Oversight of doctors needs more transparency, says P.E.I. Status of Women
'More transparency would build trust in the system between patients and the physicians'
More transparency is needed from the group that disciplines physicians on the Island, says the head of the P.E.I. Advisory Council on the Status of Women.
The group, which lobbies for women's issues on P.E.I., said the details of why physicians are sanctioned should be available to the public.
The onus shouldn't be on members of the public to seek out the information and to ask for it to be addressed.— Jane Ledwell, P.E.I. Advisory Council on the Status of Women
"I think it's really important for people to have a true account of what occurred and the disciplinary action taken," said executive director Jane Ledwell.
"More transparency would build trust in the system between patients and the physicians and surgeons."
Ledwell was reacting to a special CBC News investigation this week into how physicians in Canada are disciplined and what oversight there is to protect and inform the public.
- Breaching Boundaries: Disciplined physicians often given 2nd chance to practise
- Getting a second chance: 12 doctors who have been disciplined more than once
In each Canadian province, colleges of physicians and surgeons are responsible for regulating, licensing and disciplining doctors. The CBC investigation points to an unevenness in transparency by colleges across the country.
On the P.E.I. college website for example, basic information is posted when disciplinary action is taken. On the Ontario College site, there are full details of upcoming hearings, allegations, and files on disciplinary decisions.
'Shouldn't be up to people to protect themselves'
Across the country, Ledwell said, colleges face similar issues. She believes standard information should be available through a national database so people can discover whether a physician has been disciplined not just in their home province, but in any other Canadian jurisdiction.
"We need exactly this sort of national co-ordination so that patient safety can come first. And so when there has been inappropriate professional misconduct or if there have been even criminal activities by a doctor, that they can't move easily from jurisdiction to jurisdiction," said Ledwell.
"The onus shouldn't be on members of the public to seek out the information and to ask for it to be addressed, it shouldn't be up to people to protect themselves at all levels."
Few details available to P.E.I. public
On P.E.I. the college must, by law, inform the public when a doctor's license is restricted, suspended or revoked but it provides only a summary of the reasons on its website. Six physicians were disciplined by the college between 2000 and 2014.
The P.E.I. college told CBC News it investigated 36 complaints in 2015 and 33 the year previous.
The most notorious case of physician misconduct in recent P.E.I. history is that of Dr. Douglas Ian Cameron. The Summerside doctor lost his license in 1995 for sexual misconduct.
His licence was reinstated the next year with conditions, but it was revoked again for 10 years in 2007 for sexual abuse. Cameron was accused by two female patients of grabbing their breasts during visits to his office. A board of inquiry found him guilty of one count of sexual abuse and two counts of professional misconduct for failing to have a chaperone present during those visits.
The college's website never detailed the reasons for its findings. However, legislation in P.E.I. defines sexual abuse by a physician as "any sort of sexual conduct by a member toward or with a patient, at any time during which the person is considered to be a patient," whether it is a remark, gesture, touching, intercourse or any other behaviour of a sexual nature.
We are guided by determining what the public needs to know in the interest of public safety.— P.E.I. College of Physicians and Surgeons
The CBC requested an interview with the college about transparency. However, an official told CBC the registrar was too busy.
"This is a significant lack of transparency," said Ledwell. "If it's so challenging to provide that information to a national media organization, we can imagine the challenges and the vulnerability of ordinary citizens in trying to access information about a doctor's records."
More transparency would increase confidence by Islanders that their safety is the primary concern of the College and that any complaints they may have will be addressed, said Ledwell. Information on patient rights and where they can go to ask questions should be available in doctors' offices and medical clinics, she added.
The process to lodge a complaint is available on the P.E.I. college's website.
The Federation of Medical Regulatory Authorities of Canada sent a survey about transparency to all provincial colleges for the CBC investigation, which asked the colleges if they intend to address the need for more transparency.
"We are guided by determining what the public needs to know in the interest of public safety," the P.E.I. college responded in writing.
The college has been criticized in the past for being too secretive, while the college said it has wrestled with balancing public safety with privacy concerns.
Go public, says task force chair
A task force on preventing sexual abuse of patients was set up in 2014 by Ontario's Health minister to review that province's Regulated Health Professions Act. It will likely issue its report sometime this year.
""There should be transparency, there should be public information, there should be access to this information and it should be facilitated. It should not be at the discretion of the regulatory bodies," said task force chair and human rights lawyer Marilou McPhedran.
Governments and colleges across Canada need to show that patient safety is their primary concern, said McPhedran, and should make all disciplinary hearings public.
There is nothing in the P.E.I. Medical Act that requires disciplinary hearings to be open to the public.
Recent changes to the Medical Act aim to give the health minister more power over the P.E.I.'s college of physicians and surgeons, according to a spokesperson for P.E.I.'s Health department. The changes include bringing physicians under the Regulated Health Professions Act to standardize licensing and discipline, and requiring cabinet approval for any changes to regulations.
There are 253 practicing physicians on P.E.I., according to the P.E.I. Health department.
The P.E.I. Medical Society, which represents practicing and retired physicians in negotiations with the provincial government, does not handle complaints against physicians. However, the society said it does provide information to anyone who contacts its office about how to file a complaint with the college.