Putting patient safety first

Ontario’s medical watchdog has endangered patient health by operating for far too long — and far too often — in secret when it is disciplining doctors who make mistakes or behave improperly.

Indeed, critics have accused the College of Physicians and Surgeons of emphasizing doctors’ reputations and privacy over patient safety.

Now after three years of study under its “transparency project,” the college has lifted the veil of secrecy on one of its disciplinary actions and increased the information it will make available to the public about doctors’ past run-ins with authorities. It’s also taking steps to protect patients from being sexually assaulted by their doctors. Under its new and welcome transparency bylaws the college will: Post information on its website about doctors who receive “oral cautions” from the college after running into trouble with the regulator. The verbal warnings deal with serious issues such as improper communication with patients, lack of timely referrals and errors in prescribing medication.

Let the public know if doctors face criminal charges, have been ordered to take remedial education, or have been disciplined in other jurisdictions.

These are welcome actions, as far as they go. But the college still has a long way to go to put the priority on transparency and patient safety rather than secrecy.

Most significantly, the college is still not making all confidential agreements, called “undertakings,” public. These are backroom deals involving significant restrictions placed on doctors in cases where the public is deemed to be at “risk.”

Nor did the college decide to make public written warnings, which deal with less severe transgressions than oral warnings. (The college deals with the most serious allegations against doctors through public disciplinary hearings.)

Still, the college should be congratulated for taking a separate significant step last week to protect patients from being sexually assaulted by their doctors.

The college asked the province to change the Regulated Health Professions Act so that it requires the “mandatory revocation” of doctors’ licences in all cases of “physical sexual contact” with patients.

The legislation, which is under review, now mandates the revocation of doctors’ licences only if they have engaged in one of five acts: sexual intercourse, oral-to-genital contact, genital-to-genital contact, genital-to-anal contact and masturbation.

That led to some doctors keeping their licences even after they had engaged in other sexual acts with their patients. For example, a male doctor, Sastri Maharajh, who confessed to placing his mouth or resting his cheek on the breasts of as many as 13 female patients, was allowed to keep practising. If the college’s recommendation to the province is acted on, a doctor such as Maharajh would automatically lose his licence.

And there was more. The college says it is also considering whether to share with police information about doctors who may have committed crimes. Up until now it won’t even say whether it has reported cases, such as that of Maharajh, to police.

With its bylaw changes last week to increase transparency and its request for changes to the Regulated Health Professions Act, the college has come a long way toward making patient safety, rather than doctors’ reputations, its top priority. But it still has a long way to go.

The College of Physicians and Surgeons has finally lifted the veil of secrecy on one of its disciplinary actions and increased the information it will make available to the public