Doctors Under Fire

Canadian doctors are being harassed. Should this be happening when Canada signed international legislation protecting their rights more than 10 years ago? The Ontario Ministry of Health recently hired international consulting giant Klynveld Peat Marwick Goerdeler (KPMG). Its job is to tackle the controversial subject of how the College of Physicians and Surgeons of Ontario (CPSO) handles complaints from patients and disciplines its doctors. Even though cleaning up the CPSO may very well be a significant public health measure, a closer look at the ministry’s mandate reveals that a mere $140,000 has been allocated to the company–what a major law firm spends in a couple of days! KPMG is also not required to address the misuse of disciplinary legislation. A preliminary version of their report will be directed to the college for comment first, but the public will never see this report in any form, thereby effectively insulating the CPSO and the ministry from public accountability. Two years ago, two unrelated health-care advocacy groups both called press conferences in June. Each demanded an independent investigation of the College of Physicians. The first group, Voices on Healthcare Concerns and Accountability, has catalogued hundreds of medical disasters brought to the attention of the Ontario College. All have been ignored. The second press conference was held by Citizens for Choice in Health Care, supported by 11 provincial and national groups. When the groups joined forces, it lead to the appointment of the consulting firm Klynveld Peat Marwick Goerdeler. Alternative Targets My own three-year research into the College’s handling of disciplinary action against doctors includes evidence of deception, overt entrapment, approaching patients under false pretenses, disciplining doctors without patient or peer complaints, conducting undercover investigations into their private lives, tampering with critical documentation, denying full disclosure to the accused and misrepresentation of medical scientific evidence. What these persecuted doctors have in common–besides being deeply appreciated by their patients--is medical excellence.

• Dr Michael Smith of Almont was one of the first doctors to introduce acupuncture in Canada. He was arrested on the basis of a secret report alleging outrageous sexual misconduct. Said his widow, Joanna, "We never had pornography in the house until the CPSO brought it to us."

The press was notified before the investigation against Smith began. Four of the five patients involved, whose files were chosen unbeknownst to them, filed affidavits denying all sexual impropriety. (The fifth one was unavailable in hospital.) One of them, Margot Haug, has spent $7,000 in legal fees over the past eight years attempting to correct the "fictitious person and events the CPSO had created" from her file. Dr Smith’s license was suspended on the basis of information "doctored" in such a way as to ensure that the executive committee would agree to the suspension. Smith was not allowed to attend this hearing and no cross-examination of witnesses ever took place–four of whom, in any case, had already made it clear that the accusations were false, a fact apparently also kept from the executive committee of the Ontario college. Meanwhile, under more fire from slanted press coverage, Smith could not see how he would be able to support his family anywhere so he killed himself in 1992, leaving a young wife and four small children behind. He knew they would at least have a chance to survive on his life insurance funds.

• Dr Peter Rothbart, head of the chronic pain management section of the Ontario Medical Association, has practised medicine for 36 years. Since 1996, he has organized three international conferences on the management of chronic pain. Rothbart’s lawyer wonders if his client was hauled in for discipline (still unresolved) because his patients so often succeed with insurance claims. Several other Ontario doctors working full-time for insurance companies deny all patient claims but are never investigated by the CPSO.

• Dr Felix Ravikovich, an allergist from the University of Leningrad, escaped from the former Soviet Union and has treated childhood asthma with exceptional success. Although his research has been published internationally, he was suddenly hauled in for discipline without patient complaint and accused of using some pre-World War II equipment which he did not even own. He invited the CPSO to his office to see for themselves, but the charge remained.

  Switching its approach, the College forbade Dr Ravikovich the use of histamine, a non-prescription substance, in any of the asthma treatments he had developed with it. Public outcry resulted in a 1993 Fifth Estate television report with more than 200 asthma patients demanding, on compassionate grounds, that he be allowed to treat them. To no avail.

• Dr Norman Sutherland of Pembroke, a Harvard-trained surgeon, underwent four disciplinary hearings over a period of 15 years–all without patient complaints. The CPSO investigators secretly taped the meetings. As transcripts later revealed, the inspector also questioned Sutherland’s entire neighborhood in a fishing expedition to (unsuccessfully) find some dirt.

• Dr Carolyn Dean, formerly of Toronto, a medical doctor specializing in naturopathy and homeopathy, is now licensed in the US and lives in New York City. In 1989, the Sugar Institute of Canada complained about her comments during a television interview concerning the dangers of sugar for diabetics. The Ontario College reprimanded her for "unscientific and inflammatory statements made in public." After Dr Dean moved to the US, the College revoked her license in her absence because she supposedly failed to appear. The College’s lawyers claimed to have left messages on the answering machine, but she did not have an answering machine.

• The absurd case of Dr Jozef Krop of Mississauga is so well-known to readers of this magazine, it need not be retold here. The 7,000-page transcript of his trial reveals truly Kafkaesque minds at work at the College of Physicians and Surgeons of Ontario. Dr Krop is currently free to practise, but his case is in appeal because the diseases and treatments still stand convicted. Unless this decision is overturned, patients and doctors will continue to be harassed arbitrarily.

  Ironically, in 1989, Canada signed the United Nations’ Helsinki Accord on Human Rights. The medical section should protect physicians who practice complementary or alternative medicine from persecution. It states: "In the treatment of the sick person, the physician must be free to use a new diagnostic and therapeutic measure, if in his or her judgement, it offers hope of saving life, re-establishing health or alleviating suffering." However, this portion of the Helsinki Accord has apparently been disregarded. Aware of the growing public support for natural approaches, the CPSO responded with the so-called "Walker Report on Complementary Medicine" in 1997. The College continues to insist that doctors must "arrive at a traditional diagnosis first and use generally accepted modalities"–as arbitrarily defined by College officials. One wonders whom the Ontario Ministry of Health is trying to kid. Why bother with consultants at all?