The Ontario Hospital Association has taken a welcome step in holding health care professionals to account and providing more administrative transparency
Jul 29, 2014
Doctors and other health care professionals
who are the subjects of official complaints continue to work without
their patients being remotely aware that they may be at risk.
This is the product of a tradition of
secrecy in the medical profession that does more to protect the
reputations of doctors than the well-being of patients.
An example? The Toronto Star recently discovered
that the chief of staff at Humber River Hospital, Dr. Jack Barkin, had
been given an “oral caution” by the College of Physicians and Surgeons
of Ontario (CPSO) after the death of a patient – and has a “previous
history where the college has taken action with respect to prior
clinical complaints.”
Details of the caution came to light only
after the family of the patient, Michael Green, shared the college’s
decision with the Star. (What the “prior clinical complaints” involved
still isn’t public.)
Green died after a minor, elective surgical
procedure, which Barkin had gone ahead with despite the fact that his
patient’s heart was beating irregularly before surgery. (Barkin has
since gone on medical leave and not reapplied for his job as chief of
staff.)
Now the Ontario Hospital Association has
taken a welcome step in holding health care professionals to account and
providing some administrative transparency.
As reported by the Star’s Theresa Boyle, the OHA
is asking all associations regulating medical professionals to turn
over information on complaints made against their members by the public.
At present, health professionals are
required to report to hospitals only when their regulating colleges
actually take action against them in response to complaints.
This policy is ripe for abuse: the
professional may not ever inform the hospital administration, as the
CPSO itself acknowledges. As well, it’s important that the hospital know
of complaints when they occur so it can take steps to protect patients.
This is especially true if the complaints process is drawn out. “Access
to this information is necessary in protecting patients, and ensuring
quality of care,” the hospital association noted.
While the association’s request is laudatory, it doesn’t go far enough.
Even when doctors do report disciplinary
actions to hospitals there is no mechanism for that information to be
made public.
More welcome, then, is the CPSO’s
“transparency project,” aimed at giving patients more information about
their doctors.
For example, the CPSO is currently
considering whether it should be posting on its public online register
whether doctors have received cautions or been ordered to take
continuing education courses. More shockingly, it’s also debating
whether it should reveal when doctors have signed undertakings to cease
practicing or to abide by restrictions on their practice.
It’s even investigating whether it should
reveal on its public register whether physicians have criminal records
or bail conditions that are relevant to the practice of medicine.
The college’s transparency project was
launched in recognition of the lack of balance between public reporting
and physician privacy. Clearly, it’s long overdue.
One of its first steps was making public the
results of inspections of “out-of-hospital-premises,” such as private
colonoscopy and cosmetic surgery clinics. Previously, the college did
not publicly identify clinics that failed inspections.
Still, in the last two years the college has
imposed 619 cautions, most of them resulting from public complaints.
They are still secret.
While the moves by the hospital association
and the college of physicians and surgeons are welcome, there’s a long
way to go to ensure adequate transparency.
Professional colleges, hospitals,
administrators and doctors must put a higher priority on a more open,
accountable system. Patients’ lives and well-being are at stake.
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