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Transparency: How much information should you find online about a health care professional?

March 5, 2015

On March 11 at 1pm ET, The College of Physicians and Surgeons of Ontario (@cpso_ca) returns to consult with the #hcsmca community to ask “What do patients need to know about physicians to make informed health-care decisions?”

By Maureen Boon (@maureenboon) and The College of Physicians and Surgeons of Ontario (@cpso_ca)

The (CPSO) is currently looking to expand the information available about physicians on its website. We already include a wide variety of detail on a doctor’s profile, including his/her location, education, specialty area(s), languages spoken, and the results of any discipline findings. We’ve also recently added other details, including findings of criminal guilt, bail conditions, and any reinstatement conditions on his/her licence. Now, we want to make amendments to our bylaws that would allow us to add even more to a doctor’s online profile. Specifically, we want to add:

  • Cautions-in-person: The CPSO may order a caution-in-person when addressing a complaint. Short of a referral for discipline hearing, this is one of the most serious outcomes we can order. We issue a caution-in-person when we have a significant concern about a doctor’s conduct or practice that can have a direct impact on patient care, safety or the public interest if it is not addressed.
  • Specified Continuing Education or Remediation Program (SCERPs): The CPSO may order a SCERP to upgrade a doctor’s skills when we’ve identified serious care or a conduct concerns. SCERPS are only ordered in those instances when we believe that remediation is necessary and we could not reach a voluntary agreement.
  • Criminal Charges: The proposed by-law contemplates that all Criminal Code and Health Insurance Act charges will be posted on a doctor’s profile when they are known by the College. Information that will be posted includes the fact and content of the charge, the place, and the date of the charge (where known). This information will be removed either after an acquittal or a criminal finding which would replace the fact of the charge.
  • Licences in other jurisdictions
  • Discipline findings in other jurisdictions

In order to amend the bylaws, we must first consult widely with the medical profession, healthcare organizations, and the general public. That is why we are running a public consultation on these issues until April 1, 2015, and why we are engaging the #hcsmca community on March 11 for its perspective.

CPSO graphic representing transparencyThese issues are not straightforward. We need to ensure that we’re striking a good balance between a patient’s right to know important information about a doctor and a doctor’s right to privacy and fairness. On the one hand, in-person cautions and SCERPs have traditionally been considered educational in nature, and when a doctor is given an opportunity to improve his/her practice or conduct, the best outcomes usually emerge in an environment of confidentiality. Similarly, criminal charges may involve allegations against a doctor that have nothing to do with the practice of medicine. On the other hand, how does a regulator manage this balance of transparency and fairness in an environment where the public expects more openness from all institutions?

With these challenges in mind, here are four topics we’d like the #hcsmca community to explore with us on March 11 at 1pm ET ((check your timezone).

  • T1: Is there such a thing as “too much” transparency? How do we strike a balance between pt’s right to know and fairness to the doc?
  • T2: Should in-person cautions be on a doc’s profile? What are the risks/benefits of including this info on the website?
  • T3: If we order a doc to undergo specified continuing ed, should that get listed on his/her profile? Again: risks v benefits?
  • T4: Should criminal charges against docs go on their profile, even if they appear to have nothing to do with the practice of medicine?
7 Comments leave one →
  1. March 5, 2015 3:23 pm

    Wonderful topic. I’m curious to see what others think but my feeling is that this info will be out in cyberspace anyway, we might as well take control of it and become a credible source. Looking forward to it!

    Like

  2. March 6, 2015 9:04 am

    That’s an interesting point and one we hope to cover over the course of the Wednesday’s conversation.

    Like

  3. March 6, 2015 9:19 am

    Robyn, I thought this topic might interest you. While that info might be out in cyberspace already, it is currently scattered in a variety of places — some with credence and others without. I think taking control of it by a governing association would be helpful too.

    CPSO and Robyn,
    What do you think about the issue of maintaining currency and accuracy of the data? Quite a huge undertaking.

    What are the positive behaviours that can and should be tracked?

    Like

    • Shoshana Hahn-Goldberg permalink
      March 10, 2015 9:21 am

      I think it would be great to be able to look up languages spoken and wait times

      Like

  4. March 10, 2015 9:36 am

    Our Doc Search function in its search field does capture all the languages that a doctor speaks (http://www.cpso.on.ca/Public-Register/All-Doctors-Search). So for example, if you were looking for a family physician in Hamilton who speaks French, you could simply tick those boxes on the search and the results would come up. (There are currently 42, by the way.)

    As for wait times, this would be tricky for our website to capture, since they vary from day to day or week to week, and there is no mechanism that would feed that data into our site in real time.

    Hope this helps. Looking forward to the chat tomorrow!

    Liked by 1 person

  5. Jason permalink
    March 11, 2015 9:46 am

    I seriously hope T4 is NOT enacted. I could only image the abuse of this arising from many sources. Anyone can make a claim against another person where by a investigation is warranted. I am constantly reading articles where husbands and wife’s often go through messy divorces and accusations are thrown around without merit. People are innocent until proven guilty. If a career was destroyed based on a unfounded post I am sure a large lawsuit would be followed.
    Jason

    Liked by 1 person

    • March 12, 2015 9:49 am

      People make complaints to the police for all kinds of reasons. However, not all complaints lead to criminal charges being laid. Criminal charges are public information and this is true for physicians as well. Note that bail conditions that impact a physician’s practice are already on the College’s website as a result of recent changes. If the current proposal moves forward, criminal charges will be made public as well. Both charges and bail conditions will be removed if the charges are dropped or the bail conditions lifted.

      Like

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