Do you trust your doctor?

An exclusive Maclean’s poll shows that an increasing number of Canadians don’t

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After five miscarriages, and with the odds of ever having children stacked against her, Lee Dix was glad to get a second opinion. It was the summer of 2000, and the Toronto woman had been referred to a gynecologist based at Scarborough Hospital, Dr. Richard Austin, whom she hoped would eventually deliver her first baby. But far from feeding her optimism, Austin told Dix she had a benign tumor called a fibroid in her uterus, and made a provisional diagnosis of endometriosis, a painful disorder where cells on the uterine wall grow out of control. Between 2002 and 2005, the greying physician performed two operations on Dix—one a total abdominal hysterectomy, the other to remove her remaining ovary (she’d had one taken out in a previous operation). “I just went with what he said,” Dix now recalls. “I trusted doctors, and I thought that if anyone is going to work on me, they must have the proper schooling and knowledge.”

With that, her dream of having children ended. By 36 she was entering menopause, and thus began a medical nightmare she now blames on mistakes and misjudgments committed by Austin. She missed months of work in her job as a receptionist, suffered depression and still deals with bowel control issues because, she alleges, Austin twice perforated her large intestine while she was under the knife. More stunning still, the 41-year-old has since learned that the surgeries may have been wholly unnecessary.

In a civil suit recently filed in Ontario Superior Court, she cites the results of ultrasounds and other tests performed before and after the procedures showing no evidence of endometriosis or fibroids, raising the question of why Austin suggested surgery at all. The whole experience has left her heartbroken—and downright fearful of anyone in a white jacket. “I haven’t even gone for my yearly physical,” she says. “I don’t want to see any doctors. I don’t know who to trust.”

Dix’s allegations have not been proven in court, and Austin has not yet filed a statement of defence (his lawyer declined to comment). But she’s not the only one telling horror stories about doctors these days.

From the pathology scandals in Newfoundland and Windsor, Ont. to an O.R. slip-up that nearly cost former NHL coach Jacques Demers his life, highly publicized medical errors are taking a big bite out of Canadians’ confidence in the medical profession, leaving many suspicious before they so much as take a seat in the examination room. In a poll taken last week for Maclean’s, 40 per cent of respondents said they believe Canadian doctors care less about their patients than they did 10 years ago; only six per cent said physicians care more. One in five said doctors are more likely to make errors than they were a decade earlier, and the MDs didn’t score well on questions of honesty, either. More than half the respondents to our poll said they believe doctors do not readily acknowledge their mistakes.

This is not about respect, so much as trust—92 per cent of those surveyed said they hold doctors in high esteem, and an overwhelming proportion of Canadians believe their own GPs do a good job. But there’s no denying the impact of the recent high-profile cases, given the disproportionately large number of people affected. The doctor at the centre of the Windsor controversy, for example, went on interpreting cancer tests for thousands of patients despite suffering from cataracts that hospital officials acknowledge may have compromised her work. In Newfoundland, pathology mistakes between 1997 and 2005 resulted in wrong test results going out to nearly 400 breast cancer patients, 108 of whom have died while untold others lost breasts only because they started treatment too late. In Saskatchewan, a government review of 68,360 images interpreted by Yorkton radiologist Dr. Darius Tsatsi uncovered 1,988 mistakes that will affect patients’ treatment. In Toronto, Austin has faced complaints from scores of his former patients, at least 38 of whom have filed civil suits like Dix’s, claiming unnecessary surgery or botched procedures.

These horror stories have made Canadians wary, says Mario Canseco of Angus Reid Public Opinion, who oversaw the Maclean’s poll. “Not only do they worry that there will be mistakes, but they assume so,” he says. “Even if you’re happy with your GP, you see what’s happened to those around you. You think it may be your time next.”

For doctors, this is an unaccustomed, and not especially pleasant, spot to be in. For generations, physicians have enjoyed greater public respect and appreciation than practically any professionals—a reflection, perhaps, of their status in many communities as the most educated people in town. That’s changing, however, as post-secondary education becomes the norm and Canadians in general grow less deferential. “There used to be a very paternalistic relationship between doctors and their patients,” says Dr. Rocco Gerace, registrar of the College of Physicians and Surgeons of Ontario. “It worked both ways. Patients would essentially give doctors the decision-making ability, as opposed to considering options and then consenting. It’s changed dramatically, and I think for the better.”

That shift has been accelerated by the Internet, which puts not only diagnostic information but reviews of individual physicians at the fingertips of patients. RateMDs.com, a California-based site that went online in 2004, has doubled its traffic every year since, with Canadians as its most enthusiastic constituency. The site now has user-submitted ratings for over 85 per cent of Canadian doctors, and a surprising 45 per cent of its 1.2 million monthly visits originate in this country. The phenomenon speaks not only to patients’ doubts, but an appetite for frank criticism that Hugh MacLeod, chief executive of the Edmonton-based Canadian Patient Safety Institute, says will only grow. “For those in the system who think things are getting wild now,” he says, “put on your seat belts.”

All this crowd-sourcing raises an obvious question: are medical mistakes becoming more common? Or are they merely being amplified by proliferating media, both social and mainstream? Geoff Norman, a McMaster University psychologist who studies how doctors make errors, believes recent scandals played out in the media have simply caused patients to demand reviews and investigations, the coverage of which has fed impressions that things are going awry. Doctors are more willing to own up to mistakes, he argues, and he points to the publication in 2000 of “To Err Is Human,” a report by the Washington-based Institute of Medicine, as a watershed moment in encouraging practitioners to acknowledge their fallibility. “Now,” he says, “there’s almost like a legislative review process when something goes wrong.”

