Canadian Study Finds Small Number of Docs Responsible for Most Disciplinary Actions

According to a study published recently in Open Medicine, 606 Canadian physicians were disciplined by their provincial medical licensing authorities between 2000 and 2009. Researchers pointed out that the number of physicians disciplined each year represents only 0.06% to 0.11% of all physicians in Canada.

However, 51 physicians committed 64 repeat offenses, 19% of the total offenses. Seven of them had been disciplined three times and two had been disciplined four times. Dr. Bell said there needs to be greater monitoring of disciplined physicians.

“The medical profession must realize that although disciplined physicians represent a small proportion of total care providers, a single practitioner has tremendous potential to harm patients and the public. There is little doubt these practitioners diminish the integrity of the medical profession,” lead author Chaim M. Bell, MD, PhD, said in a statement. Bell is associate professor of medicine and health policy, management, and evaluation at Michael’s Hospital in Toronto.

The majority of the disciplined physicians were men (92%) who were veteran clinicians (with an average of 28.9 years experience) and independent practitioners (99%), according to Bell. The most frequent violations were sexual misconduct (20%), standard-of-care issues (19%), and unprofessional conduct (16%). In addition, 62% of those disciplined were family doctors, 14% were psychiatrists, and 9% were surgeons.

Fines were the most frequent penalty (27%), followed by suspensions (19%) and formal reprimands (18%). The median length of suspensions was four months and the median fine was $4,000. Only 6% of disciplined physicians had their licenses revoked.

Bell believes this is the first time such data has been collected and analyzed from across Canada; the study did not include the three territories where such information is not publicly available.

“This data is an important first step in aggregating and understanding the extent and nature of physician discipline in Canada,” he said.

Bell’s findings reflect similar studies conducted in the United States, which have found that being a male and being in practice for a long time may increase a physician’s risk for disciplinary actions. Those studies suggested there are differences in how male and female physicians interact with their patients and that female physicians may communicate more effectively with them.

Previous studies have also found that the intimate nature of the work performed by family physicians and psychiatrists and their direct relationships with patients may predispose some of them to inappropriate behavior and therefore to discipline.

Bell said it was concerning that a large proportion of violations by Canadian physicians involved sexual misconduct, “which is clearly a breach of trust.” He said this suggests that both medical students and physicians taking continuing education need more training about sexual boundaries.

SourceResearchers Track Number of Doctors Disciplined and Why [Open Medicine]