For many physicians, there is no envelope which will cause a greater sense of anxiety, nausea or dread than one from CPSA labelled “Personal and Confidential.” I would never go so far as to say I am glad I received a complaint, but I certainly understand the underlying necessity.
By the end of the 2018 calendar year, there were 11,437 regulated members of the CPSA—854 complaints were filed against 713 physicians and 14 hearings were held. Finally, a total of 10 physicians were suspended or had their licenses permanently revoked.
I highlight these statistics for two reasons. First of all, in 2018 only 0.09 per cent of physicians actually had their registration suspended or revoked. Secondly, these numbers also point out that if roughly six per cent of members are named in complaints every year, it is likely that many of us will face a CPSA complaint at some point during our 20+ year careers.
How did I feel when I received my complaint? It has taken some reflection, but I would argue the experience is similar to the five stages identified in the Kübler-Ross model of grief:
When you read a complaint, it is possible you will be referred to as the most despicable person on Earth and there will likely be a call for the Registrar to immediately shred your practice permit. When you read these words, it is only natural that you will feel hurt and offended.
However, with the exception of a few egregious behaviours, I would emphasize the following is likely accurate:
- You are a dedicated physician trying to provide optimal, timely and efficient medical care.
- None of us awake in the morning deciding that “today is the day I am going to purposefully cause harm” or “be a bad doctor.”
- You do have the support and sympathy of your colleagues. As mentioned, we have all likely been there or are fearful that our time is coming.
- I would recommend that you use the experience for self-reflection. In my case, this involved reflecting on my communication style and seeking new skills and strategies related to having difficult conversations with patients and families.
As a self-governing profession, we must be committed to investigating every single complaint raised against our members. If we are to maintain the privilege of self-regulation, when a complaint is filed, each must be taken seriously, investigated and adjudicated in an open and transparent manner. Ultimately, if the process is done well, it will allow us to be judged by our peers. The alternative is a bureaucrat or another third-party agency assuming the responsibility.
Lastly, as members, we have the absolute right to demand the CPSA do better. Depending on what process is utilized, if a physician undergoes an investigation, the average time from the filing of a complaint to resolution is between 298 and 909 days. This is unacceptable, both to complainants and physicians. I am pleased to report that the entire complaints process is currently undergoing a review. Strategies are being developed to not only deal with the current backlog of complaints, but hopefully reduce the time needed to process a file to completion in the future.
If you are unfortunate enough to receive a similar envelope in the future, please remember the following: in most cases, a single complaint will not define you as a physician and, more importantly, it will not define you as a person. It is, however, the investigation and adjudication of these complaints that defines us as a profession.
If you have any concerns or questions about this topic or any other, please feel free to contact me directly at firstname.lastname@example.org.
Dr. John SJ Bradley
CPSA Council President