The few statistics we have on the issue inspire less certainty. In 2004, researchers at the University of Calgary and the University of Toronto produced a landmark study of medical mistakes, and while they have yet to publish an update, those first indicators were enough to set off alarm bells. Some 2.5 million people admitted to hospital each year in Canada suffer what health care administrators call “adverse events” (i.e. errors), the study found, while somewhere between 9,250 and 23,750 died in 2000 because of avoidable mistakes in their treatment. Patient safety advocates say things are improving, but surveys done since suggest only marginal gains. In 2002, some 20 per cent surveyed in Pollara Inc.’s exhaustive Health Care in Canada Survey said they’d experienced some sort of adverse event while receiving care, from misdiagnosis to surgical infections to receiving the wrong medication. By 2007, the number had fallen by only one percentage point.

How many of those cases can be laid at the feet of doctors is unclear, but Canadians are making as many allegations as ever about physician misconduct. Since 2005, the annual number of complaints to provincial colleges of physicians and surgeons has climbed from 5,482 to 5,990, with the majority of reports revolving around matters of competence and the doctor’s behaviour (each province, it should be noted, defines complaints differently).

What practitioners, safety advocates and patients can agree on is that pressures within the system are often to blame when things go wrong—not least physician shortages. While more than a third of respondents to our poll believe doctors have their patients’ best interests at heart, 39 per cent say physicians are more concerned about dealing with patients as quickly as possible. And some of the most damaging scandals in recent years have occurred in parts of the country that have trouble recruiting and keeping experienced doctors, notes Dr. Peter Hutten-Czapski, the former president of the Society of Rural Physicians of Canada. Rural communities get a lot of people who are fresh out of residency training, because most doctors are born, trained and have built lives in big cities, adds Hutten-Czapski from his clinic in Haileybury, Ont., about 200 km northeast of Sudbury. “If your wife’s an aerospace engineer, a ballerina or an architect,” he says, “it’s not likely you’re going to move to Engelhart, Ont.”

This seemingly basic problem creates no end of complications, starting with a relentless turnover. One recent study suggests one in seven doctors in rural Canada plans to move in the next two years. Another is a severe shortage of specialists, who in isolated areas tend to be overworked, inexperienced or both. The problem is particularly acute in Newfoundland, which is known for its dependence on foreign-trained medical graduates to fill the demand for specialists.

Janet Henley, a lawyer and breast cancer survivor from St. John’s, learned that the hard way. She was 40 years old in 1997 when doctors performed a lumpectomy to remove cancer from her breast. After sending a tissue sample to the local pathologist, they told her she was cured. Four years later, the cancer had grown back, forcing Henley to suffer through a double mastectomy.

Exhausted, weak and hospitalized with severe depression, she began to wonder whether she might have avoided such drastic treatment. After seeing news reports that Eastern Health, the authority responsible for Henley’s treatment, had botched hundreds of other women’s breast cancer hormone receptor tests, Henley began to question her own diagnosis. In 2008, she had the tissue that was collected in 1997 sent for a second opinion at Johns Hopkins Breast Cancer Center in Baltimore. They found cancer on nine out of 14 of the slides, Henley alleges, including one lesion that measured a full 1.4 cm in diameter. The pathologist had evidently missed them all, and Henley is now suing Eastern Health for $5 million.

The whole experience has left her with a checklist of unanswered questions. Did the pathologist who handled her slides have proper training? Was that doctor overworked? Did he or she have a history of misdiagnoses? Henley may never know for sure, because when she asked Eastern Health whether it had ever reviewed the pathologists’s work, she was told that the information was confidential (her case was not part of a judicial inquiry into problems at Eastern Health which focused on hormone receptor tests). Nor can she find out whether any other women have sought disciplinary action against Dr. Jessica Shepherd, the pathologist who interpreted her test samples, because the provincial college of physicians and surgeons isn’t required to reveal the information.

That’s left Henley, like so many Canadians, doing her own research on the Internet. So far, she’s determined that Shepherd was trained at the University of the West Indies in Trinidad and Tobago, and is now an associate professor of pathology at the University of Western Ontario in London, Ont. Shepherd declined comment this week through an office assistant, and Henley’s allegations have not been tested in court. But the Newfoundland woman is not about to let up. “I would like to know whether my case was unique,” she says. “I’m not sure how you miss cancer on nine out of 14 slides.”

Her frustration points to a lingering problem when it comes to getting doctors to face up to their shortcomings: they are powerfully protective of their reputations, and have the money to be so. While some physicians point to declining numbers of malpractice suits as proof they are making fewer mistakes, others claim lawyers for the MDs have been discouraging such claims by dragging out litigation and exhausting the patients’ financial resources. Even when an issue doesn’t go to court, doctors are quick to go on the defensive, says Dr. Brian Goldman, host of the CBC Radio program White Coat, Black Art and author of The Night Shift, a forthcoming book that explores doctor error, among other issues. “I think physicians have been the single greatest impediment to patient safety in Canada,” says Goldman, who is an emergency room doctor at Toronto’s Mount Sinai Hospital. “I’m not saying they actively block the search for truth in some evil and nefarious way. But they tend to feel a powerful sense of shame at any insinuation that they’ve been less than competent.”

