Physician college clogged by cases
Watchdog should dismiss more complaints against doctors, new report says
Ontario’s physician watchdog should dismiss more public complaints, given that more than 80 per cent require little or no action be taken, according to a new report.
Released Monday, a report on “Streamlining the Physician Complaints Process in Ontario” suggests that the system is clogged because the College of Physicians and Surgeons of Ontario (CPSO) is currently compelled to investigate all public complaints.
“Too many complaints and investigations are in the system too long,” wrote Stephen Goudge, a former justice on the Ontario Court of Appeal.
He was asked by the province to make recommendations as to how the college could speed up its work and reduce the number of hearings while also maintain a fair process.
Goudge, who submitted his report to the government more than two years ago, wrote that there were an average of 2,412 new complaints filed annually to the college between 2010 and 2014. The college publication Dialogue reveals those numbers have increased. There were 2,685 complaints in 2016 and the projected total for 2017 is 3,076.
Complaints about doctors from the public are “the single most expensive and resource-consuming aspect of the physician complaints process workload, for both the college and the CMPA (Canadian Medical Protective Association),” Goudge wrote.
The CMPA, often described as a legal insurer to doctors, provides legal representation to doctors and is paid for by provincial governments, which reimburse doctors for their membership fees. The CMPA pays for the legal defence of doctors facing a complaint.
A 2015 Star investigation revealed that since the province began subsidizing CMPA fees in 1987, the cost to taxpayers grew by more than 3,200 per cent. Three years ago, taxpayers footed 81 per cent of the total bill, or more than $200 million.
Goudge wrote that more than 80 per cent of public complaints are disposed of “either as ‘no action’ or by way of advice to physicians.” Despite that, the college is compelled to investigate them.
The college’s Inquiries, Complaints and Reports Committee is legally obliged to dispose of complaints within 150 days but that “deadline is not met on many occasions,” Goudge wrote, noting that the median length of time is 200 days.
Goudge said Alberta’s college is much more efficient and recommended that the Ontario college follow its lead by creating the position of “complaints director.”
That individual could conduct early reviews of public complaints and be given the power to approve the withdrawal of a complaint by the complainant or dismiss a complaint outright where satisfied there is no reasonable prospect of an outcome other than no action. Patients would have a right to appeal in cases where their complaints have been dismissed. Goudge recommended the college create a “patient advocate” position. This individual would interact with patients as soon as complaints are filed.
Goudge also urged that a new alternative dispute resolutions process be created.
His report was met with alarm by prominent medical malpractice lawyer Paul Harte, one of the most outspoken critics of the health regulatory system.
“Members of the public, the courts and the government have all expressed concern with the adequacy of physician oversight. This report recommends limiting investigations and complainant appeal rights in an effort to save money. The government should be focused on rebuilding public confidence in the College, not saving money at the risk of public safety,” Harte said.
Laura Gallant, spokesperson for Health Minister Helen Jaczek, said the province is taking Goudge’s recommendations into consideration as it modernizes oversight of the health-care workforce.