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CMAJ
Canadian doctors are now far less likely to be named in legal actions, but more likely to face complaints lodged with their provincial regulatory colleges, compared to 10 years ago, according to the Canadian Medical Protective Association.
The association, a nonprofit medical defense fund that represents the vast majority of Canadian doctors, says the chances of a member doctor being named in a lawsuit are about half what they were a decade ago. (The tally was 928 for legal actions commenced in 2007, according to the association's annual report.)
On the other hand, since 1998 there has been a more than 30% increase in legal and other assistance provided to physicians facing college complaints. In 2007, the association had some degree of involvement, nationwide, in 2784 regulatory college matters, according to the report.
In Ontario alone, the number of complaints climbed to 4738 in 2007 from 3844 just 2 years earlier, according to the College of Physicians and Surgeons of Ontario.
The reason for the lower trend in lawsuits is not clear, but the association speculates it may be linked to improved medical care and risk management, as well as a better understanding of patient safety.
Meanwhile, the increase in complaints about doctors is probably due to greater public awareness about the role of regulatory colleges, says the executive director of the protective association. Dr. John Gray gives credit to the colleges for more actively promoting mediated resolutions to complaints, so that patient concerns can be addressed.
But there is a growing, and troubling, trend for the regulatory colleges to require more personal information about doctors at the time of license application or renewal, he adds.
For example, the Ontario college has said it will require doctors to disclose whether they carry blood-borne pathogens such as HIV or hepatitis, he says.
The question is intrusive, but even more disquieting is what could happen to the information, given a tendency of courts and public inquiries to require colleges to disclose information they have about physicians, Gray adds. "That is very worrisome to us, so we are saying, if there isn't an absolute necessity to collect this information, why are you doing it?"
The protective association's fees are set on a regional basis — there is no cross-subsidy. Gray says that 2009 will mark the first year in which none of the regions will see a fee increase. In 2007, on an aggregate basis, member fees paid to the association decreased.
Other highlights from the association's annual report to members on Aug. 20, 2008, in Montréal, Quebec:
The association once again took aim at the policies of some provinces to launch legal actions to recoup expenses for insured health care services in cases of medical negligence (a policy known as subrogation).
The actions "make no sense from a financial perspective," says Gray, since provinces themselves subsidize the fees that doctors pay to the Canadian Medical Protective Association. For example, in 2007 Ontario's subsidy to doctors for their malpractice protection was $127 million, according to the Ministry of Health and Long Term Care.
Gray says there have been occasions when the association has settled with the plaintiff but can't complete the transaction until the province comes to an agreement on their claim, which can take up to a year.
"So there are not just financial costs, but also some emotional costs for plaintiffs."
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Copyright 1995-2008, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. |
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