That attitude is born of an atmosphere in which errors can have catastrophic impact on one’s career, he says. “It’s hard to take a non-emotional look at mistakes when you’re thinking, ‘I’m terrified.’ ” But as the proverbial smartest people in the room, MDs are also prone to overconfidence—if not plain arrogance. Worried by U.S. studies suggesting such doctors can have a negative impact on patient care, professional colleges across the country have adopted guidelines to combat physicians who belittle colleagues and disregard the feelings of patients, à la Gregory House of TV fame. And physicians’ reputation for supreme self-confidence may explain why other health care professionals score higher ratings from the public when it comes to personal integrity. A 2009 Gallup poll indicated that Americans rate nurses’ honesty and ethical standards higher than doctors’—83 per cent versus 65 per cent (the Maclean’s poll also found marginally more respect for nurses and farmers than for doctors).

The good news is that the profession as a whole is starting to get the message. The Canadian Medical Association (CMA), representing some 68,000 physicians across the country, has supported numerous initiatives aimed at curbing medical errors, such as the introduction of pre-surgery checklists, the establishment of health-quality councils across Canada that measure and report on quality of care, and the creation of disclosure guidelines by the Canadian Patient Safety Institute, which promote transparency about medical errors. Last week, the association published a report called “Health Care Transformation in Canada,” calling for a culture of patient-centred care, including more timely access to services and greater accountability in the profession. “The report,” says CMA President Dr. Anne Doig, “is predicated on the principle that we need to do our jobs better.”

Doig acknowledges concern about some of the findings of the Maclean’s poll. But she wonders whether perceptions that doctors care less about patients and are more likely to make mistakes speak more to lack of access to, or long waits for, medical care. She also notes that increased disclosure of medical errors can be falsely interpreted as an increased incidence of mistakes: “We’re not making more mistakes than we ever have, necessarily.” Treatment, she adds, is more complex than it used to be and expectations are now higher. “Life was simpler,” she says, “when the doctor went around in a horse-drawn buggy with a little black bag and did the best he could.”

Perhaps. But such reassurances offer small comfort to patients like Lee Dix. These days, she quietly struggles through her shifts at a downtown Toronto law firm, pondering reforms that might save others the misery she’s endured—greater transparency when it comes to doctors’ past blunders, say, or pre-surgery checklists. “But there’s a lot of things that occurred in my case that wouldn’t have existed on any checklist,” she says. Mostly, she wonders what might have been. “Not being able to have children haunts me pretty much every day.”

Poll results are from an online survey of 1,024 randomly selected Canadian adults contacted by Angus Reid Public Opinion on Aug. 5 and Aug. 6, 2010. Respondents are Angus Reid Forum panelists. Margin of error is ± 3.1 percentage points.




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Do you trust your doctor?

  1. Hey, it's a start, MC. If people are less and less trusting of a profession that used to be held in higher esteem, that's worth at least starting the conversation.

  2. I had once read that the docs have a group liability protection organization, that seeks to compensate when the care is indeed below par (and a litigating patient suffered harm), and to defend very aggressively when the care could be defended (no "convenience settlements" of nuisance suits). Obviously, that does nothing for harmed patients who do not sue. I think I have found that approach in writing. Have a look at the "Governing Principles" of this web page:
    http://www.cmpa-acpm.ca/cmpapd04/docs/about_cmpa/

    • Even when a CMA member is in flagrant violation of basic standards of competance or care CMPA (and their multi-billion dollar endowment) agressively litigate to the nth degree and then appeal in the hope of patient death and reduced damages. The Fifth Estate (even a brokern clock is right twice a day) did a big story on this outfit years ago. It ain't just lovers who never have to say they're sorry! The best medical advice i ever recieved was " never forget it is a statistcal truth that half of all docs graduate in the bottom half of the class"

      • "never forget it is a statistcal truth that half of all docs graduate in the bottom half of the class" is so neither here or there. What's more important is that those that graduate meet the standard of competence. Where one graduates in terms of the class grades is not the only determinant of how good a doctor they would be. The book smart but socially awkward top student would do well in some internal medicine field but may not do as well in the ER where thinking quickly on the feet is required. A good doctor is one that care's about the patient, competent enough when his/her knowledge is lacking and humble enough to seek sources (be it looking it up or a fellow MD consult) when the knowledge is missing. And that and good communicative skills.

        • Well said Simon,
          A rational approach, no matter how inflamed and engaging a passionate perspective can be , is what drives the heart beyond it failings to reach for excellence. That excellence, that equanimity as you have so well pointed out is never attained alone nor without words from another.
          Physicians have worked long thankless hours and been payed little in recourse for the wealth they have given over in another's health, it is only natural then over time that some would have come to see from inside and out , not a profession in search of answers, but those in possession of them.
          Of course no one profession of person has all the answers yet every bird to it's nest does fly that all the forest may sing and so what appears neither here or there may be that; at the bottom of one class is the height of the other.

        • Joke: two engineers are talking: hey, considering what I am doing, I am afraid to go to a doctor…..

    • In Ontario, it is the policy of the medical liability insurance company to fight every lawsuit. This is their approach to deter lawsuit. You better have deep pockets if you want to sue a doctor in Ontario. Aside, the malpractice premium of Ontario doctors are heavily subsidize by the Ontario government.

      • It's everywhere, not just Ontario folks. Doctors as a "profession" are as ruthless and underhanded and vicious as lawyers. Remember, both groups are "self-regulated professionals". That means they can, and do, as they wish. And self-interest usually trumps all.

