Saturday, January 30, 2010


How system helps shield bad doctors
by ROBERT CRIBB, RITA DALY AND LAURIE MONSEBRAAT Tuesday, Dec. 01, 2009 at 7:01 AM Reposted by meverett

Of 13,000 complaints lodged against doctors, 99 per cent were either dismissed or handled in secret by the College of Physicians and Surgeons of Ontario
Taken from May. 5, 2001. 07:48 AM
How system helps shi...

College admits flaws in process


Medical Secrets

You've just been diagnosed with cancer. You're scheduled for surgery in a few weeks by a doctor you hardly know.

In Ontario - and across Canada - provincial laws governing doctors say you can't find out if your surgeon has been hauled before the physicians' watchdog for complaints of malpractice, even for the exact operation you're facing. You aren't told if the surgeon is under investigation now, or has a spotless record.

The medical complaints system is cloaked in secrecy.

Since discipline procedures at the College of Physicians and Surgeons of Ontario can take three years, some dangerous doctors continue practising without patients knowing there may be a risk.

In the last six years, the college investigated 13,000 complaints about doctors. Of those, 99 per cent were either dismissed outright or handled internally and in secret.

We can learn nothing about them. The college, which says it is bound by privacy provisions in the Regulated Health Professions Act, will not reveal the names of the doctors involved, how many had complaints against them, the nature of the complaints or how they were handled. The only window into a doctor's competence, integrity and past professional conduct is a public disciplinary hearing conducted by the college. A Toronto Star investigation shows that since 1994, when new legislation governing doctors came into effect, only 141 complaints have reached this stage.

Of 13,000 complaints lodged against doctors, 99 per cent were either dismissed or handled in secret by the College of Physicians and Surgeons of Ontario

Data on those cases, compiled by The Star using the college's public records, reveal a disciplinary system that typically hands out lenient penalties, rarely revokes licences, can take years to render decisions and puts doctors on higher legal footing than complainants.

The Star's data show that 111 doctors have been found guilty of offences ranging from fraud, drugging and sexually assaulting patients and missed diagnoses, some causing death. Of those, 34 received the college's maximum penalty - licence revocation. The majority of sanctions handed out were suspensions averaging less than three months or reprimands, usually with some conditions, such as cash fines, additional training or letters of apology. Ontario's college took an average of three years to reach those decisions - tied with Manitoba as the slowest medical disciplinary system in Canada.

The overwhelming majority of Ontario's 20,480 practising doctors - skilled professionals dedicated to meeting the highest standards of care - has never been the subject of a college disciplinary hearing. They may face a minor complaint or two over the years but for the most part their records are clean. But some physicians who have done great harm are allowed to continue practising.

Dr. Kenneth Bradley, a former Milton chief surgeon, was twice was found guilty of medical negligence involving patients who died. Still, Bradley kept his licence and later moved to Virginia, where he was implicated in another four deaths.

Dr. Stanley Dobrowolski, a London, Ont., psychiatrist, was disciplined three times for sexually related offences. He is still treating patients.

Dr. Anthony Laws, who practises in Oakville, falsified documents to cover up his role in the death of a 14-year-old patient under his care. People who feel they have been harmed by a physician can seek damages through the courts. But the self-governing College of Physicians and Surgeons of Ontario is the only authority that can suspend or revoke a doctor's licence.

The Ontario Medical Association, which speaks for the province's doctors, believes the college is doing an ``exemplary job'' of protecting the public and guiding the profession. Dr. Alex Schumacher, the OMA's immediate past president, says the low discipline rate is a reflection of the province's high licensing standards compared to other jurisdictions. But the college itself acknowledges the system should be more open and must resolve patient complaints more quickly.

`We have to act before the public loses confidence.'
- Dr. Rocco Gerace
President of the College of
Physicians and Surgeons of Ontario

``We have to act before the public loses confidence,'' says college president Dr. Rocco Gerace.
And that means getting tougher on dangerous doctors, say some college members. ``Clearly there has been less than effective identification of those (doctors) who have serious problems that need addressing,'' says Dr. David Walker, dean of health sciences at Queen's University and co-chair of the college's complaints committee.

Last year in Ontario, 21 doctors had their licences revoked or suspended. During the same period, Michigan, with a similar number of physicians, suspended or revoked the licences of 102 doctors. In Massachusetts, another comparable jurisdiction, it was 45. In Ontario and elsewhere, most doctors can keep practising while they are being investigated. But in a growing number of states, information about doctors under investigation is posted on Web sites for anyone to see.

