Dental regulator fights back at critics
Industry watchdog has used threats of legal action, repercussions to combat those who have spoken out over how it operates In 2017, the Star reported allegations of a “toxic culture” at the dental college.
Describing a toxic work environment fuelled by bullying and favouritism, more than two dozen current and former staff and executives of the province’s dental regulator have been waging a quiet war against their leadership.
In response, lawyers for the Royal College of Dental Surgeons of Ontario and its top executive — registrar Irwin Fefergrad — have issued letters threatening legal action and promises of repercussions. In recent months, the college has also launched an internal investigation seeking to identify employees they suspect have leaked documents to the Toronto Star.
That investigation has targeted one former employee with threats of legal action should he not cooperate with college lawyers. The man, who left the college last year, was blindsided and says the ordeal is “affecting my work life, my personal life, my health.” The former college employee — who has not provided documents to the Star — has hired a lawyer.
Over the past year, the Star has obtained internal college documents and letters and interviewed current and former employees and board members of the college who allege secrecy surrounding the college’s finances, conflict of interest and abusive treatment of staff.
A former senior executive at the college filed a $1-million wrongful dismissal lawsuit last year that also cited bully- ing behaviour.
Lawyers for the college — which is mandated by the government to regulate Ontario’s 10,000 dentists including investigating public complaints — have denied any wrongdoing by the college in a series of written statements since May and warned of legal action should the Star publish the allegations.
“The college takes seriously the spreading and publication of false and defamatory information,” reads a written statement to the Star Friday from college lawyer Linda Rothstein with the law firm Paliare Roland.
“We reiterate our concerns about the veracity of the information you have received, the motivation of the individuals providing it to you, and the legal implications to you and the Toronto Star in publishing that information, or opinion based on that information.”
Fefergrad, a lawyer, was appointed college registrar 18 years ago.
He had a salary rate of $607,497 in 2017, according to documents obtained by the Star. He declined requests to be interviewed, referring all questions to the college’s lawyers.
The college’s lawyers have issued warnings to critics, threatening defamation suits for public statements that question college leadership.
“In my opinion, Irwin Fefergrad goes to great pains and uses his extensive legal resources and connections to resist change and deflect reasonable, legitimate questions,” says Natalie Archer, a Toronto dentist and former college executive council member who has been publicly critical of the college. “In my opinion, the college has a history of threatening to sue dentists and anyone who questions them. This has been very effective.”
In 2013, Archer, former college president Dr. Tom McKean and dentist Dr. Dick Jones received libel notices from college lawyers after being quoted in the London Free Press criticizing the college’s controversial inhouse insurance arm. They alleged the arrangement (which is unique among medical colleges) represents a conflict of interest because the college both disciplines and insures dentists.
Beginning in September of last year and continuing into this year, 20 current and former staff and former executive council members sent letters to the provincial health ministry and MPPs alleging a “culture of hostility” within the college that presents “serious repercussions for the (college’s) ability to protect the public,” including preventing staff “from responding to patient complaints in a timely manner.”
In February, NDP Leader Andrea Horwath wrote to then premier Kathleen Wynne and health minister Eric Hoskins urging them to take “immediate action to investigate these serious allegations.”
Horwath’s press secretary confirmed there was no response to the letter.
The college’s annual legal bills have risen from about $672,000 in 2012 to more than $1 million this year as of Sept. 30 — a rise that has exceeded projections the past two years, according to college records.
In Friday’s written response, the college said rising legal expenditures were related to an increase in college members, the complexity of issues coming before its committees and the costs of investigations and proceedings against dentists.
Legal costs have exceeded budget in the past two years, the response said, because of “unforseen civil litigation costs” including defending a “significant civil action” and investigating a “potential breach of confidentiality.”
In a letter sent Sept. 17 to the former employee at the centre of that investigation, college lawyers ask him to voluntarily meet with them or “we will ask a court for assistance if you are unwilling to co-operate.”
The man worked for the college for several years and left a little more than a year ago. “When I left the college, I thought I was leaving behind all of their antics, politics and what they do there.” He is speaking on condition of anonymity for fear of compromising his current job.
“I thought I was turning over a new page … More than a year later, they’re accusing me of these things. It was shock, disbelief.” The letter reads: “We have reason to believe that the breach occurred during the period of time that you were an employee of the college, and furthermore, that you are one of certain former college employees who might have information that could assist us in identifying the person or persons who are responsible for the breach.”
Attached to the letter is a draft notice of application that col- lege lawyers said was ready for submission to court. It asks a judge to require the man to identify “every person to whom he provided the confidential documents” during his employment, along with the “particulars of the occasions on which he provided those documents and/or information, including the date and the method by which they were provided.”
Citing “circumstantial evidence,” the draft notice of application says the former employee “may be involved in, or have documents or information relating to, the theft of the Star documents from the college.”
It also asks for a court order permitting a forensic examination of his electronic devices — computers, mobile phones, tablets, hard drives and USB memory drives — on which “confidential documents are or were at one point stored.”
The application names the Toronto Star and two Star reporters, saying they provided the college with copies of documents — internal college emails, Fefergrad’s calendar entries, expense claims and regulatory records — upon which they based questions during reporting.
The reporters “refused to identify the source or sources,” the draft reads.
The man says he has repeatedly denied through his lawyer that he is the source of the leak.
“It’s had a profound effect on me that I didn’t know stress could have on the human body. It’s a devastating blow to basically have an employer make those types of allegations and come after you when there’s no tangible or real evidence. It’s based on hearsay. They’re turning lives upside down,” he said.
The “circumstantial evidence” includes allegations that the former employee was passed over for a promotion several months before he left the college and that he became “disgruntled.”
