Audiologist aims for ‘Dr.’ in charter bid
Do some health professionals have a constitutional right to call themselves doctor, regardless of government rules?
That’s what an Ontario audiologist contends in a potentially groundbreaking Charter of Rights and Freedoms challenge, after being slapped with a three-month suspension and almost $100,000 in costs for using the title.
Brenda Berge says her right to freedom of expression is being violated.
Berge says provincial law bars her from putting “Dr.” before her name, while naturopaths, chiropractors and acupuncturists, among others, can legally use the title.
The novel legal gambit comes as new questions are being raised about government licensing of alternative health-care practitioners, many of whom can use the doctor honorific yet offer scientifically questionable treatments.
Berge, 48, says it makes no sense that she faced disciplinary action for trying to call herself Dr. Berge, when she has a doctoral-level degree and a post-doctoral fellowship in a science-based profession.
Audiologists diagnose, treat and manage hearing problems and balance disorders.
“It’s completely irrational,” said the Guelph, Ont., practitioner. “How is a four-year degree on the ears any different than four years on the eyes as a doctor of optometry, or four years on the mouth and teeth as a dentist, or four years on the back as a chiropractor?”
Her arguments under the charter’s freedom of expression section will be heard by in Ontario’s Divisional Court in June, part of an appeal of her discipline conviction.
Anyone with qualifications like Berge’s should have the liberty to proclaim it, said Morris Manning, the veteran constitutional lawyer representing her.
“You want to be able to convey to patients that you are a doctor, and if you do so, that’s a form of expression,” he said. “It becomes a very important constitutional issue.”
The College of Audiologists and Speech Language Pathologists of Ontario found Berge guilty of misconduct last year for using the title. It suspended her for three months, ordered her to take a course in professional ethics, undergo two unannounced inspections — at her expense — and said she must pay the college $97,595 in costs.
The agency’s registrar, Brian O’Riordan, said this week he could not comment on the case while it’s before the courts. The Ontario Health Ministry declined to comment on the challenge and how it decides who can use the honorific.
Across Canada, self-regulating bodies govern a host of different health professions, following general guidelines set out in provincial law. Each province parses out rights to the coveted doctor title — and the choices tend to differ from jurisdiction to jurisdiction.
In Ontario, physicians, dentists, chiropractors, optometrists and psychologists are among those allowed to call themselves “doctor.”
A provincial advisory committee commented in a 2006 report that the rules seemed to lack any underlying principle, might favour maledominated professions and appear more designed to maintain certain groups’ status than to protect patients. It recommended letting any health professional with a clinical doctorate recognized by his or her college to use the title, which could include some pharmacists, nurses and speech-language pathologists, as well as audiologists.
Ontario didn’t implement the advice, which parallels the system in Quebec, but in subsequent years did extend the privilege individually to licensed naturopaths and Chinese traditional practitioners.
Berge has a clinical doctorate in audiology and a post-doctoral fellowship in neuroanatomy from Dartmouth in New Hampshire. Most of her colleagues have a lesser master’s of science in audiology.
The audiology college itself has lobbied for the right of some members to use the doctor honorific while enforcing the existing ban. Berge says in an affidavit that the body has subjected her to an eightyear “harassment campaign.”
“There is a constant stress and constant chaos with this process which leaves me with a sense of helplessness,” she said.
The recent prosecution of an Alberta couple for failing to take their toddler-son with meningitis to a medical doctor until he was fatally ill has sparked debate about whether provinces should legally recognize some alternative health-care practitioners, let alone allow use of the doctor title. The boy’s mother had consulted a naturopath.
Naturopaths argue much of their four-year training program covers standard medical science, but critics say they study treatments with little empirical foundation, like some herbal medicine and homeopathy.