Gerace doesn't think the American focus on discipline gets to the heart of the matter. ``Their measure of success is their percentage of discipline referrals. I would suggest to you that a discipline referral is a failure. ``We have to balance the will of the public for revenge - an eye for an eye and a tooth for a tooth - versus what's best for the public interest, which is having doctors deliver better care. Do we need to have a few examples out there? Just beat someone up?''

Gerace says that while U.S. jurisdictions rely solely on discipline, Ontario has developed unique programs to assess and retrain doctors whose skills are lacking. The philosophy reflects the college's belief that most doctors who have made clinical mistakes are anxious to improve and will become better doctors through education rather than punishment. But according to a recent government report about the discipline process, there is no system in place to ensure this approach is actually working.

The government-commissioned report expressed concerns that the quality assurance program ``may not be the appropriate response'' for patient complaints about doctors. And since the process is handled entirely behind closed doors, there's no way patients or the public can judge whether their complaint was handled adequately. That secrecy is only lifted when complaints trigger disciplinary hearings. In the past six years, the majority of those hearings - 77 out of 141 - concerned sexual misconduct, followed by cases involving patient deaths (19), and psychological harm inflicted by doctors (10). Other offences that went to disciplinary hearings included fraud, physical injuries and faulty record keeping.

The focus on sex-related cases reflects the college's zero-tolerance policy, adopted in 1994 following a provincial government task force that estimated 10 per cent of Ontario doctors had sexually abused a patient at some time. The Star data show that 25 of the 61 doctors found guilty of sex-related complaints had their licences revoked, 24 received suspensions averaging 3* months, 10 received reprimands and two quit their practices.

Zero tolerance covers anything from inappropriate touching to consensual intercourse to rape. The Ontario Medical Association is currently challenging this policy before the courts as a Charter of Rights and Freedoms issue.

The Star data shows that in at least four cases, physicians allowed to continue practising went on to repeat the same offence. Dobrowolski, the psychiatrist from London, Ont., is a prime example. He has appeared before the college three times since 1994 on complaints ranging from hugging, kissing, fondling and sexual intercourse with patients.

At his second appearance, in 1996, the panel concluded Dobrowolski demonstrated ``an extremely worrisome pattern of behaviour.'' Dobrowolski received a short suspension and two reprimands but never lost his licence. He continues to treat patients in London. ``It (the disciplinary system) is such an unpleasant process from the point of view of a physician that even just talking about it brings back bad memories,'' he said, when contacted by The Star. ``You try and put it behind you and get on with life.''

Many doctors see the college as an adversary that often dishes out unwarranted punishment.
Of the 19 cases of death under physician care that reached the disciplinary committee since 1994, no fault was found in five. In the other 14 deaths since 1994, the college did lay blame on substandard care. Three of the 14 doctors had their licences revoked, while the rest were handed reprimands or given short licence suspensions.

On Aug. 20, 1993, Tom and Patricia Bain buried their only son, 14-year-old Jonathan. At the time, the Mississauga couple were told his death was caused by a viral infection. The family contends that tests later revealed prescribed drugs caused the teenager's death. They complained to the college that Oakville physician Anthony Laws covered it up.
Throughout the process, Laws continued to practise with a clean record. College documents show Laws first prescribed the drug Cylert, which has been linked to liver problems, to treat Jonathan's Attention Deficit Disorder (ADD) in 1992. In July, 1993, the boy was admitted to hospital with severe liver problems. He died after undergoing two liver transplants. Following the teen's death, tissue tests revealed Cylert was the cause of Jonathan's liver failure, according to the family. The Bains complained to the college that Laws ``never told us of the risk in advance, he never monitored our son when he was on the drug, he never ordered blood tests despite the risks.''

The Bains are upset that Laws prescribed Ritalin, another ADD drug, along with Cylert.
``He was experimenting with our son,'' Tom Bain told The Star. But at the hearing, medical competence wasn't the focus. The panel was more concerned about Laws' conduct after Jonathan's death, ruling that he falsified letters to the Bains' family doctor and entries in Jonathan's chart and failed to warn them about the risks of liver failure. ``Our complaint was never dealt with because our complaint was never for forgery, falsification or perjury,'' Bain says. ``It was for the medical aspect.'' In June, 1999, Laws was found guilty of professional misconduct and handed a six-month suspension, reduced to three for meeting conditions such as seeking psychiatric treatment and upgrading his skills.

