30 July 2014

CPSO complaints against Ontario doctors

See additional info added Friday, Aug 8 & Tuesday, Aug 12, 2014; one paragraph revised Aug 18, 2014; minor revisions throughout and update Sept 2, 2014, paragraph added Sept 3, 2014).

Today, in the newspaper - July 30, 2014 - the suggestion was made that complaints about Ontario doctors be made public (see Make all complaints about Ontario doctors public). Trial lawyers aren’t the only ones in favour of this potential exposé of the College of Physicians and Surgeons of Ontario, an organization supposedly meant to protect the province of Ontario’s public and not only its physicians. Commenters on the article in the Star had the opportunity to express their views, if only for a few hours, before the comments section was closed to further comments. Those comments still remain, for anyone interested. It is one aspect of the health machine on which proponents of an improved health system have not yet been able to give their views, in only due to the secrecy involved in dealing with complaints by the public.

As chance would have it, today was also the first call I received from someone from CPSO in response to the complaint I submitted a month ago. I’m not sure, from our brief chat, however, that my complaint is being taken seriously. She started off speaking in such a shrill voice that I thought she must be new to the job, and a bit nervous.  She also spoke too loudly for me to hear her without holding the telephone receiver a few inches away, and even then, her voice was muffled and unclear. Combined with that were various interruptions, from being cut off for a few seconds to scratchy background noises, as indicated in these excerpts from the CPSO's rep's ten minute phone call , combined in one MP3 - 3 minutes long - and playable on various media.  It's difficult to get across how it felt to receive this phone call from this supposed investigator, who seems to be so unprepared and unprofessional (Paragraph revised Aug 18, 2014).

I eventually asked the CPSO contact to call back, after she had sorted out the problem with the new system she said she was using. When I inquired, she said she had been doing this job for 7 years, though it seems to me she was quite disorganized and had not even made herself familiar with the letter of complaint I sent to her.  She didn’t act like a person who was representing the CPSO and dealing with an official complaint. She sounded more like a receptionist - a particular receptionist with the same habit.  I’m not sure what kind of way that is some women have, of speaking three octaves higher than what’s normal. Is it done intentionally, or just a bad habit, I wonder.

The girl from CPSO, said she had dealt with this kind of case before and I asked what kind of case, exactly, and she responded “communication” and “termination.”  To me, the kind of case it was and the kind of treatment I received while under the doctor’s care was more of an abuse problem than one of his inability to communicate well.  And it was not so much that he decided to “terminate” me than the way he did it. Apparently, doctors can get rid of a patient, if they have good reason, and if they contact the CPSO and inform them, and provide reasons. That’s not how it happened in this case. I don’t consider myself a difficult person, and especially under such circumstances where my health depends on the good will of the doctor, I am not going to make life difficult for him. I always think a person deserves the benefit of the doubt.

The girl informed me about the process of an investigation, which involves her collecting information from me, then writing up her own "unbiased" report, and sending it to the committee of doctors and other members of society who would examine the case and rule on it. She said to me that she had sent to the doctor a copy of the letter of complaint that I had submitted to the College but had not yet requested a response from him. Instead, she was calling me and asking me about what was already in the letter of complaint, that she appears not to have read too thoroughly. She wondered what was most important, what I would like to see happen from this, and I could only respond with several important issues, as I saw it, not just one or two.

As far as this girl who called from the CPSO to deal with my case, I have already given her the benefit of the doubt, and there is little doubt left. And that goes for the doctor, too. I had already tried to have this situation resolved through the London & District Academy of Medicine, in a letter presented at their board meeting, with no response at all from them, except to find a new doctor. I presented them in writing with what at first was a minor issue but which soon evolved into something more serious. And yet these issues were not dealt with at all in the written response I received, nor in the telephone conversation I had with the President.