        In BC a physician molested two young teenage girls. When they got older and made a complaint to the BC Medical Association, this physician wasn't suspended or punished in any way. Only when he murdered the still-teenage girl, did the BCMA take his license away — and only after he was convicted of her murder.

    • So what? It's a protective ass'n, a union in other words Yes doctors'make mistakes because they are humans. Whoever told they were God some time ago was ignorant. When they do make a mistake, if the victim if still alive, otherwise the family should be compensated for real loss. But money does not replace love for most people. I think it would be a tragedy, not for doctors, but for our health care system if we allow settlements to mimic those in the US. A doctor can lose his licence fo negligence and there could be other penalties as well like prison.

      I personally have been under the doctor's thumb many times in my later years. While most have been excellent, it doesn't hurt to get a second opinion, or third if you aren't sure. But be prepared to pay for that second opinion.

    •  This is not true. Only 2 percent of patients get any compensation. Rarely are doctors in Canada found guilty of anything.
      With 24,000 people dying in Canada a year,80,000 admitted to acute care hospitals and over 5 million claiming to have had a medical mistake or know someone who has then you will see this is not true.

  3. There are not enough safeguards in the medical profession. For instance, when a pathologist analyzes a tissue sample for cancer, why isn't there a second set of eyes that analyze the sample? For something so important, such a safeguard seems essential. There's too much pressure in the system, that's why. The same pressure that causes people to wait months to see a specialist is also causing specialists to make mistakes.

    • I don't know about where you live scf, but tissues are routinely sent to three pathologhy labs. For example, in Victoria it could also go to Vancouver and sometimes Seattle – routinely.

    • I agree. Why isn't there a proper peer review process in place, particularly when you're dealing with such critical illnesses. Further, I agree that rationing in the system is partly to blame. However, regarding the issue of trust, my experience has been far worst in the US. Often in the US, I have a hard time distinguishing the motives of my doctor and that of a salesman. In a private system, the profit motive causes severe challenges for establishing trust. And, I argue that this paternalistic relationship between a doctors and patients is necessary, and indirectly, it is part of the healing process of the patients. There is value to viewing doctors as guardians, and to strip doctors of that title has costs. In my opinion, medical students need to be trained (and perhaps selected) to value humility and the inherent altruism of their profession, and not just their status and earning potential. Doctors need to get over their ego — we need doctors who have wisdom, not just knowledge.

    • Be afraid doctors hide cancer diagnoses.
      I am a victum of medical abuse in Alberta,
      The brotherhood of Doctors stand together at the cost of human life.
      I am critically Ill due to the neglegance of doctors.
      Canada rates almost last among advanced countries.
      I stood up against a Prominent surgeon and now no doctor will help me.
      The health ministeries are corrupt.
      I was told by The provincal and federal minister that there was nothing more they could do for me!
      I was told by the Alberta Minister of health, that he is at arms lenght to his tribunals. This is a lie!
      The health Minister has all the authority through the power and authority act.
      The judicial system is just as corrupt. I now have a law suit . The Justice is bias and refuses to uphold the charter of rights'and freedoms. "I am not here to save your life, only to ensure this lawsiut proceeds"

  4. This article doesn't even touch on another big issue at play: the role of big business in determining what pharmaceuticals make it to market and are advocated. There is no credible evidence to support the efficacy of flu shots, and I personally know someone who had a serious adverse reaction. It will be interesting to see if Gardasil actually proves to be safe after the insane push to get the government to spend millions on it. Anti-depressants are doled out like candy, despite research showing that they are only effective in severe cases of depression and are, in fact, no more effective than candy for its milder forms. Most doctors, it seems, are happy to push whatever the drug companies are advocating without much question. We all have to be our own health care advocates these days. Not only can we not trust doctors any more. We also can't trust the government to act in our interest when it comes to drug regulation.

    • If only the records of nursing homes were made public, then you'd see where our taxpayer dollars are really going –– to drug the residents into barely functioning zombies. Using drugs that aren't approved for this purpose, have very harmful and even deadly 'side-effects' and – get this – have been shown in studies to not have any effect in improving dementia. Nope. It's just for the convenience of staff.

      The Pharmaceutical companies have been so successful in flooding newspapers with stories about you should "see your doctor" if you're the least bit sad or down. I'm not talking about people who are seriously ill. Just the ups and downs of everyday life. Let's drug 'em. The side effects of these drugs being given to seniors for dementia, actually include memory loss, confusion, anxiety,…. So, beware folks. You may start out mildly depressed about some matter, but very soon you'll be a dementia patient.

      Just be careful about what anyone in a white coat hurriedly tells you to take. He/she have been told to dole these drugs out by the pharmaceutical drug companies. The doctors are their "pushers". Most doctors have no time or interest in reviewing the studies. They rely on the sales force of pharma companies.

      Now, before anyone gets the idea that I think all doctors and all drugs are bad, I'd like to say that I know many good doctors, and good medication. However, the good doctors are bullied by their own medical associations. Indeed some doctors are even persecuted by medical associations for not towing their line.

      Every person needs to consider that when they see a doctor or take a medication, they are taking their lives in their hands. And, the doctor has very little interest in you, other than your role in his bottom line. Forget what doctors say publicly. As your mother told you, it's not what they say, it's what they do that we should pay attention to. Protect yourself, knowledge is power. And if your doctor berates you for asking questions, taking an assertive role in your own health, RUN.

      • Once again, I don't know where you live but once again in BC those issues are routinely monitored by the licening authority or the doctor. The practice of deliberately and routinely zonking long term care patients so they are la-la and manageble is ancient history since 1978. Now the BC system has been crapp[ed uponsomehwat by the current government, butb the professionals involved are experienced nurses and question that sort of drug administration. And their visits are linked to program payments. .

