Totals |
2019 |
2018 |
2017 |
2016 |
2015 |
No. of complaints received |
857 |
854 |
826 |
831 |
746 |
No. of physicians complained about |
756 |
713 |
712 |
702 |
623 |
Complaints open at year end |
500 |
553 |
523 |
406 |
311 |
Complaint Process Used |
2019 |
2018 |
2017 |
2016 |
2015 |
Hearings |
786 |
909 |
742 |
643 |
995 |
Investigation/Resolution |
465 |
464 |
374 |
335 |
344 |
Resolve with Consent |
230 |
163 |
249 |
119 |
130 |
Investigation/Dismiss |
339 |
298 |
225 |
180 |
150 |
Direct Resolution |
50 |
90 |
40 |
28 |
30 |
Outright Dismissal |
13 |
8 |
12 |
11 |
18 |
Definitions of processes
An investigation is a formal process used for complaints that are serious in nature and/or have complicating factors such as when the complainant has no authority to receive medical information about the patient. These complaints often involve more than one physician, require additional information from others involved and/or the collection of medical records. If the investigation finds no evidence of unprofessional conduct, the complaint is dismissed. When the Complaints Director dismisses a complaint, the complainant can request a review of that decision.
An informal resolution process best suited for single-issue complaints usually related to practice management or explanation of a medical decision. With this process, the College encourages the physician to work directly with the complainant to resolve the matter. Open and honest discussion between both parties helps them to understand the issues, and often a simple explanation or apology can close the file. More importantly, both the physician and the complainant learn from this process improving future interactions.
An informal resolution process used when the complaint seems straight forward, but one in which the physician needs to provide further explanation to the complainant and the College about the care provided, and, when necessary, make a change to his/her practice. Consent from both the physician and the complainant is required to proceed with this approach; the College then works directly with the physician to address the complaint. The underlying issue in many of these complaints is poor communication, often around patient consent or follow up care rather than lack of knowledge or skill. Resolve with Consent enables the College to respond more quickly to the complaint and allows the physician to implement practice changes sooner.
If a complaint lacks sufficient information to identify unprofessional conduct or is frivolous or vexatious in nature, the HPA allows the College’s Complaints Director to review the complaint and then dismiss it with no further action. When the Complaints Director dismisses a complaint, the complainant can request a review of that decision.
An investigation is a formal process used for complaints that are serious in nature and/or have complicating factors such as when the complainant has no authority to receive medical information about the patient. These complaints often involve more than one physician, require additional information from others involved and/or the collection of medical records. If the investigation identifies one or more problems, the College engages the physician and complainant in a collaborative resolution process that allows for a comprehensive, effective and timely intervention. These files are resolved through a written agreement and may include things like peer review, assessment and educational activities.
Disciplinary hearings occur when informal methods of resolution are unsuccessful, or when a complaint investigation reveals a serious breach of a practice standard or ethical conduct by a physician.
* Note one complaint file may have multiple natures
Nature |
2019 |
2018 |
2017 |
2016 |
2015 |
Practice Management |
283 |
271 |
257 |
227 |
246 |
Medical Reporting |
148 |
126 |
156 |
116 |
115 |
Third Party |
4 |
9 |
14 |
18 |
18 |
Ethics |
129 |
102 |
131 |
134 |
91 |
Quality of Care |
541 |
520 |
495 |
461 |
421 |
Systemic |
3 |
4 |
5 |
10 |
14 |
Unclassified |
51 |
51 |
66 |
74 |
64 |
Total |
1,159 |
1,083 |
1,124 |
1.090 |
969 |
Practice Management – Physician availability, office management including finance and communication
Medical Reporting – Release of records, report completion and accuracy
Third Party – Independent Medical Examination, (WCB, and Non-WCB, all others)
Ethics – Confidentiality, informed consent, advertising/self promotion, research related, and boundary violations (including sexual, financial and others)
Quality of Care – Diagnosis (incorrect or delayed), Treatment (prescribing, procedural and counseling, referral/consultations, follow-up)
Systemic – Access to human resources and technology, continuity of care and interdisciplinary issues
Unclassified – All others