Dr Richard Austin's Scarborough
gynecology practice was going just fine, at least as
far as the College of Physicians and Surgeons of Ontario
(CPSO) knew. But then last year, all of a sudden, a
Toronto Star investigation revealed there had
been no less than 14 malpractice lawsuits against him
for surgery screw-ups since 1991 — all of which
had gone unnoticed by the CPSO.
Now, pushed into action by new
legislation, the CPSO is vowing to make sure that it
doesn't miss cases like Dr Austin's again.
Starting this month, Ontario physicians
will have to divulge much more about themselves on their
annual licence renewal forms than they used to be required
to — including a list of all malpractice findings
against them, which will be made public on the CPSO's
website in June 2009.
NEW
CHANGES
Ontario physicians will see four new mandatory questions
on the new licence renewal forms. These ask about malpractice
findings and settlements, criminal offences, changes
in doctors' scopes of practice, and drug and alcohol
abuse problems that aren't currently being treated by
the province's Physician Health Program.
The CPSO says the new changes are
in line with, and even ahead of, the continuing trend
across Canada toward greater disclosure of both personal
and professional information by physicians, and increased
transparency.
Only doctors' malpractice findings
will be made available to the public. "It's public information
so if it's easier for people to find that's a positive
change," says CPSO spokesperson Kathryn Clarke. Answers
to the other questions will be kept private unless they
become part of a College disciplinary hearing later
on.
In reality, however, many of the
changes were at least in part prompted by the Health
System Improvements Act (Bill 171), a set of amendments
to existing healthcare legislation that was introduced
by Health Minister George Smitherman in December 2006
and passed last May. Asked whether the alterations to
the renewal form came about under duress from the government,
Ms Clarke demurs, "It's hard to make a blanket statement."
Some of the changes being added to the renewal form
this year were mandated by Bill 171, like the one about
malpractice findings; others are above and beyond the
questions required by the legislation, like the ones
about malpractice settlements or addictions. In fact,
the CPSO's submission to the government during public
consultations on Bill 171 urged Mr Smitherman to amend
the legislation to be even more expansive in requiring
transparency from health professional regulatory bodies.
PRIVACY
CONCERNS
The new mandatory questions have raised questions of
their own. The CPSO's consultations with members and
other groups, published in February, revealed some confusion
about the changes. "Most of the concerns raised by stakeholders
appeared to be based on a misunderstanding about information
the College is already collecting," the summary read.
The most controversial element
of the new changes may be the requirement to report
addictions. Despite the fact a similar question is already
asked of physicians in Quebec, Nova Scotia and Manitoba,
this aspect of the changes drew criticism from the Ontario
Medical Association (OMA) earlier this year in a submission
to the CPSO. "The OMA wishes to state its strenuous
objection to the overly broad wording... and the intrusive
nature of questions regarding a physician's health,"
said the commentary.
The CPSO plans to add another health-related
question next year asking for doctors' virological status
if their practice puts them at high risk for exposure
to blood borne pathogens, according to Ms Clarke. The
OMA has already said it is "especially concerned."
The OMA's commentary also criticized
the new question about criminal offences, which requires
physicians to report any charges under the Criminal
Code of Canada, the Controlled Drugs and Substances
Act, the Food and Drugs Act or the Health Insurance
Act, in Canada or elsewhere since June 2003. The disclosure
requirements should have been left as they had been,
said the OMA — simply asking doctors to report
any charge "relevant to your suitability to practice
medicine." But the CPSO has gone ahead with the more
specific question.
Feedback from physicians has been
slow in arriving so far but that may change this month.
"We may be getting more calls when physicians receive
the annual renewal forms," Ms Clarke says. They're being
sent out now and are due June 1 along with the $1,200
fee.
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