Thursday, April 30, 2009
Nosocomial: Hospital-acquired
To a distinctly greater extent or degree, nosocomial infections often can be identified by clinical criteria alone, such as through ongoing concurrent medical record review.
Tuesday, April 28, 2009
Medical horrors in Canada !
Slate -> The Fray -> Fighting Words
CTV.ca | Three in 10 Cdns. report medical errors
Canada's health care myth
Are you aware that not diagnosing a condition is one of the most common forms of medical negligence? The Institute of Medicine explains: medical mistakes are responsible for close to one hundred thousand fatalities every year.Doctors seek gag orders to stop patients' online reviews ...
Dr. Hall of Shame
Corruption in Ontario's HEALTHCARE System..!
|
Arlene H. Berry
1958-2000
A Penetrating Analysis
of Corruption
In
Ontario's
HEALTHCARE System..!
The truth about Corruption in the Ministry of Community Safety and Correctional Services via the Office of the Chief Coroner for Ontario: This Ministry's mandate is a commitment to "ensuring that Ontario's communities are supported and protected by law enforcement and public safety systems that are safe, secure, effective, efficient and accountable". This of course is bullshit. In fact, nothing could be further from the truth.
Ontario has a long and sad history of socially unacceptable medical corruption and criminal coverup under shield of the College of Physicians and Surgeons of Ontario that has sought to institutionalize rip-offs with OHIP, and to keep sick people sick and their families oblivious to it, and to shield bad doctors from medical procedure mistake(s) and criminal accountability.
Make No Mistake: Medical Errors Can Be Deadly Serious.
Neither the government, the medical profession, nor the press desire to lift the manhole cover on this Sewer of corruption, needless suffering, and unnecessary deaths. Perhaps it’s time they had their moral codes thoroughly overhauled.
Shame: A Major Reason Why Most Medical Doctors Don't Change Their Views
WHY AREN’T MEDICAL AND SURGICAL PROCEDURES STUDIED?
When medical science abandons safe medical practices for highly dangerous ones we have a serious situation that we need to look at under a microscope.
A definitive review and close reading of medical peer-review journals, and government health statistics shows that Canadian and American medicine frequently causes more harm than good. Perhaps the words "health care" give us the illusion that medicine is about health. Allopathic medicine is not a purveyor of healthcare but of disease-care.
IATROGENIC DEATH
Iatrogenic means "caused by medical treatment". The term iatro comes from the Greek word "iatros", for medical or medicinal.
Iatrogenic death occurs when people die due to errors or negligence caused by doctors and pharmacists. Thousands of patients in our hospitals or under doctors care die annually and scores of others suffer serious injury because of medical "mistakes" and "doctor-caused" injury and illness is clearly the leading cause of death in Canada. All Canadians should be outraged at this monstrous wasting of human life.
It is estimated that one in every 200 patients in our hospitals has an iatrogenic death annually, even homicide can go undetected because autopsies are not being performed and there are no safeguards in place. The truth is that many diseases, including cancer can be traced to "iatrogenic" causes. In fact, more patients die from the treatments they receive than from the malaise doctors so dubiously seek to cure, with iatrogenic deaths attributed to "natural, non-specific or undetermined" causes.
Since fewer than 10 percent of medical mistakes are reported to hospital authorities, or any other authorities for that matter, the patients, or their families are never told that the injuries were caused by the doctors. That means greater than 90 percent of iatrogenic deaths go undiscovered, hence no disciplinary action is ever taken on any of the doctors involved in these incidents. It is also a measure of honesty and integrity in the medical profession, a profession that has its roots in occult formulas, medieval magic, and quackery of all kinds.
The 1960's saw physicians in Canada go on strike and the mortality rate dropped.
Beware of the backstage workings of Ontario’s medical establishment, and in particular, the College of Physicians and Surgeons of Ontario and its conflicting interest relationship with the Office of the province’s Chief Coroner.
That the purpose of a coroner’s investigation is to determine cause of death, or that the prime function of the coroner’s office is to prevent deaths is grossly misrepresented. Alarmingly, the Coroner’s Act precludes coroners from finding fault or assigning blame, a perversion incorporated into the Act to "shield" bad doctors from medical wrongdoing.
