When it comes to doctor competence, ignorance is not bliss

At the beginning of October, Ontario’s Minister of Health, Dr. Eric Hoskins, did a good thing. He demanded that colleges of all regulated health professions take concrete steps to increase transparency in college processes and decision-making, and to make more information available to the public. The colleges, which include the College of Physicians and Surgeons of Ontario (“CPSO”), have until December 1st to report back to the Minister.

It appears that someone is finally minding the shop.

Over a year ago, CPSO Registrar, Dr. Rocco Gerace wrote:

 “…the public protection work of the regulator must not only be done, it must be seen to be done…Information needs to provide assurance to the public that practitioners are competent and that the public is safe.”

To date, the public still has little access to information from the College about the doctors it regulates. Complaints, once found to be legitimate, are seldom publicly disclosed if a deal satisfactory to the CPSO and the doctor can be struck. Patient safety is often negotiated and determined in private. Members of the public are denied the ability to assess for themselves the risk of treatment by their doctors. In only a small number of very serious cases will the College’s Inquiries, Complaints and Reports Committee refer an allegation of professional misconduct or incompetence to the Discipline Committee, a public forum, and only where it has already determined that there is a reasonable chance of a successful prosecution.

Even if there is a finding in court of medical malpractice, the information provided by the CPSO provides little assistance. Recently, Dr. Richard Edington, an emergency room doctor, was found to have failed to consider the possibility that his young patient was having a stroke. His negligence left her very debilitated. The College’s website refers only to a court finding of “professional negligence in respect of an incident that took place in December 2008.”

Those who practice medical negligence know that patient ignorance is not bliss. Patient safety cannot be adequately maintained if people are precluded from making their own decisions not just about treatment but also about choice of doctor. There is no reliable place to find information about doctors. Instead, patients must rely on gossip or doctor ratings websites. While both may be entertaining, neither is particularly reliable.

It remains to be seen whether the mandate imposed by the Ministry of Health will result in a more open exchange of information. Noting his responsibility to the people of Ontario, the Minister has reserved his right to take all necessary measures to ensure that the public interest remains paramount. Strong words – cross your fingers for strong action.

This blog post was contributed by Joni Dobson, OTLA Director and Lawyer with Legate & Associates LLP.

 

Joni Dobson
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Joni became a partner at Legate & Associates in 2012 having joined the firm 6 years before. Her practice is restricted to serious personal injury disputes, with a particular focus on medical malpractice and motor vehicle collisions. She has represented injured people both at trial and on appeal. Joni believes that an injured person should have a strong advocate who will go the full distance when required to obtain fair results.

  • Douglas Mackenzie

    You have the complete authority over a doctor as you need to be completely satisfied with the way your doctor is treating you. Reviews help in this case, as you know about the doctor you are visiting. So you will be prepared and deal with him/her accordingly.

  • Diana Ford

    The first and most important requirement should be that the CPSO has all their hearings recorded and transcripts be made available to the public upon request and upon payment of a fee. Every judicial and quasi-judicial Forum such as courts and Boards in Ontario have their hearings recorded and transcripts are made available to the public except the hearings of the CPSO that deal with loss of life due to medical negligence. Even the Landlord and Tenant Board has the hearings recorded and the transcripts are available electronically to anyone who wants them, although by comparison it deals with a lot less serious matters.

    When professional hearings are held behind closed doors and heard by unknown individuals, when the outcomes are not published but it takes 12 weeks to issue a decision because the writers have no recordings to go by and once the decision is written it gets vetoed by only one person, the chairman or director of the CSPO, who could possibly change it any way he wants, since no one holds him accountable, something is definitely not working correctly. It leaves ample room for secrecy, manipulation and corruption, not that it happens, but it could!

    Meanwhile, these secret meetings and secret agreements are made on taxpayers’ dollars. I believe that since we pay for them and since they are supposed to be hearings conducted in the public interest, in order to protect the patients from possible professional misconduct, every action and every hearing the CPSO is party to, or makes a decision in, ought to be made available to the public and in my opinion, all complaints, hearings and decisions, should be available in their entirety, online, with all the supporting documentation: the claims, the responses, the transcripts of the hearings as well as the decisions with the respective reasons for the decisions. Anything else would appear to the public as a conspiracy to manipulate the public and to mislead justice.

  • My story is far too lengthy but you can find it on my blog:

    Over the years I have contacted each and every single MPP in Ontario with very little response. Steve Clark’s Bill 29 is crucial if we want to see the CPSO accountable and more transparent to the citizens of Ontario who have allowed this institution to be self-regulatory. They have not truly investigated citizen’s complaints for the past two decades and have masked negligence and hidden away the many errors that surgeons and doctors have committed. How do we truly know that these surgeons have learned from their mistakes? We can’t without Bill 29 becoming law. (Keep in mind, open abdominal surgery to remove a tumor and have colon resection without the mandatory antibiotic prophylaxis being administered, no antibiotics for infected abdominal incision whereby all staples were removed and no antibiotics for the presence of “many gram negative bacilli”)
    http://anangelinourlives-awk.blogspot.ca/
    The MPPs of Ontario do not really know how a death of a loved one affects the family but worse the contempt shown by the CPSO in their failure to truly investigate. Perhaps, if there is indeed a heart within each of you, reading the following may help to persuade you to do the right thing. Support Bill 29! Terra bled to death!
    Re: Dr Laz Klein
    CPSO COMMENT “The routine use of antibiotics prior to bowel surgery is an important aspect of care that was neglected by [the Respondent] in this case. The Committee would suggest that [the Respondent] consider the routine use of antibiotics in such circumstances. Having said that, we do not consider this oversight to have contributed to the unfortunate outcome in this case.” PURE BULLS***!

  • I have been fighting for justice for my son since he died on June 12/12 there is no doubt that the doctors are responsible for his death. I have formed a group called cpso.co and we have set up a website telling all of our horror stories. Doctors have a license to kill and are mostly protected by the college. this is a very unfair and one sided system. I would be glad to send you a new version of my story which explains in layman’s terms exactly what happened to my son.