Ontario docs are leaving – patients have trouble finding good doctors




The more people reporting  to you, the more you’re paid….   At least that’s what is clearly top priority for CPSO’s Rocco Gerace – Registrar. He is only safeguarding his more than generous salary, benefits and pension by creating more work than the various CPSO committees can properly handle. It’s a fact: Investigators for the CPSO continue to be hired but the College has been unable to keep up with investigations for some time now, especially the notorious S.75 investigations.  Docs often immediately have their licenses suspended while they wait for their case to be heard  – waiting time at least a year  –  even if only allegations exist. That’s an awful lot of power for the patient and the College, while the doc can do nothing.  This certainly should discourage a good number of potential medical students. Are Ontario doctors that bad?  Actually, the majority of investigations are about records, nothing serious, and certainly nothing warranting full and extremely expensive S.75 investigations as has been the case for some time. If physicians were to write down everything the College would like them to record, the doctor could see only 7 patients a day.


The OMA (Ontario Medical Organization) recently sent a letter to all docs in Ontario, asking them if they are currently under a S.75 investigation, and if so, how long the process has taken so far. Responses to be returned to  Dr. C. Appleyard in Renfrew (Ontario).  Both OMA and CMPA (Canadian Medical Protective Assocation) express great concern over the extremely costly and very lengthy S.75 investigations affecting large numbers of Ontario physicians.  It does not take much for a physician to find himself at the receiving end of such an investigation. A minor complaint, no matter how ridiculous and sometimes not even related to medicine, is enough to spur the boys and girls at the College into feverish and enthusiastic  action. Concerns which could and should be resolved by short discussion are turned into full-blown S.75 Investigations, lasting at least a year, and often around two years or even longer. Of course in the eyes of the public, the CPSO can do no wrong when their complaint is thus taken “seriously”. The College will even find 25 or so “witnesses” –  patients who, on properly being coaxed by a College Investigator and made to feel ‘important” to the investigation,  are quite willing to find something negative to say about the doc, even if it’s nothing to do with the treatment they received.  It’s of course not the patients the CPSO is concerned about, it’s about staying in business, plain and simple.


Who are victims of a S.75? On the whole they are physicians with a busy practice who are putting in long working days. The docs’ many “peer assessors” (hundreds of them), are poking about in the practices of hard-working docs and learning from them what they can, before reporting minor deficiencies in their records to the College, often resulting in S.75 investigations. Peer assessors don’t have busy practices themselves which immediately significantly reduces the chance of complaints by patients against them. Wouldn’t look too good for the College to subject its own peer assessors to a S.75 investigation anyway. Come to think of it, unless they committed true professional misconduct, being a peer assessor would provide certain immunity against an Investigation as they would not be held to the same impossibly high standards set for their physician colleagues in the field. Let’s face it, being a “peer assessor” is being part of a network which guarantees certain “benefits”, just as any other network does. Peer assessors have nothing to recommend them over their colleagues who are busy being physicians and treating patients. Peer assessors have not had to take any exam to qualify as peer assessor. Heck, they need only volunteer. You’ll see many young docs, recently graduated who are in the business of policing their much older more experienced colleagues with established practices. Sure pays to start young and inexperienced. Of course, making close to $1000/day (including traveling expenses) “assessing” a colleague is attractive, as is the fact that they can learn from more experienced colleagues while stabbing them in the back with criticism to the College at the end of the assessment.    The smell of “fear” from the “assessee” is nothing to sniff at either.  Another nice “side-effect” is there is little chance for the assessor to be assessed when he/she has only a “skimpy” practice and is busy doing unto others………    Naturally, at the end of the day, the College expects some criticism in return for payment……..  et voila!……..  the cozy existence of the College boys is guaranteed for another year at least with yet one more s.75.  My advice:  if you are looking for a good physician, avoid one who is a “peer assessor” and find one who can still “think” for him/herself instead of fitting the standard basic-medicine CPSO mould. Nothing worse or more dangerous than a doctor who is  intent on filling out a standard list of questions on his/her computer without actually looking at you and deviating from the “script”,  clearly more intent on covering his/her “a*s” than practising medicine! 


Call me crazy but should it not be a requirement for would-be assessors to at least have a good number of years of experience under their belts before they’ll be considered qualified for the job of poking about in the practices of their elders and betters?  What about a test to assess how much they really have remembered from their medschool training which is all they have to rely on as they have little or no experience yet?  An inexperienced assessor will shy away from assessing difficult cases and correct diagnoses and will quickly attack the doc’s notes i.e. legible/illegible, not enough writing, too long, too short, blah blah blah.  Attacking the doc’s notes is really the bread and butter of the whole  business and serves both the assessor and the College extremely well. 


Ultimately of course, the healthcare consumer  –  you and I –  are victims. Older docs  just don’t bother to continue their practice once they are considered for a S.75 and simply retire sooner rather than later.  Younger docs move to greener pastures and prospective medical students are turned off by the idea of becoming a doc when they grasp the true sad state of affairs in Ontario where excellent docs are at the mercy of not so bright docs who wish to appear important by serving on CPSO committees or as peer assessors where they do nothing but cause trouble for colleagues who do the real job of practising medicine.  If you are looking for a doc who will truly focus on your health, avoid those who are “peer assessors”  (see list issued by CPSO)   http://www.cpso.on.ca/uploadedFiles/members/engagement/cpso_participate.pdf


If we want to keep our docs, we  should really think twice before making a petty complaint or pretty soon we’ll only have nurses left to treat us, as the best doctors will have left the province, disillusioned and in disgust.   Hopefully the OMA and CMPA will turn the tide and save our docs. The tug-of-war between the OMA, CMPA and CPSO will be an interesting one to follow.




concerned about corruption says:

Good Article but forgets to mention the cozy relationship some of Ontario’s law firms have with the CPSO.. These firms are hired by the CMPA
( fees currently paid by the Ont taxpayer) to represent the targeted physicians and are able to bill unlimited amounts to defend these S 75. It is a win for the law firm and the CPSO lawyers (whose fees are paid by physicians.).The losers are the public and the MD’s.
Why would the CPSO lawyers seek to resolve anything simply when there is so much money available to be shared with their legal colleagues down the street?

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