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.