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Public Exit: How Alberta Lost a Skilled Surgeon to the US

Dr. Daniel O’Brien says his determination to operate in Edmonton’s public system versus privately owned clinics led to a dead end.

Charles Rusnell 9 Jan 2024The Tyee

Charles Rusnell is an independent investigative reporter based in Edmonton.

You might think Dr. Daniel O’Brien and his wife, Andrea Dekeseredy, are exactly the sort of young professional couple that Edmonton and Alberta should strive to keep.

O’Brien, a highly trained American rhinologist, was one of only three in northern Alberta with the specialized skills to perform certain types of complex sinus and skull-base surgeries. The 35-year-old is also completing a doctorate at the University of Alberta in preparation for a career as a surgeon/scientist.

Dekeseredy, 31, has two master’s degrees — one in social work and a second in sociology — and now has a full scholarship to pursue her doctorate in sociology at the University of Alberta.

They loved the city, their new friends, the people they worked with. They especially loved living near the North Saskatchewan River ravine. Edmonton, they thought, was the perfect place to raise their five-year-old son, Oliver.

Now they live in Omaha, Nebraska.

“My wife is about as Canadian as they come,” O’Brien said in an interview. “She is a staunch believer in, and lover of, the country.

“And she has told me repeatedly she felt as though she was abandoned by her country; that she was told, and I was told by extension, that we are not wanted, and that we are easily replaced.”

O’Brien agrees with the assessment of a former mentor and colleague who said the young surgeon was “collateral damage,” the senseless victim of a dispute over patients and operating room resources and hiring.

Health policy experts say this toxic infighting can be linked to the United Conservative Party government’s headlong rush to outsource surgeries to private facilities.

The Tyee obtained an internal Alberta Health Services whistleblower complaint that details conflict of interest allegations against Dr. Daniel O’Connell. As an interim senior AHS administrator, the complaint alleges, O’Connell played an indirect but instrumental role in the loss of O’Brien and Dekeseredy to the United States.

Five surgeons, including O’Brien, signed the 13-page whistleblower complaint against O’Connell in November 2022. All except O’Brien declined an interview request.

The complaint includes conflict of interest allegations related to O’Connell’s part ownership of the private Canadian Cancer Care, or CCC, clinic.

O’Connell declined an interview request and instead directed The Tyee to AHS, which in turn issued a statement that said the complaint — filed more than a year ago — is still under investigation. The allegations in the complaint remain unproven.

Alberta Health Services provided no explanation for why it recently promoted O’Connell to a permanent position while he is still under investigation.

O’Brien is an American from Sacramento, California. Dekeseredy grew up in Ottawa. They met at West Virginia University, where they were both students, and married near her mother’s family farm near Kincardine, Ontario.

Dekeseredy wanted to go back to Canada. O’Brien wanted to study rhinology and endoscopic skull-base surgery. The University of Alberta was the only Canadian university that had a surgery fellowship certified by the American Rhinologic Society.

The plan was for O’Brien to undertake both the fellowship and his PhD for two years while Dekeseredy finished her second master's and started her PhD.

“Then hopefully we would figure out a way to stay in Canada because we didn't want to come back to the United States afterwards,” O’Brien said.

Allegations of favouritism and conflict of interest

About 18 months into his fellowship, AHS and the University of Alberta posted a job for a rhinology surgeon/scientist. O’Brien was one of the two finalists chosen by a search committee after a nearly yearlong process.

But before the committee began its final interviews, one of O’Brien’s mentors, Dr. Hadi Seikaly, was abruptly removed as head of the ear, nose and throat division, a position he had held for 16 years.

O’Connell replaced him on an interim basis and also arbitrarily took over from Seikaly as the search committee chair.

“Dr. O’Connell proceeded to direct his support to a candidate who, unbeknownst to the committee, he was not only a reference for, but who also had a past financial connection to the CCC clinic,” the complaint states.

“Dr. O’Connell’s reference status was not declared to the rest of the committee until the very end of the interview process, and he did not recuse himself from the evaluations.”

Most members of the committee allegedly disagreed with O’Connell’s choice and instead supported hiring O’Brien. Shortly after that decision, O’Brien said he received a call from O’Connell in which he questioned his immigration status and the progress of his PhD, both of which he had addressed during the interview process.

“He was aggressive and it felt predatory,” O’Brien told The Tyee. “He was basically trying to find a means to discredit my application. It felt as though his efforts were to intimidate and to discourage.”

The complaint says, “O’Connell did not move forward with the job offer to Dr. O’Brien, leaving him in the difficult situation of being a successful candidate with no job.

“As a result of Dr. O’Connell’s actions, the [ENT] section currently has a vacant position that was advertised as part of an agreed upon resource plan, and a demonstrable demand in the patient population, at a time when Albertans are in desperate need of highly trained, and difficult to recruit, health-care professionals.”

The complainants go further, alleging O’Connell used his interim position “to preferentially assign or support AHS privileges to graduating fellows to the direct benefit of the CCC clinic.”

O’Brien needed his AHS privileges to continue to see patients at the university’s ENT clinic and to earn income to support his family while he awaited the final decision on when he would get the job for which he had been selected.

At a meeting of the ENT surgeons, the complaint states, O’Connell “aggressively questioned the appropriateness of potentially extending the AHS privileges to O’Brien,” and he eventually refused to. O’Brien grieved the decision and was granted a further six-month extension, although he had asked for a year.

That same month, the complaint says, O’Connell, without any input from the other ENT surgeons, raised no objections to the ongoing privileges of another young fellowship surgeon who “immediately began working for CCC clinic surgeons, including Dr. O’Connell, to the direct financial benefit of Dr. O’Connell and the CCC clinic ownership group.”

‘I would probably still be there’

The complaint says Alberta Health documents show O’Connell was the electronic submitter of record to AHS for the young surgeon’s billings and “that the payee for that business arrangement is the CCC clinic.”

O’Brien, in an interview, said that a few days after O’Connell refused to extend his AHS privileges, another surgeon, Dr. Brock Debenham, a business partner of O’Connell in the CCC clinic, tried to recruit him to work in that clinic.

O’Brien subsequently exchanged numerous texts with Dr. Raiyan Chowdhury, a co-founder of the CCC clinic and part owner of another clinic, Alberta ENT Consultants, about joining one of the clinics and potentially working in one of several private surgical facilities.

But O’Brien eventually decided he had to remain loyal to the two surgeons who mentored him — Hadi Seikaly and Erin Wright — who were on the opposite side of O’Connell in the ongoing dispute over patients and resources in the public versus private systems.

“You can make an argument that I should have abandoned the ones that brought me through, because then I would probably still be there. I would have been working in the private clinic, and I probably would be working in the private ORs.

“At the end of the day, I wasn't willing to betray the folks that had sponsored me, that had brought me to where I was,” he said.

O’Brien is now a surgeon in a non-profit hospital and an associate professor at Creighton University in Omaha. He and his wife still have to figure out how to complete the PhDs they began at the University of Alberta.

Every few months, O’Brien sends an email to the AHS Edmonton zone chair of surgery and the interim AHS medical director asking for an update on the job he was offered. Either his inquiries are ignored or he receives a perfunctory non-response.

O’Brien has filled in as a surgeon in Yellowknife but his permanent residency in Canada is running out. He figures he has nothing left to lose by going public about how he was treated by O’Connell and AHS.

Yet he and his wife still hold out hope they can eventually return to Edmonton.

“I can't believe we're not there,” he said. “I can't believe that we had to leave Edmonton, leave Alberta, leave Canada.

“But we weren't given an alternative. We weren't given another option.”  [Tyee]

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