  5. To reduce medical errors, the compensation scheme for doctors have to change. Instead of pay for service, they need to be on salary. Also, Canada needs to increase the pool of doctors. Competition is necessary but you can't have real competition if the pool of doctor is limited by the regulators. Until we can increase the pool – either through tele-medicine or letting in more foreign-trained doctors – there's nothing much we can do about the increase in medical errors.

    • Oh, please. In order for doctors to do the right thing, to act properly, we need to pay them more???? Come on. Doctors' unions (medical associations) are always the first with their hands' out whenever healthcare budgets are discussed. And they are the first and best compensated by governments. Why is this? Well, lawyers and doctors work very closely together. Lawyers make lots of money, on both sides, whenever doctors screw up. Medical association insurance companies spend huge amounts of money on lawyers, and so as the clients with the deepest pockets, they will be coveted by lawyers.

      Why do I go on about lawyers? Well, they make the laws. To suit themselves. Check it out. Delivery of health care is a provincial responsibility. And in each province there are working committees of lawyers whose responsibility it is to make and change laws. It's not the elected representatives (MLAs) who make laws. They just vote on them, and by the time the laws are made, the MLAs do little, if any, tinkering with the laws. The way they vote has pretty much been decided behind the scenes.

      So, that's the story about why there will never be any meaningful accountability. Doctors are just too powerful as a group.

      • Oh really? Gee, what about medical manpopwer authorities who know nothing about klawyers; they influence med school intakes so the province isn't overpopulated in the wrong places with doctors; they try to influence the distribution of GPs through approval of med plan tickets, and othe influencing things- like paying an extra stipend (contract) for GP to go to an underserviced locale. Your account of these other provinces is very interesting. Have they heard?

        However, your copmment on pharmaceutical companies seems on the mark.

  6. some years ago I had surgery to reverse a tubal ligation with a local ottawa doctor. Unfortunately for me this happened just as the Riverside Hospital was being closed. My doctor said he would have to move the surgery to the Civic hospital and that although I should be paying more for the surgery he was willing to give me a break. A break he gave me. He performed micro surgery which I paid for without a microscope. It was his first surgery at the civic hospital and when he asked for a microscope there was none in the surgery. He went ahead and performed the surgery without a microscope. This I learned a year later after having spent a year on fertility medication with no luck. I made an appointment with a fertility specialist who asked for my records. After picking up the records I was reading them in my car when I discovered the truth. I was so upset I called the doctor and he agreed to meet. His comment was "I am sorry, what did you want me to do? you where already opened up when we discovered there was no microscope"

    One of my customers husband went in for routine back surgery and came out of surgery a paraplegic. Doc said oops sorry the knife slipped.

    I have done business with CMPA and was in a meeting which really disturbed me. I was speaking about the American system of medical malpractice and how they will refuse to insure a doctor that has been sued numerous times. I was thinking it would be the same here in Canada. A group of about 10 high level CMPA folks laughed at me and asked "you mean the frequent flyers?" lol no, we know who they are but no we do not refuse to insure them" At that moment I lost all faith in our medical system. Imagine CMPA knows who the "frequent flyers" are and do nothing to protect the Canadian people from being victimized and butchered by doctors who are doing it every day!

  7. One way to reduce the harm caused by bad pathologists (Smith) or rogue gynecologists (Wai Ping, Austin) would be to ask the CPSO to quit dragging out complaint investigations for years on end – even as the pile of victims (like Austin's victims) piles up. And then after dragging its heels for years the CPSO, if it does anything at all, usually chooses to opt for censures which can be kept secret from the public (like "cautions"). Dr. Gerace, in this article, says he is gald to see the end of the paternalistic doctor-patient relationship. Too bad he continues to prefer the paternalistic and secretive CPSO approach to protecting the public from the likes of Dr. Austin.
    (By the way, the CMPA's heavy-handed, scorthched earth approach to victims of medical negligence is funded by the taxpayer. Doctors only pay about 15% of their CMPA insurance premiums. The province picks up the other 85%. The irony in this is that Austin's victims are funding his high-paid CMPA defence lawyers but have trouble coming up with the money to pay a lawyer of their own.)

  8. Just got back from a Dr.'s appt. She made me wait for half an hour (no patients had left during the time). My previous Dr. of 17 yrs. didn't have enough courtesty to send us a note that she was retiring (in her early 50's) and passed on our files to our current one. Our current Dr. spends more time checking and updating her online records than she spends with me face to face. I finally told her so. She couldn't remember that she had requested certain blood tests – just referred to the blood results my 'marvelous' Oncologist requested. Am sure she has never read through my, admittedly, thick paper file. She didn't know I'm a 7/8 yr stage IV cancer survivor, yet she's had my file for 2 yr+. Have a knee problem. Explained what happened. Her response, it's got to be arthritis – get an Xray. I'll be looking for a new Family Dr. tomorrow.

  9. PS to my previous post. Wish me luck in finding a new GP.

  10. I have spoken once to one of the technicians working in a hospital lab (Pathology), and he cautioned me that if I have lab tests done, it is better for patient to always check your physician for the results, do not wait for them to call you. He said many of the samples sent to them, have no labels and name. They have to phone offices that sent those to ask for proper labeling for those blanked samples. And in many cases those doctors do not respond to their calls, or if they do, sometimes they can't properly identify whose those blank samples belong to.

