Ontario docs are leaving – patients have trouble finding good doctors

{May 2, 2013}   Colleges: Who will watch the watchers?



Written by Colin Leslie on April 23, 2013 for The Medical Post

When senior editor Julia Belluz and I talked six months ago during the planning stages of the colleges investigation, we decided we wanted to see whether we could gather data from the provincial regulatory bodies that would allow us to compare the colleges to address two questions:

• Are the colleges being run efficiently?

• Are the colleges fair to doctors?

You’ll find our coverage that tries to answer these questions on page eight (efficiency) and page 10 (fairness).

In general, the colleges and their national body, the Federation of Medical Regulatory Authorities of Canada, were good about being transparent and making their data available.

The key challenge is that without pan-Canadian standards, how the colleges track what they do varies widely province to province.

So who, as a matter of course, is watching what the colleges do?

There are, to be sure, independent financial audits making sure the receipts match up and such things.

But beyond that much of the responsibility falls upon you, the doctors of Canada. You’re a self-regulating profession. You elect most of the physicians who make up the majority of council members across the nation (see below).

Of course, it is hard for groups to exercise that duty democratically without data and guidance.

There is no equivalent of parliamentary budget officer Kevin Page, whose term just ended, or former auditor-general Sheila Fraser looking at the colleges periodically.

Maybe there should be. Even the overseers need oversight.

There is no evidence that it is, but the colleges’ attitude cannot be: “We’re quasi-judicial bodies and it costs what it costs to do our work.”

Yes, of course, the colleges are there to protect the public first and foremost, but looking for efficiencies and boosting accountability and fairness must be goals of all Canadian institutions.

Lastly, journalism like this takes a lot of reporting muscle and I want to thank Julia for co-ordinating this investigation and reporter-intern Diana Duong for organizing the college data into a large database for this project. MP



College # council
# MDs MDs selected Lay members
B.C. 15 10 Elected by doctors by district. Five, appointed by health minister.
Alberta 16 12 11 elected by doctors. One is dean of medicine (shared by the two deans in Alta.; they alternate attendance). Four, appointed by health minister public.
Sask. 18 13 12 elected by doctors. One by dean of medicine or designate. Five, all Lieutenant Governor in council appointments.
Manitoba 22 18 Most elected by constituency. Two are appointed by the dean of medicine. One is elected from the learners and physician assistants. Two are elected by council. Two are appointed by government.
Ontario 32 – 34 19 16 doctors are elected by their peers on a geographical basis. Three physicians are appointed from among the six faculties of medicine in Ontario. Between 13 and 15 public members are appointed by the provincial government.
Quebec 28 24 20 are elected. Four physician members are postgraduate vice-deans of four faculties of medicine in province. Office of professions, a governmental body that regulates professional orders, selects the four lay members.
N.B. 17 13 12 elected. One appointed by health minister. Four, appointed by health minister from list offered by college.
P.E.I. 9 7 Six elected by membership.
One appointed by government.
Both are appointed by government.
N.S. 15 10 Six elected by membership. One appointed by Dalhousie University. One by Doctors Nova Scotia. Five, appointed by the provincial government.
N.L. 13 members of council and registrar who is an ex-officio member. 10 Seven are elected by doctors. Two are appointed by health minister by nominations received from the NLMA. One is appointed by Memorial University of Newfoundland. Three, appointed by health minister.




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