`He should have been revoked.' - Tom Bain referring to the family's complaint
about Dr. Anthony Laws `(Laws) felt the disciplinary decision was fair and he didn't have any complaint about the process.' - Tom Curry

Laws' lawyer ``He should have been revoked,'' says Bain. ``The system failed us.'' Tom Curry, the Toronto lawyer representing Laws, said his client ``felt the disciplinary decision was fair and he didn't have any complaint about the process.'' Like all complainants, the Bains had no official standing before the college, acting merely as witnesses in the case. College lawyers, much like crown attorneys, act on behalf of the system, not the individual. Complainants cannot call witnesses or ask questions. If complainants want their own legal advice, they must pay for it themselves.

On the other side of the room, money is no object for doctors. The Canadian Medical Protective Association (CMPA), which represents more than 90 per cent of doctors in Ontario, picks up the tab for top legal representation. Doctors, in turn, are reimbursed with public money for most of the insurance premiums they pay. This year, it is expected the province will pay just under $70 million out of total malpractice premiums of about $100 million. ``I've walked out of college hearings thinking physicians are protected far more than they deserve,'' says Toronto lawyer Barry Swadron, who has represented several clients in complaints against physicians. ``Doctors stick together. If a fight is involved, the odds against the victim are astronomical.''

College president Gerace dismisses the claims of a power imbalance between doctors and complainants, saying the system is designed to protect the public interest.
``The analogy is the criminal system. If someone gets drunk and kills my child, I want to be a party to that but I'm not. The prosecutor is there to protect the public interest,'' he says.
``We're there to ensure that either a physician is found to be okay or is found to be wanting and that the correct steps are taken.''

Investigative reporter Robert Cribb can be reached at:

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A doctor is history's worst serial killer

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Dr. Harold Shipman

Harold Frederick "Fred" Shipman (14 January 1946 – 13 January 2004) was a British convicted serial killer and former doctor. He is one of the most prolific known serial killers in history with 218 murders being positively ascribed to him, although the real number may be twice that.

On Medical Secrets

Stories on errors in Ontario's health system spurred province to boost access to information on adverse events in the medical system. Breaking down the walls of secrecy in the medical profession goes far beyond getting people to talk openly about medical errors to include medical wrongdoing, corruption and coverups of all kinds. Some doctors and hospitals are getting away with murder, literally.

Medical Terrorists

Doctors as Terrorists?

Not Surprising After All

David C. Stolinsky, MD
July 9, 2007

Three physicians are arrested in the London and Glasgow fire-bombing plot, and as many as 45 others are under suspicion.
News item

When a doctor goes wrong he is the first of criminals. He has nerve and he has knowledge.
Sir Arthur Conan Doyle

Conan Doyle knew what he was talking about – he was a physician himself. When news broke that doctors took a major part in the recent plot to fire-bomb London nightclubs and the Glasgow airport, most people were shocked. But why was I not surprised? Why would Conan Doyle not have been surprised?

Most people, especially in the Western world, respect education. In fact, they worship education, believing it can solve all problems. Clearly, doctors are highly educated. In fact, one of the accused terrorists was a physician at the hospital associated with Cambridge University. You can’t get a more prestigious education than that.

But what do we mean by “education”? Do we mean a program, beginning in childhood and continuing into adulthood, that is designed to produce cultured, broadly informed, humane individuals? Or do we mean a program designed to impart the skills needed to perform a specific technical job? In years past, we meant the first. But I sadly conclude that in recent years, we mean the second.

So why is anyone surprised when a technician turns out to be a criminal? What did we expect? Why is it any more surprising when a medical technician turns out to be a criminal than when an automobile technician does so? If I know how to repair a broken arm, am I any less likely to be a criminal than if I know how to repair a broken transmission?

Even worse, the amoral physicians and would-be mass-murderers who attacked London and Glasgow would have been the very ones to be “fast-tracked” under the immigration bill that was just defeated. Think about that the next time someone wants to bring in more “educated” immigrants. “Educated” to do what?

I am not talking about Muslim doctors, or even immigrant doctors. When I was an intern years ago, I was supervised by two female Muslim physicians from Iran. Both were highly intelligent, very well trained, and – most important – humane. Of course, this was in the “bad” old days of the Shah, so these doctors dressed and acted in the Western fashion – no head scarves or tent-like clothes for them.

