the meeting with MLA Leonard in 2017, Bellamy, Tabarsi and Giobbe questioned the priority of these contracts.
“It is scandalous that a public body like Island Health would use taxpayer money to sign a multi-million contract with a private, for-profit corporation under a non-disclosure agreement,” the doctors wrote in their presentation to Leonard.
And they alleged conflict of interest in how the contracts were awarded.
“Island Health allows some of the senior VICPCC shareholders to hold key administrative positions … including department and division heads who then dictate changes in service delivery to the detriment of the patients of the North Island and to their own financial benefit,” according to the presentation.
Island Health maintains there was no conflict of interest and has relied on a ruling by the College of Physicians and Surgeons, whose function is to protect the public.
Bellamy says Island Health has wrongly interpreted the College’s ruling.
“The College didn’t say there wasn’t any conflict, only that there was no conflict that had conclusively resulted in patient harm,” he said. “There was no absolute proof that patient care had been compromised because at the time no citizen had formally complained to the college.”
Since then, however, a citizen has made a formal complaint to the College, and there have been complaints to Island Health’s Patient Quality Care Office.
Dr. Donn has already taken another job in the Fraser Valley. Dr. Giobbe remains on medical leave.
Dr. Bellamy is taking time to decide whether to go back to work in another capacity or to retire. Regardless of what his future holds, Bellamy says he wants to see this issue finally resolved.
“Politicians need to have their feet held to the fire,” he said. “The Comox Valley Hospital laboratory service is no longer good value for money and Island Health won’t change without public pressure.”
MEDICAL TERMS USED IN THIS ARTICLE
Anatomical pathology deals with tissue biopsies, such as biopsies from breast, colon, skin and liver.
Clinical pathology deals with body fluids such as blood, urine and spinal fluid, and includes three areas of specialization:
Microbiology deals with the identification of infectious organisms.
General pathologists are medical specialists who study an additional five years in all areas of pathology.
Clinical pathologists are medical specialists who study the same additional five years but in only one of the areas of specialization.
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