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Military's physician dearth
a formidable foe
The Canadian Forces' doctor
shortage is severe. The Canadian military has
about half the doctors it needs to serve overseas,
and only two thirds the required number at home.
This makes every doctor a hot commodity and the
loss of a civilian MD like Dr Hanley that much
worse.
To combat the problem. the
Canadian military offers attractive incentives:
licensed doctors who offer their services will
receive a $225,000 signing bonus with a paycheque
ranging between $120,000 and $165,000 annually
in exchange for a four-year enlistment.
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After psychiatrist James Hanley
had his license to practise in Newfoundland and Labrador
suspended in late March for sleeping with a patient,
the College of Physicians and Surgeons of New Brunswick
had to decide whether to allow him to continue to practise.
On the one hand, a psychiatrist had entered into a sexual
relationship with a patient and had to be disciplined.
On the other, the doctor seemed properly contrite and
was providing excellent and much needed services to
the soldiers at CFB Gagetown — at a time when the
Canadian Forces are suffering a severe physician shortage,
not to mention a whole lot of Afghanistan-triggered
shell shock. Does one lapse in judgement justify depriving
hundreds of patients of a physician's assistance?
DOCS
BEHAVING BADLY
In 2003, Dr Hanley began a relationship with Kathleen
Wiseman, a longtime patient suffering from depression
at the time. The psychiatrist had a well-established
practice in Newfoundland and was working part-time at
the military base in New Brunswick. The relationship
ended in 2004, and Dr Hanley's legal troubles began
soon afterwards.
Ms Wiseman filed an official complaint
with the Newfoundland and Labrador College of Physicians
and Surgeons in 2005. Eighteen months passed before
the regulating body scheduled a hearing. During that
interval, Dr Hanley voluntarily withdrew from practice
in Newfoundland. However, he continued working in New
Brunswick — even though he promised the Newfoundland
College he wouldn't.
The New Brunswick College was informed
about the complaint against him, and knew he was working
at CFB Gagetown, but says they didn't have enough evidence
to make a decision before the Newfoundland hearing was
over.
"I'd never heard of a case like
this before, where there had been a voluntary withdrawal,"
admits Dr Ed Schollenberg, registrar of the College
of Physicians and Surgeons of New Brunswick.
Within a week of receiving the
Newfoundland decision in late March to suspend Dr Hanley's
license, the New Brunswick College followed suit. That
decision, Dr Schollenberg points out, is an interim
one and Dr Hanley has the right to appeal.
THE
ARMY TAKES A HIT
With soldiers returning from Afghanistan with post-traumatic
stress disorder and other soldiers facing imminent action,
the need for psychiatrists at CFB Gagetown is overwhelming.
The military has openly criticized the NB College's
decision.
"Everything in life is a trade-off,"
Cdr David Wilcox, Regional Area Surgeon (Atlantic),
explains. "You have to trade-off a theoretical risk
of re-offending, which is remote, with the potential
harm of removing the healthcare provider to 300 people."
According to Cdr Wilcox, who oversees medical services
for the Canadian Forces in the Atlantic provinces, Dr
Hanley's patients were very disappointed to lose his
services and most expressed their support for him.
The military kept Dr Hanley on
as long as they could, and Cdr Wilcox suggests they'd
be more than willing to hire him back if his licence
is reinstated. In fact they knew all about his Newfoundland
troubles before the hearing. "We do risk assessments,"
says Cdr Wilcox. "Dr Hanley had informed us himself
of the complaint, and because there hadn't been any
similar complaints against him and it wasn't a predatory
type of behaviour, we felt it would do more harm to
remove him." Cdr Wilcox insists the decision was not
taken lightly, but points to the fact that Dr Hanley's
patient population was predominantly male and that his
practice at CFB Gagetown was a collaborative one, with
each patient being seen by more than one provider.
DESPERATE
MEASURES
Given the situation, should the New Brunswick College
of Physicians reconsider? "The argument is a valid one,"
Dr Schollenberg concedes. But he maintains that the
College made the right decision: "You have to weigh
the negative impact on innocent people, but at the end
of the day, this sort of conduct from a physician cannot
be accepted."
The ethical questions raised by
this case are still under debate. At the hearing last
March, Dr Hanley himself urged the tribunal to consider
the good he's done and can do in years to come. "He's
shown remorse and has taken ownership for his actions,"
Dr Hanley's lawyer Paul Stokes told the CBC.
As for the military, they're doing
their best to compensate for the loss of Dr Hanley's
work. "The situation has forced us to look more actively
at hiring psychiatrists," says Cdr Wilcox. "We did have
to scramble, but we have found another psychiatrist
and we're beginning to see the light at the end of the
tunnel."
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