The Shah was authoritarian, but his real sin was that he was pro-American. Now the government of Iran is much worse. It is totalitarian and misogynist, but also anti-American, so leftists believe it can’t be all bad. Apparently religious fanatics developing nuclear weapons deserve the benefit of the doubt – so long as they hate America and all it stands for. Or at least that’s what leftist pundits tell us.

No, I’m not talking about Muslim doctors, or immigrant doctors. I’m talking about all doctors. If we train them as mere technicians, they will act as technicians. They will do as they are told. If an HMO tells them to save money by withholding expensive care, they’ll do that. If a government bureaucrat tells them to avoid expensive tests or procedures, they’ll do that. In fact, they already are doing that.

And if an official tells them to dehydrate and starve the severely disabled to death, they’ll do that, too. For 2400 years, Western physicians took the Hippocratic Oath, which states:

I will give no deadly medicine to anyone if asked, nor suggest any such counsel.

Since ancient times, society assigned the task of saving life to physicians. If killing people was required, that task was given to executioners. Now we have confused these opposite roles.

A milestone on the road downhill was the publication in Germany in 1920 of “Permission to Exterminate Life Unworthy of Life.” The “unworthy” included the incurably ill, the mentally ill or retarded, deformed children and the comatose. Killing was “healing treatment” to be administered by physicians.

For the first time, killing and healing were mixed together. And physicians’ loyalty was no longer to the individual patient, but to “society.”

Once the Nazis took over, medical graduates no longer took the Hippocratic Oath, but an oath to the health of the state. Most American medical graduates also no longer take the Hippocratic Oath, but a variety of other oaths, of which only 8 percent reject abortion, and only 14 percent reject euthanasia. This is called “progress.”

I believe the chief cause of the Hippocratic Oath’s demise is its ban on abortion. But in the Oath, euthanasia and abortion are next to each other. Discarding one prohibition weakened the other. If all human life isn’t sacred, none is. Intermediate positions are weak and are being overrun one by one. Who is worthy to live becomes just a matter of opinion.

The phrase “life unworthy of life” was used by the Nazis, but it originated before anyone heard of Hitler. Nazism was a seed that fell on soil that had already been fertilized by the manure of viewing human beings not as having intrinsic worth because they are created in God’s image, but as having worth only if they are useful to others.

Those who now spread similar manure will not be able to claim innocence when similar seeds sprout. The lesson of history is clear.

The Nazi euthanasia program used drugs, then gas, and was the physical and psychological prelude to the Holocaust. It was opposed so strongly by Catholic and Protestant churches that it was stopped, though it continued unofficially. Sadly, there was no organized opposition by physicians.

Of all professions, medicine had the highest percent of Nazis. Note that Bin Laden’s number-two man is a doctor, as is the terrorism-sponsoring dictator of Syria. When leading doctors support late-term abortion, assisted suicide, euthanasia, and cloning of human embryos, remember not to expect moral leadership from the medical profession. This lesson is also clear.

So with this brief history lesson, are you still surprised when a few – or more than a few – physicians become would-be mass murderers? You shouldn’t be. They are following in the footsteps of those doctors who, like Dr. Mengele, facilitated the Holocaust by exterminating those who were “less than human.” They are following the example of those doctors who allowed Terri Schiavo to dehydrate and starve to death over 13 days, because she was “less than human.” The London and Glasgow bombers merely tried to blow to pieces and incinerate a bunch of “infidels,” who are “less than human.”

Once we start making a list of those we consider “less than human,” sooner or later someone will put our names on the list. You may call this fate, or karma, or simply logical progression. I call it reaping the whirlwind.

If you take moral, humane people, and you send them to a moral, humane medical school, you will get moral, humane doctors. But if you take amoral people, and you send them to an amoral technical school, you will get amoral technicians. You will get, in Conan Doyle’s words, the first of criminals, because they have the nerve and the knowledge.

We created value-free education. We shouldn’t be surprised when it produces value-free graduates. We told doctors to kill the very young, the very old and the severely disabled. We shouldn’t be surprised when the monster turns on us. We defined some human life as “less than human.” We shouldn’t be surprised when others define us that way.

I wish you good health and good luck. With doctors like that, you’ll need both.


When a doctor goes wrong he is the first of criminals

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