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College of Physicians and Surgeons of Ontario

Regulating MDs:  The Complaint Process, Discipline,
and Screening for Fitness to Practice

CPSO Disclosure Policy

The Regulated Health Professions Act (RHPA) states the College shall maintain a list of the medical doctors authorized to practise medicine in Ontario. The RHPA and the College by-laws specify what data about each doctor is to be recorded and made available to the public. This is called the Public Register.

The Public Register keeps a record of each MD's qualifications including medical degree, postgraduate training, and broad specialty designation. The Register does not keep on file the MD's scope of practice, particular areas of interest or expertise, or whether the MD performs a given procedure.

The Public Register also notes the terms, conditions and limitations on each physician's certificate of registration. This includes information about current allegations or previous findings of professional misconduct, incompetence, or incapacity. Sources of this data are:

Discipline Committee
Investigates professional misconduct or incompetence.

Fitness to Practise Committee
Investigates incapacity.

Inquiries, Complaints and Reports Committee
Can impose an interim order on the physician after it has referred a complaint to one of the committees above. Interim orders will appear on the Public Register for as long as they remain in force.

The Public Register can be accessed at any time by visiting the Doctor Search page on the College website, or by contacting the College during business hours.

Discipline & Fitness to Practice Information

On the Ontario College site, use the All Doctors Search page to locate archived disciplinary decisions. Scroll to the end of the page to the oblong box titled Discipline & Fitness to Practice Information. Select either current or past records – choose one at a time as they give different results depending on whether an inquiry is underway or has already been completed. You can also select the Registration Status from among three options: Active physicians, Inactive physicians, or All physicians.

Criminal Record Screening of Physicians

The Ontario College is aware that the results of a criminal record screen are not predictive of future behavior, and cannot guarantee good character in a physician nor whether he or she might pose a future safety risk. The College endorses the criminal record screening policy as part of its efforts to promote safety in the health care environment.

All Ontario MDs must submit to a criminal record screen as a requirement of registration and in order to maintain the right to practise medicine in Ontario. Screening is repeated at set intervals for each MD. The screen is accomplished by running a criminal record check against the Canadian Police Information Centre (CPIC) computerized database.

Positive findings from the criminal record screen will be considered for further action by the College based on the following criteria:

  • Recency of the conviction;
  • Seriousness of the offence; and
  • Relevance of the details of the offence to the practice of medicine.

Managing Disruptive Physician Behavior

Definition of disruptive physician behavior: Inappropriate words, actions, or inactions which interfere with delivery of care. It may comprise a single egregious act, or several events demonstrative of a pattern. Included are rudeness, outbursts of anger, arguing with patients or their family, bullying, insensitive comments, gratuitous jokes, repeated refusal of requests for information, defying instructions, creating inflexible barriers to assistance, and boundary violations.

Causes: the disruptive behavior may have been learned through poor role models and then entrenched through habit. It may be a response to a thorny or unhealthy work environment, or the MD may have physical or mental health issues (the latter should especially be considered if the behavior is new). The gravity depends on the nature of the behavior, the context, and the consequences flowing from it. The College disciplines serious cases under the heading professional misconduct.

Health Record Privacy and Amendment

Provincial and Federal Legislation

Federal
Level
PIPEDA Personal Information Protection and Electronic Documents Act
This privacy law covers private-sector commercial organizations, including medical clinics and physicians in private practice.
Privacy Act Privacy Act
This privacy law relates to an individual's right to access and correct personal information the Government of Canada holds about them.
Provincial
Level
HIPA Health Information Protection Act
This legislation, locally enacted by each province, governs the trustees of health records.

The federal PIPEDA law governs private-sector organizations engaged in commercial activities across Canada. It sets down clear rules for how these organizations may collect, use, or disclose personal information, and guarantees concrete avenues for amending flawed information. PIPEDA applies to medical clinics and physicians in private practice.

Some provinces have HIPA legislation that, on inspection, is deemed substantially similar to the health-records subset of PIPEDA.  An organization that operates solely within such a province will be exempt from PIPEDA, unless the personal information crosses provincial or national borders.

But more than half the provinces and territories have HIPA legislation which is not substantially similar to PIPEDA. In such provinces, an application to PIPEDA may succeed.

Ontario is a compliant province: Its local HIPA legislation offers a realistic protection of health records, which is deemed substantially similar to PIPEDA. The Office of the Privacy Commissioner of Canada oversees compliance with PIPEDA.

Georgena S. Sil
Saskatoon, Canada
Physicist & Technical Writer
Alumnus: University of British Columbia

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