When doctors are accused of thoughtcrimes
The long history of College of Physicians and Surgeons of Ontario and the Glasnost Report of 2001
Having had the experience of now twice had “Section 75 investigations” aimed at me by the College of Physicians and Surgeons of Ontario - one in mid-2021 and one in January 2022 - it was with some interest that I read this report. A senior colleague made me aware of its existence, written over two decades ago. The similarity in College methods, and peculiarities of due process, are strikingly similar to what I and some of my colleagues are encountering.
Ideally, a lawyer would take up the challenge of depicting the procedural irregularities that Covid-19 has created for the CPSO, when it comes to policing the public statements of its physician members.
In my case, I learned that a “Section 75 investigation” was being initiated via an email from a College investigator.
It was all very strange, and felt rather less organized than the patient complaint process, which I had encountered once in my 17 years as an Ontario MD.
This prompted some consultations with colleagues, who reflected upon procedural irregularities.
With luck/persistence, a colleague pointed me to a report from 2001, that outlined many of the same observations and concerns regarding CPSO investigations that I and my colleagues had noted.
This report is called the “Glasnost Report” and I have not yet found it online. Below are some preliminary notes from the report.
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There is evidently quite an institutional memory or ethos at the CPSO. Presumably some of the abuses of power and legal process that are outlined in this 89-page report have been corrected. For example, the Discipline Committee of the College has been reconstituted to include a tribunal with no institutional ties to the College.
This 89-page document was brought to my attention by a colleague to whom I had commented on the joys of being investigated by the College for my work on Twitter. Evidently the current Charter concerns that are being raised have a history:
This report was assembled by both physicians and patient advocates, and collated investigative work by the Toronto Star, KPMG Accounting, criminal lawyer, Mr. Michael Code, and whistleblowers from the CPSO itself.
At the time of the report, it was noted that College investigations tended to be directed at specific subgroups of medical practice, such as chronic pain/opiate treatment, environmental medicine, IV chelation therapy. It was proposed by whistleblowers that the registrar during that time period was especially concerned about these areas.
Themes from this report include secrecy, modifications of due process, exclusion of both involved patients and physicians from the process of complaint evaluation, mid-process modification of investigation parameters, misallocation of College resources on persecutory investigations relative to actual patient complaints.
Specific legal concerns with regard to due process were described, which appear to be remarkably similar to present 2022 issues. Of particular interest is the fact that investigations are not driven by patient complaints. Rather, many investigations appear to originate from the College, and its particular philosophical concerns.
One of the proposed reforms from the 2001 investigation appears to have been carried out, with the inception of the Medical Tribunal.
This is obviously a work in progress and I welcome feedback. JMB