    As for medical trust, I believe the doctors are lossing much of those trusts and respect due to their pharmaceutical allegiance. They boxed themselves as nothing but legitimize drug pushers. As for liability insurance, CMA and their insurance group fight every mal practice issue to discourage patient from suing, not to protect the patient.

  11. I am always amazed when people complain about physicians being "pill pushers" when it has been my experience that patients expect a "magic pill' to fix everything that is wrong with them. Certainly, behavioral therapy works as well as anti-depressants but requires a great deal more work on the part of the patient; yes- you can treat severe obesity without medication or surgery but it requires a great deal of commitment on behalf of the patient; yes – you can quit smoking without medication but again it is not easy…Yes it would be better is you ate a healthy diet without using vitamin & mineral supplements……need I go on? Do people honestly believe that physicians don't want their patients to take responsibility for their own health? Should your physician give you a "pep talk" instead of just handing over the prescription, you file a complaint with the college.

    • Finally, someone who knows what he'she is talking about I suspect there is more attention given to online quacks than their own doctor. And other so-called disciplines that are barely tolerated by doctors but somehow have been fiven a looky-see. And people are so gullible about these "healers" – have you tried aroma therapy? Really! And then there is getting your spheres aligned and on and on. Wherever there is person vainly l;ooking for what doesn't exist, there are these quacks. Despite all this some doctors do make mistakes. And other patients wander between doctors looking for the cure that may not be there. Cancer cure, for example. I have had cancer and I understand what it means to be given very unfavourable odds. I was lucky and it was caught in time for excision by surgery (radical prostate surgery for aggressive cancer).

      Personall,y I have a lot of time for my doctor.

      • Glad to hear you came through all right!

        I suspect the state of affairs really does tend to the following: "I've got the greatest doctor, but as a group they're a bunch of greedy, parasitic, irresponsible, uncaring, self-protectng, elitist so-and-so's…" That's if you're lucky enough to even have a doctor.

  12. As an ER doc with 13 years of education, 8 years of experience, and ongoing medical education & courses (that every licensed MD does)…. I see often overwhelming waves of patients with complex acute and chronic problems – and I struggle to do my best despite numerous system and resource limitations and pressures. I don't know a single colleague that wants anything but the best for the patients we see, despite the fact that many of the problems we're faced with don't have easy clear-cut solutions or guaranteed outcomes.

    An article like this, and especially the posted comments below, make me feel at best sad, and at worse despondent.

    • you must live in the land of unicorns and rainbows. to say you know of no colleague that does not want the best for patients they see leaves me incredulous. -I have worked for many years as a R.N and have seen The great, The good , The bad and The ugly. (in all aspects of health care professionals) . what I have found really appalling is the lack of accountability a bad doctor or even a good doctor who clearly has made a bad mistake has to the Canadian patient. ER doc,— if you are at all honest you know you could cite many examples of things that "just weren't right" being swept under the carpet. Real and decent people get hurt by the deceptions. It is doctors like you that sit back and do nothing but lobby for the status qou that are turning Canada's medical system to a scary place to get sick in.
      Given a choice I would love to be able to buy a private insurance plan -expensive as they are- so that at least I could complain about substandard treatment and the insurer would be happy to listen and act. What we have now is sub par-. The only Canadians that are smug about out "world class" health care are politicians (who go elsewhere or to the VIP lounge) and Canadians that have not been sick lately. Peop;e reading this may want to write and say you think your care was wonderful– maybe it was and maybe it wasn't– sometimes the biggest box's of chocolates and thank you cards come from the people who haven't a clue that they survived not because of but in-spite of the care they received. Oh and by the way- I am one of the good guys that work hard and always put the patients first. I wouldn't say all this if I didn't care.

  13. Interesting that the surgery may have been unnecessary to begin with. Heath care is a business, at least for physicians. What I would like to know is why there is a blood test for prostate cancer, but no equivalent test for cervical/ovarian cancer? Could it be the case that there is such a blood test, but because physicians get a great deal of business from performing pap tests the blood tests are kept out of the country? It is odd that there would be a blood test for prostate cancer, but not one for cervical or ovarian cancer. Imagine . . . no more paps! How wonderful would that be? But a great deal of lost business for physicians.

  14. Doctors hide Cancer Diagnoses.
    The brotherhood of Doctors stands together , even at the cost of Human life.I stood up against a prominent surgeon and now I am left to die!
    Canada is rated among the lowest of all advanced countries.
    The Health ministeries will not uphold their mandate. They allege they are at arms lenghth to their tribunals. This is a lie. The power and authoroty
    act gives the minister authority over all his agents.

  15. I am liniving with blood cancer and organ failure.
    I know first hand the corruption in the Medical and Judical systems.
    The Judicial system protects the doctors.
    View my story on Youtube
    fightingforjustice10

  16. Hi Valerie
    I read your sad story and feel your frustration with the system. I too am a nurse who struggles every day with a system in Alberta that keeps promising to improve access to care and perhaps quality of care but in reality until the powers that be start listening to the front-line workers, things will not change. The money is usually spent on setting up programs and putting another layer of management in place rather than provide for more front-line workers or perhaps solve community social issues to improve lifestyles. My sympathies and best wishes to keep your chin up–you can proceed with a clear conscience.