The truth is that the coroner’s office is used as a dumping ground for cases embarrassing either to the government or the medical profession, as in the case of Arlene H. Berry, who died suddenly, and unexpectedly at the age of 41. She was the victim of a horrific chain of medical negligence that is nothing short of criminal. No autopsy was performed. A family request for a formal inquest was also denied.
That it is still possible to bury things in the coroner’s office is both shocking and appalling. My experience with the coroner is that this office is "totally corrupt", and involved in "massive coverups" of it’s own, primarily involving iatrogenic (doctor-caused) deaths. One might ask how many iatrogenic deaths are uncovered as a direct result of a coroner’s investigation? How many reported by the office of the Chief Coroner in his annual report? The answer is NONE.
According to a CMAJ-JAMC report on medical ethics "The profession has accepted that dishonesty is necessary because of the dire consequences of being truthful."
Among disgraceful physicians attached to the public purse include more than 400 appointed local "cash-for-life" (up to age 70) coroners throughout the province who report to the regional coroner who ultimately reports to the chief coroner of Ontario.
Although a coroner’s responsibility is to the public, his allegiance is first to the government and medical profession, corruption notwithstanding.
"The coroner’s office has been regarded for too many years as a "convenient rug under which embarrassing cases could be swept, safely hidden from public scrutiny."
- Dr. Morton Shulman - Taken from his books entitled: Can't Somebody Shut Him Up? - Shulman, Morton Dr. & Kastner, Susan and Coroner.
The coroner’s office works under a "cloak of secrecy". They tell the police, the press, and the public only what they want them to know. Downplaying by omission is common since the basic selection/omission process necessarily omits what they don’t want the public to know, with coverups and criticisms suppressed.
The coroner perceives his findings to be unalterable. One might argue that such findings are not credible because no matter what the facts, he would still conclude no findings of medical wrongdoing, evidence of altered and falsified medical records notwithstanding.
The purpose of an inquest is not only to determine the cause of death, but look for ways to prevent similar deaths in future. To hold an inquest means hearing evidence from all of the witnesses who have information about a death. The decision not to hold an inquest is up to the coroner, but dirty politics dictate the course of that direction, with determination of holding an inquest at the whim of the coroner, and those who pull his string, akin to censorship, and "concealment".
The coroner regards an inquest "unnecessary" whenever there is a likelihood that the public will become enraged because they are afraid of the anger and embarrassment that will result - consider a few iatrogenic causes: Iatrogenic death by Water Intoxication, or Dehydration, Acute Pulmonary Oxygen Toxicity, Oxygen Depravation, SIRS and SEPSIS due to clinical insult, Drug Induced Cardiomyopathy with contraindicated medications, Withholding Life Support and scores of medical secret methods employed by doctors and nurses to kill their patients to coverup their negligence, or outright stupidity.
"In one case, an effort was made by an official of the Attorney General’s department to hand pick an inquest jury, by-passing the normal selection system. One proposed juror was connected with the company involved in the death under investigation."
- Dr. Morton Shulman
If common sense prevails, medical opinion must be logically sustainable, but most often it is not, and so is seen to be flawed. If medical opinion were to be accepted without scrutiny, health professionals could legislate themselves right out of liability for negligence. For this reason multiple medico-legal opinions are sometimes necessary. To compound the problem, one cannot find a doctor who will testify against another doctor, and the coroner’s office is no exception. They all belong to the same fraternity of freebooters that focuses on use of deception, dishonesty and outright lies to protect "it’s own".
Coroners rely explicitly on the opinion of others, because they have none of their own. The bald truth is that specialists in a given field are "not always expert in that field". What they don’t understand is what they are too lazy or incompetent to find out, Dr. McLellan.
As a death investigator, the coroner, with his immature posture of infallibility does not have first hand knowledge of the topic on which he professes to affirm, yet he concurs with opinions of others that lie outside the field of his own expertise, with his own opinion, if he had one, being of secondary value.
Bias is the single most serious problem when dealing with expert opinion and doctors are the worst offenders. There is no such thing as an unbiased expert, and scientific misconduct goes far beyond discriminating against ethnic groups to include targeting the "have-nots" of society. Lawyers often regard certain doctors as "hired guns", who take cash for comment.
