Concentration of Power – Are Medical Regulators Autocratic?

Many docs say they’d rather be sued than face a college complaint; at least they could defend themselves.

Faced with reprimand by the College, lawyers advise doctors to bow their heads and accept punishment.

If docs refuse, a mark will be put in their file. Things will go worse next time.

The College of Physicians and Surgeons of Ontario (CPSO) reports that several thousand doctors help out doing peer reviews of other doctors. This implies, as the College presents it, that many docs must love the College.

But maybe docs help out because they want peer review to be educational, not punitive? Maybe it has nothing to do with loving the College?

The CPSO also notes that most complaints are not serious. Despite the ulcers and lost sleep caused by a complaint, the majority resolve without event.

Furthermore, the CPSO says it is bound by draconian legislation and driven by activist media outlets. It’s not their fault.

Even so, most doctors cower in fear of the CPSO. Six doctors commit suicide each year in Canada while under investigation by their regulator, with no prior history of mental illness.

In my last blog, Is Self-Regulation Dead?, some readers asked for more about the concentration of power.

If there is no “self” in self-regulation, then all that’s left is an autocratic body with power to create laws, enforce laws and punish lawbreakers. Continue reading “Concentration of Power – Are Medical Regulators Autocratic?”

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Is Self-Regulation Dead?

I believe the term ‘self-regulation’ is well on its way to the dustbin of history.”

With this, the registrar of the College of Physicians and Surgeons of Ontario (CPSO) wrapped up his final note in From the Registrar’s Desk.

He went on,

In the future, College work will no longer be described as ‘the privilege of self-regulation,’ but instead ‘the responsibility of medical regulation.’

Candor comes easy when people leave office.

Is Self-Regulation Dead?


Was the registrar simply making an observation, or was he stating what he believes to be good? Does he believe self-regulation belongs in the dustbin?

I know many doctors who became Chiefs of departments. Chiefs oversee quality. They handle patient complaints.

Chiefs see problems before they become patterns. A good Chief tries to build safety into a department to prevent problems becoming patterns.

Good Chiefs try education, encouragement and incentives as ways to improve quality.

But they never eliminate problems, and many Chiefs start to despair.

So, they take charge.

They make tough decisions.

They put their faith in power: rules, oversight, punishment.

After 10 years in charge, some Chiefs are damaged; irreversibly anti-physician. They lose hope in clinical judgement and put their faith in systems instead of people. Continue reading “Is Self-Regulation Dead?”

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Offence, Free Speech and a Code of Conduct

I’m offended.

You’re offensive.

I’m offended that you are offended!

Two train wrecks have collided around free speech in medical politics right now.

The first has to do with the politically correct/social justice warrior/virtue signalling/identity politics movement.

Proclaiming personal offence has replaced sticking out one’s tongue in the schoolyard of adult conversation. Signalling solidarity with every oppressed group is the new morality.

Thou shalt show empathy.

Thou shalt not ask rational questions such as, “Why can’t you afford meds, but you upgrade your iPhone every 6 months?

Brace yourself. People will take offence. Listeners will join a mob to signal their own virtue at your malfeasance.

There is only one accepted view. Questions are out. Debate is unwelcome.

The second train wreck has to do with the Summer of 2016. It was a dark and nasty time for doctors in Ontario. Continue reading “Offence, Free Speech and a Code of Conduct”

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