The man says he left the college because of a poisonous work environment where bullying is rewarded with promotions and those who speak out face reprisals.
“I spoke out against my own manager and I paid the price for it,” he says. “They’re spinning it back on me. We were all walking on eggshells, worried and stressed because that was the environment there … I just couldn’t take it anymore.”
In the Friday response to the Star, Rothstein said the college does not “target” individuals.
“The college investigates all allegations against it and its employees and council members seriously, regardless of the source ... The college also takes carefully considered, appropriate and measured steps to mitigate the harm done by the spreading of false and defamatory information, particularly when that conduct appears to be ill-motivated. This may involve the delivery of a libel notice.”
The college sent three separate letters threatening libel suits to Archer, Jones and McKean in October 2013 in response to their comments in the London Free Press. The letters alleged published comments by the three dentists — two of them former executive council members — were “false, misleading and patently defamatory” of Fefergrad and the college.
The college demanded written apologies and retractions of their statements “in a form satisfactory to us.”
Jones refused and, in a sixpage response, dismissed the college’s claims as “frivolous, vexatious and without merit.”
In a recent interview, Jones, a Waterloo-area dentist, said he, Archer and McKean were “bullied for simply expressing our legitimate concerns” about Fefergrad’s leadership.
“It’s a toxic situation that’s gone on for far too long.”
The libel notices to Archer and McKean were the second each had received within two years after they had made comments critical of the college.
“Dr. Archer regards your communication as a wholly unreasonable personal attack made in the face of legitimate and necessary criticism,” reads the response from her lawyer. “Moreover, threatening to take legal action on notice of one business day hardly seems like notice at all.”
The college never pursued legal action against any of the three.
In an interview, Archer said her attempts to raise concerns about Fefergrad’s management during her six years on the college council were met with “hostility, attacks and the most inhumane, unprofessional behaviour and tactics I have ever been exposed to.”
In October 2017, 16 current and former college staff anonymously wrote to Hoskins, then provincial health minister, asking for the ministry to appoint a supervisor to oversee the college because of “serious systemic problems,” including a “toxic culture” that included sexual harassment in the workplace, “abuse of power” and a “failure to protect the public.”
“We have reached the conclusion that the deficiencies in the (college) cannot be fixed under the present leadership or within the current system,” it reads.
In a response to questions from the Star in June, the college “cautions the Toronto Star about publishing any of the anonymous, speculative and factually untrue allegations contained in the anonymous letter.”
In December 2017, Archer also wrote Hoskins alleging “financial mismanagement,” conflict of interest in the college’s dual role as disciplinary body and malpractice insurance provider, and “interference in the regulatory processes” by Fefergrad who, she alleged, “inserted himself into (disciplinary) panel deliberations.”
Archer wrote that during her time on college council as vicepresident and member of the finance committee, her requests for detailed information about major expenditures were routinely refused.
“I observed very significant legal expenses,” she wrote, including large budget items for which she sought greater detail. “The request was rebuffed ... A forensic audit must be conducted to identify and remedy any fiscal oversight issues at the (college).”
A written statement from the college to the Star in July says Archer is “actuated by malice in the defamatory statements she makes about the college, its employees and its council members.”
The ministry never responded to the letters, the authors say.
Also last year, the former head of the college’s insurance arm, Rene Brewer, filed a $1-million wrongful dismissal suit against Fefergrad and the college alleging a “systemic culture of harassment and workplace bully- ing,” conflict of interest and sexual harassment toward staff.
In a statement of defence, the college and Fefergrad cited Brewer’s “abusive management style” as cause for her firing and said her “false and reckless” allegations have “maliciously and vindictively” impugned their integrity.
The dispute remains before the courts and none of the allegations have been proven.
The Star investigation has found other examples of swift college response to public criticism.
Marco Caminiti, a prominent Toronto oral surgeon, strongly criticized the college’s online self-assessment tests in a June 2016 opinion piece published in a dentistry magazine.
“Even our great regulators, the Colleges, fall short in assessing our competencies. The farcical attempts to ensure practitioners are up to date and ‘educated’ using online competency exams … highlights our ignorance even more,” Caminiti, who was then president of the Ontario Society of Oral and Maxillofacial Surgeons, wrote. “Unbeknownst to them, they are, to a certain extent, allowing and enabling the incompetency of some of our colleagues to grow and fester, creating a dark stain on this great profession.”
The tests are composed of about 200 multiple choice and case study questions. Virtually every dentist who takes the assessment is successful on their first attempt.
In an email exchange with Fefergrad, obtained by the Star, the college’s then quality assurance manager Michael Gardner writes: “Did you see Marco Caminiti’s editorial in the most recent issue of Oral Health? He called the College’s assessment farcical.”
Fefergrad says he had not read it. He then writes 11 minutes later: “Pisses me off to no end.”
In a June 2018 written statement to the Star, college lawyers said Fefergrad “endeavours to maintain open and courteous dialogue with (dental) associations and their leadership. (His) response to the criticism in respect of the Oral Health article was made in that spirit and was resolved amicably.”
In an interview, Caminiti said he received a call from Fefergrad about the opinion piece.
“Irwin was very succinct in his discussion with me about the article that I wrote, he was not pleased with the comments,” Caminiti said, adding that he stands by what he said in the opinion piece.
“Irwin Fefergrad goes to great pains and uses his extensive legal resources and connections to resist change and deflect reasonable, legitimate questions. In my opinion, the college has a history of threatening to sue dentists and anyone who questions them. This has been very effective.” NATALIE ARCHER TORONTO DENTIST, AND FORMER COLLEGE EXECUTIVE COUNCIL MEMBER