The coroner, in his biased efforts to prejudice the results of his investigation does not give his "hand-picked" expert all of the facts. All communication is limited, slanted, or biased to include or exclude relevant information. But omission can also be used as a deliberate way of concealing. By withholding vital information, such as iatrogenic radiation injury to the nervous system, for example, he tells the expert only what he wants him to know. The expert knows this, and so analyses and returns his opinion according to data input.
With a simple "meeting of the minds", the expert proceeds to tailor or lard the report to justify the opinion that is in his opinion, being sought, often using parallel links in the given theory to obfuscate the truth.
While pretending to educate the coroner in the technical matters at hand, the objective of the biased expert is to make it appear as though the coroner understands the technical issues, while also giving as little information as possible.
Once there is a perception of understanding the expert infers from the opinion expressed that the coroner is the one making an independent decision and that his opinion will be correct rather than just agreeing with him. Of course this is just theatre which allows professional bias to skew the results.
"The opinions expressed herein by the author do not necessarily take into account all the facts and circumstances surrounding the death."
"The final conclusions of the Coroner’s investigation may differ significantly from the opinion expressed herein".
Further findings suggest that expert opinion, in the absence of consensus "evidence-based medicine", and published literature, is totally worthless.
A medical expert renders his opinion in his own "self-serving" interest, given his own values, and how much credence should be given to such opinion may well be subject to debate. It is in the analysis of "self-interest" that values most clearly play their role. For example, the coroner’s expert invariably has insinuated himself into a case or “conspiracy” for money, some with "revolving door" payoffs.
The coroner in his “dubious” dealings with other doctors would invariably have wheedled himself, predictably, upon the favours of one or more of his self-aggrandize and flatter colleaugues, i.e., classmate or golfing buddy, or other conflicting interest minion he knows personally due to being involved with one doctor or hospital or another, such as from Sunnybrook Hospital, for example, Dr. McLellan.
One might ask whether it is possible, in his field of expertise for legitimate differences of opinion to occur between qualified experts. Since the answer is invariably “yes”, the opinion expressed is not necessarily the correct one, is it? The expert therefore is not a wholly dependable source of information.
Any medical professional who, in rendering his opinion as to cause of death, volunteers his unsolicited belief as to another doctor’s conduct or standard of care, finding in favour of his fellow colleague invites being labeled retrospectively with the most nefarious motive.
In this regard, one might well ask what is the frequency with which such expert sells his opinion for monetary gain, including the side for which he predominantly finds, and whether he consistently finds in favour of his fellow colleagues. One might also ask what is his relationship to the coroner.
As can be seen, the coroner’s expert is, if not a charlatan, at least not what he is purported to be. In fact, he is nothing more than a paid shill and thus unworthy of belief. Indeed there is no need for him to show up at the coroner’s office - he would simply have mailed his opinion together with his time and charges.
Coroners are keen to play a role in decision-making but generally lacking when it comes to problem solving where expediency is a "means-end". Being closed minded may predispose.
The coroner sometimes uses the police to assist with an investigation, but the police rely on the coroners to interpret what they have uncovered. The coroner has no expertise in forensic science and the police have none in medicine. They tell each other only what they want each other to know. The coroner has the final say and will say what he is told to say by the hierarchy. Coroners neither investigate a complaint thoroughly, impartially, or accurately, unless considerable legal and public pressure is brought to bear. And in the absence of an autopsy or fact-finding post mortem, a coroner’s report can be a mixture of half-truths and bald falsehoods.
Much about what we have come to learn about disease, including statistical information, was discovered and confirmed through autopsies. But as it now stands, doctors seek to confirm their findings through human experimentation, i.e., by trial and error, using unsuspecting patients as their test subjects.
Autopsy findings help measure the overall quality of care in a hospital and community. But autopsies are seldom performed, except in medico-legal cases or where they are specifically requested, and in fact doctors try to discourage them, usually because they themselves have something to hide.
Coroners don’t do post-mortems, they know almost nothing about pathology. They are performed by a pathologist, who reports his findings to the “attending” physician. Talk about a "conflict of interest" should the attending physician or medical negligence be at fault.
Coroners are a partisan group of professional disinformation artists with a vested interest concealed behind a neutral, bland, inoffensive name who tend to operate in self-congratulatory and complementary packs or teams whose prime function is to prevent rational and complete examination of evidence which would hang them or any of their self-aggrandize and flatter colleagues. They are white coats in black hats acting as provincial government officials, licenced to practice ignorance, mayhem and unpardonable blunder with immunity from liability for wrongdoing.