  17. After just returning from the US after 15 years, I have so far been unimpressed with Canadian health care, other than the fact that it is "free," insofar as being universally available. One clinic doctor (apparently trained overseas) misdiagnosed my ulnar nerve compression (which I had diagnosed correctly since it caused numbness in my little and half of my ring finger) as carpal tunnel syndrome which causes numbness in the other fingers. I even took my research in with me, and she ignored it. To add insult to injury, the Chinese "nurse" could hardly speak English and could not spell "ulnar."

    Just today, a friend told me about pain in both feet. Her GP threw pain pills at her and referred her to a rheumatoid specialist. In 5 minutes, I found a note from a US podiatrist that pretty much ruled out arthritis (since my friend is in her mid-30s) and recommended being seen by a DPM, who then might refer her to a neurologist… and in fact, the issue may be in the lower back. Where are many Canadian doctors getting their information, and why are they ignoring common medical knowledge? It's somewhat scary.

    In the US, health care was very good to me, but there are obvious issues for 30 million people there who do not have any coverage whatsoever, those with HMOs as their provider (as opposed to a PPO plan where the patient somewhat controls their destiny), and those with pre-existing conditions.

    • If you live in Canada, forget it. You are NOT safe.

      One unethical doc protects the next unethical doc, etc.

      More and more Canadians are going out of the country for our medical care. It seems the physicians in Canada (at least in BC) take no responsibility if they injure patients physically and emotionally. They lie, they withhold files, they destroy files, they leak information to the media. They drive people to suicide and to the psyc wards – where they work.

      Its time to wake up and smell the stink, aka medical "care."
      In Canada, where the doctors are guaranteed their salary health "care" is incredibly sh*tty! Why the hell shouldn't they have to earn it like every other doctor on the planet? At least they'd be MOTIVATED, which they definitely are not.

      I've worked in many Canadian hospitals, and I know of what I speak.

      I'm really distressed that so many people have been unnecessarily, and permanently harmed. It's SICK.

  18. Had surgery almost two years ago to remove cancer. My first surgery was in November of 2009 to remove a large cyst and this is when they found the cancer in my neck. My second surgery was in January of 2010 was to remove my thyroid and lymph nodes.I was very upset that I had to wait for my second surgery in January, I waited almost two months to have the cancer removed from my neck. My second surgery was more difficult and I after 3 months I had to get back to work and forced myself to feel normal, even though I had been suffering inside while I worked. When I felt somewhat better to visit my surgeon I requested a report of my surgery, I read the details of my surgery and found that the surgeon slipped with the knife and accidentally sliced open my cor artery and my jugular vein. It says they repaired my co artery and had to sacrifice my jugular. I was extremely upset when I read this because nobody informed me of the mistake. I woke up from my surgery and could barely open my right eye, I have no feeling on the right side of my head and part of my face. For almost two years I have been dizzy and still feel out of sorts most days, I do try and do activities that I love, but I can’t do them as often and I feel out of sorts most of the time.  When people look at me, they cannot tell that I am suffering, I guess I hide it very well. Just very upset, its bad enough that I had to deal cancer.

  19. Had surgery almost two years ago to remove cancer. My first surgery was
    in November of 2009 to remove a large cyst and this is when they found
    the cancer in my neck. My second surgery was in January of 2010 was to
    remove my thyroid and lymph nodes.I was very upset that I had to wait almost two months to have the
    cancer removed from my neck. After I had my second surgery I had a lot of difficulties, I couldn’t sleep lying down, i blacked out if I laid down flat, half my body would go numb, it took me about  3 months before I had to force myself back to work. It was very difficult trying to pretend to look normal, even though I had been suffering inside while I worked. When I
    felt somewhat better to visit my surgeon I requested a report of my
    surgery, I read the details of my surgery and found that the surgeon
    slipped with the knife and accidentally sliced open my cor artery and my
    jugular vein. It says they repaired my co artery and had to sacrifice
    my jugular vein. I was extremely upset when I read this because nobody
    informed me of the mistake. I woke up from my surgery and could barely
    open my right eye, I have no feeling on the right side of my head and
    part of my face. For almost two years I have been feeling dizzy and still feel
    out of sorts most days, I do try and do activities that I love, but I
    can’t do them as often and I feel out of sorts most of the time still.I guess the only positive thing I can say is that I am slowly feeling better every day. Just very upset, its bad enough that I had to deal with cancer.

  20. It is very difficult to sue a doctor in Canada. Its hard to trust anyone when you know that they are not fully accountable for thier actions. Personally, I have not been seriously ill in some time but I find if I go to see a doctor Im usually brushed aside and nine times out of ten sent home with only some advice. Of course, they still collect thier money from Medicare. I wont waste my time going to see doctors anymore unless Im deathly ill. If I just want some advice I ll get it from the net. Its a lot cheaper for our health care sytem.

    • You could be blacklisted from any care,tests or treatment but do not realize what is going on. JMO

    • In the US, it is terribly hard to sue a physician for anything. You read about cases in the papers but I’ve yet to actually MEET anyone who was harmed and who did try to sue, manage to even get the lawsuit off the ground! Insanity! Our dental boards and medical boards, the supposed policing arm for those professionals, is made up OF their peers! I want MY state to begin having as many healthcare CONSUMERS on those Boards as well as peers. THAT should at least get the “layman’s” points of view on the table … have OUR peers there!

  21. Even we personally experience these happening in Ontario.  We complained about Surgeon doing unnecessary caserean section and giving false information.  The CPSO and Ontario Health also covered up and sided the reckless surgeons for wrong doings. Someone should come with a website, to blacklist the doctors so that to protect the public interest.  We are not being protected instead of becoming a victim and endangering our lives with such reckless doctors. After the operations there are complications. They are trying to cut down the birth rate by this method. Beware.

