Focus: Colleges ready to disclose more information

The more than two dozen colleges that regulate health professions in Ontario are in the process of making more information about their practitioners available on their public registries within the next few months.

The move to provide more information began with the formation of an advisory group in 2012 by six of the largest colleges. Last fall, provincial Health Minister Eric Hoskins wrote to all of the regulators asking for responses that outlined the specific steps they planned to take to improve transparency.

Since that time, some regulators, such as the College of Pharmacists and the Royal College of Dental Surgeons, have amended their bylaws to implement new measures.
Others, such as the College of Physicians and Surgeons, will be meeting later this spring to vote on proposed changes after its consultation period ends on April 1.

While the pace of implementing the new measures has picked up, what’s not clear is exactly how much more information the colleges will actually disclose under the new policies and how that might affect the disciplinary process.

“I think this is a significant change,” says Lonny Rosen, a partner at Rosen Sunshine LLP in Toronto who specializes in health law.

The first phase of the changes dealt with an agreement to disclose criminal convictions, Health Insurance Act offences, and any bail conditions.

The colleges are now considering more contentious changes under the second phase that would disclose criminal charges, licences in other jurisdictions, and disciplinary findings in other areas to the public. As well, the colleges would also make so-called cautions-in-person and “specified continuing education and remediation program” orders public.

The most recent annual report from the College of Physicians and Surgeons states that of the more than 2,100 complaints reviewed by its inquiries, complaints, and reports committee in 2013, only seven per cent resulted in oral cautions or continuing education orders.

It ordered no action in almost 60 per cent of the cases. Complaints referred to the disciplinary committee made up two per cent of the total.

The college won’t make cautions-in-writing public as part of the proposed changes and they’ll come under the advice or recommendations category, according to spokeswoman Kathryn Clarke. “Not all colleges had, in the past, a caution-in-writing outcome. Work has been underway to bring uniformity to the outcome terminology used by health colleges,” says Clarke.

If the proposed changes had been in place in 2013, the college would have made 80 cautions-in-person and 76 continuing education and remediation orders against doctors public.

While they make up a small percentage of the outcomes, disclosing these orders could alter the disciplinary process, according to Rosen. “It will significantly impact how a professional responds,” he says. A caution isn’t a disciplinary finding but is rather an effort to educate the health professional. “It is not about publicly shaming a member,” says Rosen.

The screening committees may also be more leery of issuing a caution-in-person if the colleges have to make them public.

The push for more transparency is understandable, says Rosen, but he’s not sure all of the changes are necessarily going to improve the regulation of health professionals in the province.

“The fact that the public is interested does not always mean it is in the public interest,” says Rosen.  

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