Coroners, as with other physicians, are incredibly polished, and they are all charmers, but they are basically narrow, shallow people who don’t give a damn about iatrogenic death, or the pain and suffering that doctors have caused. Further findings suggest that coroners, like many other doctors, suffer from metacognitive skill deficit disorder, a syndrome that spans a broad continuum of metacognitive incompetence or lack of capacity to distinguish accuracy from error. Not only do these doctors reach erroneous conclusions and make bad choices, but their incompetence robs them of the metacognitive ability to realize it. Faulty reasoning may predispose.
With iatrogenic death falsely ascribed to illness, chalked up to natural, non-specific or undetermined causes, skewed by indiscreet investigative case histories, medical omission and bold-faced lies (to include falsified information on death certificates) undoubtedly surfeit and permeate the coroner’s files with disgust to excess.
Ontario’s coroners have adopted as their motto "We Speak For The Dead To Protect The Living", a quotation from Thomas D’Arcy McGee, a journalist and poet as well as a politician. In my opinion, if the dead could speak there would be dire consequences for the living, and many Canadian doctors would be facing “prison terms”.
That the "Office of the Chief Coroner for Ontario serves the living through high quality death investigations and inquests to ensure that no death will be overlooked, concealed or ignored", is an insult to one's intelligence - an absolute afront to one's dignity. The truth is that the Coroner's office only supervises inquiries into deaths of persons "other than those under medical attention" at time of death. In short, Ontario's doctors can thus get away with murder, and they do indeed. The philosophy "don’t cause any trouble for the government and especially not for the medical profession" is the philosophy of the Ontario government.
Mike Harris gutted the health care system in Ontario and used those monies to grease the political cogwheel, to feather his own nest and squandered the rest to the detriment of health care throughout the province, precipitating a rash of doctor-caused illness and untold deaths in hospitalized patients.
If the truth be known, the elite in Ontario are effectively immune to law. The law is a tool (as is the office of the Chief Coroner) to serve the ends of the powerful, where selective enforcement is the norm.
Bad policies based on misguided notions and a patronizing, pseudo-moralizing Harris government paternalism have produced disastrous consequences for health care in Ontario. Corrupt politicians and cabinet ministers cynically exploit the resulting suffering to maintain their positions of power, reinforcing their misguided policies. Police on the street end up bearing the brunt of selective enforcement due to political intervention, and political ass kissing while innocent lives are being destroyed and hideous crimes are being committed by bad doctors and nurses , in the name of "medicine".
The modern physician has already become one of man’s most potent killers and cripplers, and iatrogenic (doctor-caused) disease is in effect epidemic.
In failing to exercise simple prudence to protect the public from medical atrocities, the Ontario government itself is criminally negligent.
The reason police investigations into medical negligence and mishaps involving criminal negligence cases are not especially effective, is that their investigators are either uninformed, ignorant, or completely outclassed by a group of professional disinformation artists (liars), trained to subvert justice. It is the disinformation artists and those who pull their strings who have a vested motive for concealing the truth. Further findings suggest that the outcome of any meaningful investigation into doctor-caused death is "dictated" by the extent of political intervention, and cover-ups go straight to the top, the Attorney General of Ontario, et al.
Although the medical disciplinary machinery exists, it does not function due to dysfunctions in the self-regulatory system overrun by unchecked abuse.
Self-regulation is a failure. Despite record numbers of complaints against bad doctors to official bodies and severe criticism from the press, the government has never taken serious action against the College. Why?
The annals of medico-legal literature on civil malpractice and litigation are comprehensive, each bearing another gothic medical horror story.
In May of 2001, "The Toronto Star began undertaking a serious investigation into the College and exposed that 99% of all complaints are either dismissed or handled in secrecy."
"My experience with this system is that this agency is totally corrupt, and involved in massive coverups... The investigators who handle the complaints for the College of Physicians and Surgeons are either uninformed, ignorant or criminal in their investigations." Thunder Bay On-line
The Toronto Star - recent multiple front page headline series, How System Helps Shield Bad Doctors (May 5-7, 2001 and follow-ups) revealed heart-wrenching butchery, incompetence and coverups.”
