Family doctors have highest discipline rate

About 62 per cent of Canadian physicians who were disciplined by medical authorities were family doctors, according to the first analysis of its kind in the country.

The study in Tuesday's issue of the journal Open Medicine is the first time that researchers have tracked the number of doctors disciplined by provincial medical licensing authorities and why, said Dr. Chaim Bell of Toronto's St. Michael's Hospital.

Bell and his co-authors looked at cases of doctors who were disciplined between 2000 and 2009.

Of the 606 cases, 92 per cent of those doctors were men.

The majority were family physicians, 14 per cent were psychiatrists and nine per cent were surgeons.

Previous studies suggested that the intimate nature of the work that family physicians and psychiatrists do, combined with their direct relationships with patients, may predispose some of them to inappropriate behaviour and discipline.

"This study constitutes an important first step in aggregating data on and understanding the extent and nature of disciplinary actions involving physicians in Canada," the study's authors concluded.

"The medical profession must realize that, although disciplined physicians represent a small proportion of the physician population, a single practitioner has tremendous potential to harm patients and the public."
Prevention and education

The study's authors called for programs to prevent transgressions, which they called an important area of patient safety that must be a priority for the medical profession.

Unlike other physicians who specialize in treating one particular organ or disease, your family physician is uniquely trained to care for you as a whole person, regardless of your age or sex. In addition to diagnosing and treating acute and chronic illnesses, your family physician provides routine health screenings and counseling on lifestyle changes in an effort to prevent illnesses before they develop. And, if a health condition arises that requires care from another specialist, your family physician will be there to guide you and to coordinate all aspects of your care. You and your family physician will work together to achieve the best possible outcome in the most cost-effective manner.

The number of doctors disciplined represented only 0.06 per cent to 0.11 per cent of all physicians in Canada, the researchers said.

But 51 doctors committed 64 repeat offences, or 19 per cent of the total.

The most frequent violations were:

* Sexual misconduct, 20%.
* Failure to meet a standard of care, 19%.
* Unprofessional conduct, 16%.

The researchers called for more emphasis on sexual misconduct in medical training.

What a difference a year makes. During pandemic (H1N1) 2009, primary care providers were scurrying around offices and clinics removing books and toys from waiting rooms, positioning bottles of hand sanitizer, passing out surgical masks to patients who presented with a cough or fever and using hospital-grade disinfectant to mop up floors when a suspected H1N1 case left their office or clinic.