While many readers from the discussion on the article in the newspaper agree that it would be a good idea to make cases public, there can be no agreement how that would happen. If the CPSO is left to make them public, there needs to be a standardized complaints form for the main issues that are the basis of the complaint, or to describe what the problems were. As it is right now, when I attempted to complete the form, I found that the issues I listed as concerns – "manipulative, hostile, and bullying tactics," "rushed decision-making, irrelevant treatments and tests," and "unprofessional, lack of attention to maintaining records" did not match up precisely with the details I wrote about in the letter of complaint. The girl from the CPSO seems to have picked out a couple of items with the intent of focusing on them, apparently, when I speak with her next, after she has sorted out her new telephone system. So instead of seeing the entire time I spent with the doctor as a pattern of abuse, she appears to want to simplify it into a couple of specific problems. The form itself, as it stands, requires a list of behaviours, or areas of concern. She has taken those that I listed and changed them into two areas of concern – or two issues – "communication" and "termination." But that doesn’t cover it. It doesn’t make sense.

To be continued

Added Friday, Aug 8, 2014

I could speak at length about this, as there are so many things about not only the doctor himself but now, the person assigned to look into what happened, not to mention the complaints form itself.

The CPSO girl and myself spoke again the day after, on July 31. Her telephone was still not working as it should, her voice coming across loud and unclear at times. I found it difficult to talk to her and answer her questions as, like the doctor himself, she seemed to be missing the point or unable to understand, or chose to go off on a tangent – or perhaps use information retrospectively, to try to explain something that had not yet happened.

She did ask, at one point, did I still want him as my doctor, an indication that she did not comprehend one main aspect of my complaint, that the doctor quit, and did so suddenly, without a closing-out period to wind up, which is not the way the CPSO directs their physicians to “terminate” (her words) a patient.

Up to that point, when the doctor became exceptionally hostile and mean, I was still thinking that we might be able to work things out. But it is as though one must not bring shortcomings to some doctors’ attention, but simply put up with it, which I did for over a year, in this case.

So, she asked me if I still wanted him as a Dr and I said no.  But the doctor did make accusations against me, in a letter to me. And was I expected to be happy about the idea of this man still being my doctor, after receiving this letter?  What did she think, that I would want to still have him as my doctor, or was she going to use this statement of mine to imply in the formal report that I was going to quit the doctor anyway?

The CPSO girl also asked me whether the doctor had sent the final closing-out letter by registered mail. But that information was also available in the material I had sent to her. Perhaps there was too much to read through, or was she going to try to find a trivial matter to lay on the doctor, as an explanation for my insistence that he did not follow policy.

As it stands, the doctor made accusations against me, and according to CPSO policy, if he does that he is supposed to back them up. Although I did make an attempt to find a new doctor after he sent the letter to me, I did not succeed, and soon decided that I should not be the one to quit, as I did previously with a former doctor who had written nasty, untruthful comments about me in a letter of termination.

Doctors can do this – become unlikeable, thus an encouragement to the patient to leave the practice. I realize because of my research and writings, and somewhat controversial views, that some individuals and groups in society might not appreciate what I have to offer. So if being unkind doesn’t work, the doctor can then resort to harsher methods, such as blaming it on the patient in writing, after which, normally, I imagine, the patient would become only too willing to seek another doctor and try to put the past behind her. I know I did, the first time. And I now I suspect, from a comment made by the President of the London & District Academy of Medicine, that my past did come back to haunt me (via the letter written by the first doctor) and was being used against me in this new scenario with the doctor under complaint.

Thus, despite encouragement by walk-in clinics, where I have had to go for treatment and prescriptions, I have not continued to seek a new doctor. I have had a doctor make false accusations against me. If I let them go, they will stand as truth. So I am obliged to speak out. What’s more, it is entirely possible that the CPSO girl has misunderstood to such an extent that the real issues won’t even get looked into, possibly no farther than his not using registered mail to send his final letter to me.