What we need is a sustained, non-partisan political consensus to clean out the medical establishment’s dirty secrets, give all victims of medical malpractice redress, punish medical negligence, dispense with self-regulation, police the doctors, turn coronership over to the electorate, and start fresh without the baggage of secret, unacknowledged medical atrocities.
HOW RELIABLE IS MEDICAL OPINION?
"A pier review against an incompetent or corrupt physician is composed primarily of equally incompetent or corrupt pier review pannels. The medical complaints system in Ontario is cloaked in secrecy." - Malcolm Everett
Get The Facts
Truths, Half-truths & Lies.
Health Care Truths
Demon Doctors Physicians as Serial Killers
Canada Supreme Court Sends "Mercy Killer" to Jail
Dangerous Doctors: How to Find Them Before They Kill You
Doctors' Strike: Death Rates Fall
Doctors can carry dangerous bugs from patient to patient ...
Iatrogenic Death Fred Foldvary
White Wall of Silence...
Book Details - Wall of Silence
Disposing of patients to protect doctors
Breaking Down the Wall of Silence by Alice Miller and Simon Worrall
Killer Doctors
The Politics of DEATH
DOCTORS' ETHICS? EXAMPLES OF THE LACK THEREOF
Under Siege | canada.com Network
canada health scientists - DRUG Safety Whistleblowers In Canada
Medico-legal Conspiracies & Medical Fraud - exposed
Cancer quackery exposed - Don't be fooled by shady doctors
MDs , ALLOPATHIC MEDICINE , IATROGENIC DISEASE , MALPRACTICE AND ...
CQ - Canadian Quackery Watch -
THE POISONED NEEDLE by Eleanor McBean
If doctors don't understand ethics, it's time to start teaching them...
Addendum - Re: The Arlene Berry Death Coverup
Rx for Injustice!
Coroner orders review of Toronto pathologist. It seems clear, Ontario's Chief Coroner should be reviewed!
TheStar.com/doctors
Therapist denied sex, cocaine use with patient Mar. 13, 2003. 01:00 AM A therapist accused of initiating sex and cocaine use with a patient denied both allegations to an investigator, a disciplinary panel has been told. Therapist turned patient on to sex, cocaine, disciplinary panel is told Mar. 12, 2003. 05:39 AM A Toronto man who sought psychotherapy says his female doctor turned him on to cocaine and encouraged a sexual relationship. The patient told an Ontario College of Physicians and Surgeons disciplinary hearing yesterday that Dr. Allyson Koffman, who operated a therapy practice from her downtown condominium, accompanied him to parties and bars, writes Diana Zlomislic. Panel rules Hamilton psychiatrist incompetent Sep. 24, 2002. 02:00 PM HAMILTON — Ontario's medical college says a Hamilton psychiatrist should either be barred from practise or placed under restrictions. Hep B victims reap legacy of neglect Sep. 2, 2002. 01:00 AM The hepatitis B outbreak at Dr. Ronald Wilson's EEG clinics, revealed in March, 1996, was among the worst involving this most infectious of blood-borne diseases. Thousands were exposed. One man died. Rita Daly reports on the victims who still suffer Wilson's legacy of neglect. MD guilty in hepatitis B outbreak Aug. 23, 2002. 06:42 AM Dr. Ronald Wilson, a Toronto neurologist whose clinics used dirty needles on patients and caused the worst hepatitis B outbreak in Ontario, has been found guilty of incompetence by the College of Physicians and Surgeons of Ontario. The Star's Rita Daly reports. Therapist barred over sex with client Jun. 29, 2002. 01:00 AM A Toronto psychotherapist who left a patient feeling like his "whore" by sending her pornographic e-mail, having sexual intercourse and performing oral sex on her, has lost his medical licence. Finally, surgeon barred for years of negligence Jun. 11, 2002. 12:02 AM It took nearly two decades, three disciplinary hearings and the negligent deaths of at least seven patients before the province's medical watchdog finally stripped Kenneth Bradley of his licence to practice yesterday Ñ for good. Psychiatrist abused patients, hearing told May. 21, 2002. 11:16 PM HAMILTON - The prosecutor for Ontario's college of doctors says prominent Hamilton psychiatrist Dr. Paul Michael Porter sexually abused two female patients at his downtown office and fudged his medical records to obscure it. MD's level of care criticized Mar. 10, 2002. 01:00 AM A Toronto psychiatrist has been harshly criticized by the College of Physicians and Surgeons of Ontario for giving the controversial drugs Ritalin and Dexedrine to a patient who was getting worse. Warnings about hepatitis B clinic ignored Feb. 5, 2002. 