College of Physicians and Surgeons wants more transparency

College of Physicians and Surgeons wants more transparency about doctor discipline
A "transparency project" aimed at giving patients more information about their doctors may result in more specific details on its website.

Ontario’s medical watchdog, long criticized as being more interested in protecting doctors than patients, wants to be more transparent.

The College of Physicians and Surgeons of Ontario is considering a proposal that would make it easier for patients to get more information about doctors accused of wrongdoing.

As part of a “transparency project,” it may even look at making public the “cautions” issued to doctors for transgressions such as providing inadequate treatment, poor record-keeping and raising their voices in arguments.

A Star investigation earlier this year revealed the college has issued more than 1,000 such cautions since 2007, but patients have no way of learning whether their doctors have been the subject of any.

The “transparency project” has its roots in a decision taken last summer by the college’s governing council to make more information publicly available.

“Providing access to additional physician-specific information may assist the public in making informed choices about which physician or facility to seek care from. In addition, increasing the amount and availability of physician-specific information may improve accountability to the public and/or improve public protections,” explained college spokesperson Kathryn Clarke.

Regulatory colleges for other health professionals in the province are looking at following the College’s lead.

Organizations representing doctors are opposed to some proposals under consideration, arguing they could hurt physicians’ reputations.

And lawyers representing patients in malpractice cases are mystified as to why the college did not seek out their opinions in a public consultation on phase one of the transparency project, which wrapped up in early June.

“The CPSO gives far greater consideration to the interests of the doctors that it is supposed to police than the public it is supposed to protect, with the result that patient safety is frequently neglected,” charged malpractice lawyer Paul Harte.

The College plans to decide in September whether to amend its bylaws so that it can post on its website cpso.on.ca a notice of hearings on discipline cases for allegations that include sexual abuse of patients, incompetence and fraud. (Confidential patient information is always redacted.)

These notices are already in the public domain, but access must be formally requested. Only brief summaries of the cases are posted on the college’s website.

Also in September, the college will decide whether to post on its website:
Reinstatement decisions, in cases where doctors have successfully reapplied for medical licences after losing them for a period due to wrongdoing.
Hearing status of disciplinary proceedings.
Location of medical records of patients whose doctors have retired, moved, lost their licences or died.

Phase 2 of the transparency project, which gets underway in earnest early next year, will be even more controversial. Information the College may make publicly available “may include” any cautions, criminal convictions, bail conditions, findings of regulatory bodies in other jurisdictions where doctors have worked, and details on doctors who are also licensed to work in other jurisdictions, Clarke said.

Many dynamics have led to the transparency project, according to a December briefing note from the college’s governing council:

“There are likely a number of factors that have contributed to the recent increased focus on transparency in the public sector both in Ontario and around the world. One factor may be the rapid pace and accessible nature of modern communications …. Another contributing factor could be recent high-profile public sector scandals, which have fostered dissatisfaction with closed-door modes of governance.”

The Ontario Medical Association and the Canadian Medical Protective Association, an organization that defends doctors in malpractice cases, are concerned that publicly posting notices of hearings on the college’s website could unfairly prejudice physicians.

In a written submission, the OMA argues that details of allegations should remain confidential until after a discipline committee determines whether a doctor is guilty. Meantime, the limited number of people who know about a case can always make a formal request for a copy of the notice of hearing.

“This process prevents ‘fishing’ for information on the public register by prospective patients, the media or others,” the OMA writes.

The CMPA is also opposed to full reinstatement decisions being posted online, arguing that this would serve no public purpose and could again be prejudicial. The College website currently posts only brief summaries of decisions when it reinstates doctors who had lost their licences.

“The decisions may include personal information about the physician, such as the fact that she/he has attended addictions counselling,” the CMPA writes.

Lawyer Amani Oakley is angry that medical malpractice lawyers — a subgroup of the Ontario Trial Lawyers Association — were not invited to participate in the consultation. Lawyers contacted by the Star weren’t even aware of the transparency project.

_{Source:  By: Theresa Boyle Health, Published on Tue Jul 02 2013 thestar.com}