  22.  As the victim of an extensive fraud and cover up I would not trust a doctor for any reason. I was left in a life threatening condition and denied medical help.
    Charts were altered and the mental illness diagnosis was put in place to cover up negligent care. I reported this as an infectious disease cover up but those complaints quickly covered up.
    Canadians have no idea what is going on in their hospitals and what things are being swept under the rug. If they knew they would be shocked and disgusted.

  23. What we need – what we need – it to be able to sue them!

  24. Saying that
    I am grossly disappointed with the Canadian Health care system would really be
    a HUGE understatement. In 2002, my mother suffered internal damage in her left
    ear as a result of a myringotomy procedure, which involved the insertion of a
    tube in the ear. It was within 2 weeks of the procedure that she suffered a
    serious bacterial infection which was not adequately treated and/or managed by
    the physicians responsible for her care. After intensive research and a lot of
    back and forth with different “specialists”, we learned that the tube
    insertion procedure was unnecessary and should not have been recommended.

    The
    extensive damage that resulted from the tube insertion left my mother completely
    deaf in her left ear but with all this clearly documented,, it has been nearly
    impossible to hold anyone accountable, 10 years later! My mother is a fighter
    but she has not been able to lead a normal life since then e.g she can’t work
    because she now has permanent vertigo spells, a damaged neglected ear (which
    has created further complications), balance problems………and so much more.

    Everyone
    that has had their life destroyed, altered by negligent, arrogant doctors
    should keep fighting. I know it is not easy, but they have to be held
    accountable for their actions.

    Everything
    that is done in the dark, eventually comes to light”, victims should keep
    fighting because justice always prevails, ALWAYS!! This may sound naive to some,
    but in some circumstances, optimism and hope is what is left to hold on to.

    Also, never
    fully trust any doctor that you may be seeing, always listen to your body and
    do extra research about your health.

    Saying that
    I am grossly disappointed with the Canadian Health care system would really be
    a HUGE understatement. In 2002, my mother suffered internal damage in her left
    ear as a result of a myringotomy procedure, which involved the insertion of a
    tube in the ear. It was within 2 weeks of the procedure that she suffered a
    serious bacterial infection which was not adequately treated and/or managed by
    the physicians responsible for her care. After intensive research and a lot of
    back and forth with different “specialists”, we learned that the tube
    insertion procedure was unnecessary and should not have been recommended.

    The
    extensive damage that resulted from the tube insertion left my mother completely
    deaf in her left ear but with all this clearly documented,, it has been nearly
    impossible to hold anyone accountable, 10 years later! My mother is a fighter
    but she has not been able to lead a normal life since then e.g she can’t work
    because she now has permanent vertigo spells, a damaged neglected ear (which
    has created further complications), balance problems………and so much more.

    Everyone
    that has had their life destroyed, altered by negligent, arrogant doctors
    should keep fighting. I know it is not easy, but they have to be held
    accountable for their actions.

    Everything
    that is done in the dark, eventually comes to light”, victims should keep
    fighting because justice always prevails, ALWAYS!! This may sound naive to some,
    but in some circumstances, optimism and hope is what is left to hold on to.

    Also, never
    fully trust any doctor that you may be seeing, always listen to your body and
    do extra research about your health.

  25. My doctor, got me onto Prozac, at my insistence because of bad side effects, moved me to a different Prozac strain. My wife didn’t like the new me (neither did my friends) and was concerned that the new Prozac me was also drinking more than he used to. She set me back up with the same doctor, who sent me to 2 x 45 min session with a psychiatrist. The psych for his 90 minutes wrote a report labeling me as Alcohol dependent and my wife to be a full blown Alcoholic. My MD (the genius in hush puppies) promptly turned me into the MOT who took my drivers license. They do this to 10,000 Ontarians/yr and it feeds the private rehad clinic industry. It’s gone for a minimum of 1 year, must not drink at all and to make sure they want to stick a needle in my arm once per month. It’s done under the Highway traffic Act it should have been called the Minority Report Act. Bottom line is your doctor is not your friend, they work for the government and spy for them as required, there is no such thing as Doctor/Patient confidentiality (they share your information with all kinds of companies). If you find that a member of your family has developed a drug or alcohol problem, find a private clinic or settle it in the family, don’t go near a doctor. Same applies for several other medical conditions. It’s like insurance, they make you pay for it, and when there is an accident, your afraid to use it. BTW, the greatest concentration of real addicts are scattered in 50 (were talking about thousands of people) or so clinics around the province and not one has ever had their patient records audited for valid drivers licenses.

  26. Victim here too but NOT a volunteer! NEVER go to another dentist OR doctor without asking a TON of questions FIRST, and IN HIS/HER OFFICE … not the exam room! DO THAT … CONSULT FIRST, CLOTHED IN OFFICE … starts things off MUCH better! YOU are in more control when dressed, seated in a chair (psychological equal) and doc takes you much more seriously if you do this before “hiring” him. I’ve ‘fired” docs in the past ten years, and will keep on doing it AND reporting them to our Medical Board and Dental Board. I’m sick of being a victim. It’s not a role I play well. I’m much too bitchy! LOL

  27. Is there an update on progress since 2010 on these topics? Healthcare in this country has gotten significantly worse not better!

  28. I do not trust any doctor. My son was killed at our local hospital by three incompetant doctors. If you don’t believe me just check out my site. http://www.justiceforjosh.com

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