12:05 AM Ontario health officials and the physicians' regulatory body were warned of unsafe practices at a Toronto diagnostic clinic almost five years before an outbreak of hepatitis B put 14,000 patients at risk, a hearing has been told. Court backs reprimand against alternative MD Jan. 31, 2002. 01:00 AM An alternative medicine doctor reprimanded for professional misconduct has lost his appeal against a ruling by the College of Physicians and Surgeons of Ontario. Neurologist pleads not guilty at hearing Jan. 22, 2002. 07:34 AM A Scarborough neurologist who recently settled the largest medical malpractice suit in Canadian history after his diagnostic clinics exposed 14,000 people to the hepatitis B virus has pleaded not guilty to charges of professional misconduct. Woman faces silence over silicone Dec. 16, 2001. 01:00 AM When one of Canada's leading dermatologists couldn't find a legal source of liquid silicone to inject into people's faces, he obtained a supply from a Miami post office box and went to work. Ontario doctors to face criminal record screening Nov. 23, 2001. 02:00 AM Ontario's doctors will soon be facing mandatory criminal background checks as part of the screening process to get a licence to practise. Web site now puts spotlight on bad doctors Nov. 8, 2001. 12:02 PM Details about any Ontario doctor disciplined for professional misconduct, sexual abuse or medical incompetence will now be posted on the Internet for public access. Psychiatrist stripped of his medical licence Oct. 20, 2001. 02:00 AM In a surprise move, a Cambridge psychiatrist changed his plea to guilty on one count of "disgraceful, dishonourable or unprofessional" conduct yesterday and was permanently stripped of his medical licence at a disciplinary hearing. Doctor abused vulnerable boys, hearing told Oct. 19, 2001. 02:00 AM A Cambridge psychiatrist allegedly preyed on the innocence of pubescent boys and abused their trust by sexually assaulting his mentally vulnerable patients, a professional disciplinary panel has heard. `Reckless' doctor gets licence back Oct. 16, 2001. 02:00 AM A Toronto physician has had his licence reinstated with some restrictions after being found guilty of professional misconduct related to complaints that he brushed his penis up against two female patients during eye examinations. Hospital forces doctor to resign Oct. 13, 2001. 02:00 AM Whitby obstetrician Dr. Errol Wai-Ping has been forced to give up his medical practice at the Ajax-Pickering hospital following an internal investigation involving more than 150 women who complained about his surgical care. Doctors look for strategy to stop medical mistakes Sep. 25, 2001. 02:05 AM OTTAWA - Canada needs a national plan to help reduce serious medical errors such as giving patients too much of a drug or surgery on the wrong body part, says a doctors' group. Files of MD should be reviewed: Board Sep. 25, 2001. 02:14 AM A complaints committee established by the College of Physicians and Surgeons of Ontario was correct in deciding that a Toronto physician provided inadequate and inappropriate care to a patient, an appeals board has ruled. Doctor loses licence over therapy Sep. 22, 2001. 02:08 AM A controversial Toronto psychiatrist who practised bizarre ``reparenting'' therapy on patients that included giving them baby bottles to suck and dolls to hug has been stripped of his medical licence. Medical watchdog sparks painful row Sep. 10, 2001. 02:00 AM The debilitating pain, nearly forgotten for years, has returned for John Bauder. And he blames the province's medical watchdog for his anguish. Doctor's licence revoked for sex abuse of patients Sep. 8, 2001. 02:00 AM Patients came to him for help with their depression, childhood sexual abuse trauma and the grief of a dying mother. |
How system helps shield bad doctors
May. 5, 2001. 07:48 AM | ||||||||
How system helps shield bad doctors ROBERT CRIBB, RITA DALY AND LAURIE MONSEBRAATEN 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.
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.
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.
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.'' FILE COPY Investigative reporter Robert Cribb can be reached at: rcribb@thestar.ca |