College of Physicians and Surgeons of Ontario
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The college issues certificates of registration for all doctors to allow them to practise medicine as well as: monitors and maintains standards of practice via assessment and remediation, investigates complaints against doctors, and disciplines those found guilty of professional misconduct and/or incompetence.
Structure and mission
The College of Physicians and Surgeons of Ontario (CPSO) is the self-regulating body for the province's medical profession. The College regulates the practice of medicine to protect and serve the public interest. It issues certificates of registration to doctors to allow them to practise medicine, monitors and maintains standards of practice through peer assessment and remediation, investigates complaints against doctors on behalf of the public, and disciplines doctors who may have committed an act of professional misconduct or incompetence.
The medical profession has been granted a great degree of authority by provincial law, and that authority is exercised through the College. This system of self-regulation is based on the premise that the College must act first and foremost in the interest of the public. All doctors in Ontario must be members of the College in order to practise medicine in the province. The role of the College, as well as its authority and powers, are set out in the Regulated Health Professions Act (RHPA), the Health Professions Procedural Code under the RHPA and the Medicine Act.
The duties of the College include: issuing certificates of registration to doctors to allow them to practise medicine monitoring and maintaining standards of practice through peer assessment and remediation investigating complaints about doctors on behalf of the public, and conducting discipline hearings when doctors may have committed an act of professional misconduct or incompetence.
The College is governed by a council. The RHPA stipulates that it consist of at least 32 and no more than 34 members: 16 physicians elected by their peers on a geographical basis every three years; 3 physicians appointed from among the six faculties of medicine (at the University of Western Ontario, McMaster University, University of Toronto, Queen's University, University of Ottawa, and the Northern Ontario School of Medicine); no fewer than 13 and no more than 15 non-physician or 'public' members appointed by the provincial government for terms decided by the government.
Both medical faculty members and public members may be re-appointed at the end of their terms. The College President is elected from and by Council and serves a one-year term.
Council members sit on one or more committees of the College. Each committee has specific functions, most of which are governed by provincial legislation.
General Council meetings are held four times a year, at which time the activities of the College are reviewed and matters of general policy are debated and voted on.
Meetings of Council are open to the public and are held in the 3rd floor Council Chamber at 80 College Street, Toronto, Ontario.
In October 2008, the College was named one of "Canada's Top 100 Employers" by Mediacorp Canada Inc., and was featured in Maclean's newsmagazine. Later that month, the College was also named one of Greater Toronto's Top Employers, which was announced by the Toronto Star newspaper.
The complaints process regarding physicians begins with a phone call to the Public Advisory Department at 416-967-2603 or 1-800-268-7096, extension 603. A College staff member in the Investigations and Resolutions Department experienced in health care will help the caller. Staff may be able to answer questions about care, clarify which questions to take back to one's doctor, and/or answer questions about how the health care system works. The caller's medical records may be reviewed and a discussion with the doctor in question will be scheduled. Staff will ask the doctor for a response.
College staff may also arrange to meet with the individual who initiates the complaints process, and possibly with this individual and the doctor(s) – perhaps even hospital administrators – to communicate and clarify issues. This gives the individual who initiates the complaints process the opportunity to tell the doctor and others about any concerns.
This process provides a forum for individuals to have their concerns heard and acknowledged by the doctor and/or hospital representatives, and is done only with both the patient and the doctor’s agreement. Occasionally, an improvement to the way in which health care is delivered has come about as a result of these discussions.
Criticisms associated with the college
Since 2007, the College had issued more than 1,000 "cautions" against practicing doctors. Cautions are issued to doctors for transgressions that include providing inadequate treatment, poor record-keeping and raising voices in arguments. However, the college has been criticized in the past for not being transparent to patients as to which doctors have been subject to cautions. The college has been criticized for being more interested in protecting doctors than patients.
Since 2004, the College has prosecuted four physicians with improperly blocking fees, which the College considered professional misconduct.
Most recently in 2012, the College has forced Dr. Dockrill — a former head of neo-natal care at Ontario’s Lakeridge Hospital - to lose not only her home and clinical practice, but also hundreds of thousands of dollars defending her actions of charging a concierge fee for services not covered by ohip. CPSO's actions caused her to leave her own country of Canada to practice in Buffalo, NY. The college has been criticized for squelching entrepreneurial innovation needed in healthcare, where the CPSO sees all practice of medicine as a commodity.
The "Transparency Project"
In 2013, in response to some of the above criticisms, the College announced that it would begin its "Transparency Project". The goal of the Transparency Project would be to make it easier for patients to gain more information about doctors who have been accused of wrongdoing. The College Council gave its support to a transparency initiative that had four categories. One, an increase in the transparency of the transfer of patient medical records. Two, a proposal that the Notices of Hearing for the College's Discipline Proceedings be posted to a physician's profile on the public register. Third, a proposal that the status of discipline matters as they are proceeding be added to a physician's profile on the public register. Fourth, that reinstatement decisions in their entirety be posted to a physician's profile on the public register.
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- Armstrong, Laura (September 18, 2014). "Mississauga doctor sees male-only patients after sexual abuse discipline". Toronto Star. Retrieved October 7, 2014.
- "Reasons for Selection, 2009 Canada's Top 100 Employers Competition".
- Boyle, Theresa (July 2, 2013). "College of Physicians and Surgeons wants more transparency about doctor discipline". Toronto Star. Retrieved October 7, 2014.
- (PDF) http://www.markcardwell.ca/wp-content/uploads/2013/05/MP-Ont.-doc-fights-CPSO-Oct.-4-2011.pdf. Missing or empty
- http://news.nationalpost.com/news/canada/ontario-doctor-to-leave-country-after-financially-devastating-battle-with-ontario-college-of-physicians. Missing or empty
- College of Physicians and Surgeons of Ontario - Official web site of the CPSO.
- College of Physicians and Surgeons - Provincial Offices