How it stands at this time, after a second talk on July 31, with the same girl, she is going to contact the doctor and have him respond to some of the issues we have discussed, and I have a feeling they are not going to be the ones I asked about in my letter of complaint.                                                                                              

Update Tuesday August 12, 2014

Today I sent a letter to the Registrar, CPSO, explaining that the person assigned to my case was distorting what I said to her on the phone, ignoring what I had written in my letter of complaint, and generally, appeared to be either completely on the side of the doctor in question or just enjoying her position of power as mediator/troublemaker in this case.  I stated in my letter to the Registrar (dated Aug 11, 2014) that I would like to have someone else take over, that I will not speak with her again; I also requested a copy of the letter she informed me she had sent (the second letter) to the doctor I made the complaint about. But now, to return to the main problem . . .

This is about the doctor and letting him know what I hope to accomplish by making this official complaint. There was no space on the form to state what I hoped would come from it. If the girl had read what I wrote originally, however, she would see that it was implied in the details I gave. I would like to have my reputation restored, that was harmed by his harsh attitude towards me on April 28, 2014, at his office.  I need to have another doctor, and trying to obtain one while having unexplained problems with a previous doctor makes it more difficult. Of course, a patient with chronic medical issues, and with no apparent connection with the community, might be seen as not worth taking on. For these reasons I need to have the doctor take responsibility for his behaviour towards me, which was uncalled for.

So to make it clear, contrary to what the girl has assumed in her letter dated Aug 1, I am not seeking a new doctor. I have not derostered myself in order to be able to take on a new doctor. The doctor has made accusations against me in a letter to me, part of the method of termination of a patient. But he needs to stand by those claims, and not simply allow his claims about me to drop by having me deroster myself.  I did not deserve to be treated the way I was at the end, nor from the start, as it happens. Why the doctor did so, and what other people – other girls in the secretarial pool said to him I don’t know. I just want this done with so I can find a doctor to look after my health concerns as I grow older.

Update Tuesday, Sept 2, 2014

On Aug 29, 2014, I sent a letter to the CPSO - to Sandy McCulloch, the Director, and Associate Registrar, Investigations and Resolutions.

The letter was a followup to the letter I wrote about two weeks ago, on Aug 11, to The Registrar, from whom I never did hear back – though I did get a response to the letter from the girl investigator. I have decided not to post here the letters she  - the girl - has sent me as they would only draw the readers away from the complaint I made, which is probably her intention.

I am trying to get her taken off my case and someone put on it who hopefully would treat my complaint with sensitivity instead of making a joke of it and taking the doctor’s side.

Added Sept 3, 2014)
One main point in all this is that the doctor terminated me as his patient, with no follow up of current medical issues, and made accusations against me in the letter he sent to me. And yet it appears that I am expected to deroster myself formally so that I am able to register with another doctor instead of having to attend walk-in clinics and see whoever is available. But if I deroster myself with the Ministry of Health, then he is off the hook and doesn't have to explain his questionable comments about me. And it is these remarks and accusations by him that I would like the CPSO to investigate so that they can be shown for what they are  - as distortions and untruths (paragraph added Sept 3, 2014).




Reference List

Hospitals and doctors must make openness a top priority: Editorial  (added Aug 8, 2014)
The Star
Jul 29 2014
http://www.thestar.com/opinion/editorials/2014/07/29/hospitals_and_doctors_must_make_openness_a_top_priority_editorial.html
                               
Make all complaints about Ontario doctors public: trial lawyers
By: Theresa Boyle
The Star, Health
Wed Jul 30 2014
http://www.thestar.com/news/gta/2014/07/30/make_all_complaints_about_ontario_doctors_public_trial_lawyers.html#

Should cautions issued to health professionals be publicly reported?   (added Aug 8, 2014)
by Jeremy Petch & Mike Tierney
Healthy Debate.ca
Feb 7, 2013
http://healthydebate.ca/2013/02/topic/quality/should-ontarios-regulatory-colleges-publicly-report-cautions


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