Two decades after Ontario’s medical profession declared "zero tolerance" for the sexual abuse of patients, it remains among the most frequently cited reasons for physician discipline.
A CBC News Toronto investigation has found that at least 125 doctors have been disciplined by the College of Physicians and Surgeons of Ontario since 2007 — and one in four of these cases involved physicians being disciplined for sexual comments or acts against their patients.
Furthermore, there are 22 cases of similar allegations before the college today.
And many of the doctors disciplined or who are currently the subject of similar complaints continue to practise across the province.
Marilou McPhedran was the chair of the college-commissioned task force whose work prompted the province, the college and the Ontario Medical Association to declare zero tolerance for sexual abuse of patients in 1991.
That has since become the standard approach for dealing with sexual abuse in many settings involving a victim and a person in authority.
"If it's a priest, if it's a hockey coach, if it's a football coach, if it's a teacher, what you'll hear is that the standard that is being applied is zero tolerance of sexual abuse," McPhedran told CBC News in a recent interview.
"Have we achieved that? … not at all."
Under Ontario’s Regulated Health Professions Act, sexual abuse is defined as:
On its website, the college describes its function as "the body that regulates the practise of medicine to protect and serve the public interest."
Among its duties are to issue certificates of registration to allow physicians to practise in Ontario and to help uphold standards of practice. The college also investigates complaints about doctors and conducts discipline hearings.
In a recent interview with CBC News, Carolyn Silver, senior counsel for the regulatory body, said the college "investigates all allegations of sexual abuse thoroughly and all of those cases are vigorously prosecuted if they are sent to the discipline committee."
Silver said this full process involves gathering information from the complainant and from witnesses, and cases can change from the investigative stage to the hearing stage.
But Silver said that "when there's a reasonable prospect of a finding of sexual abuse, we take those cases to discipline and we engage in these hard-fought battles to get a finding of sexual abuse," including defending appeals from the doctors.
The discipline committee can impose "a number of penalties" on the doctor, according to the college website. These include a reprimand or fine, or revoking or suspending the physician’s certificate of registration.
Critics, however, say the system moves too slowly and makes victims feel as though they are not the priority. As McPhedran sees it, patients are left on the outside, waiting for others to make decisions about what will happen.
"There's this real sense of powerlessness for many of them," said McPhedran.
Silver said that patient testimony is critical in prosecutions and that "many patients" have gone through the process and been successful.
A 28-year-old woman who was sexually abused by her doctor as a teenager told CBC News that she felt re-victimized by the system that dealt with her complaint.
CBC News is protecting the woman’s identity at her request. While she is not afraid of telling her story, she has concerns about being attacked legally by her former physician.
According to paperwork filed by the college discipline committee, the woman brought forward complaints related to two visits she made to her family doctor in 2002.
During those visits, the doctor touched the woman’s breasts "in an inappropriate manner" and "without medical explanation or justification," according to the college. During the second visit, he reached inside her underwear and touched her genitals.
"It was, like, full-out groping of my breasts and my pants coming off, for bronchitis that I came in there, and his fingers inside my underwear," the woman said, describing the second incident to CBC News.
That physician served a suspension, which was over in less than a year.
The doctor continues to practise in Toronto today — a scenario that has left his victim aghast that he is still able to see patients.
"I think that's the hardest thing for me to accept and for me to deal with … to know every single day there's a chance of another child or little girl being hurt and nothing, no one's stopping it, it’s infuriating," she said.
Silver acknowledged that the issue of sexual abuse remains a problem for the profession.
"I don't know if it's the single biggest problem, it's certainly is a challenge that the college still faces," Silver said.
Silver said the public is more aware of the issue than it was in the past, which may be a factor in the overall number of disciplinary cases.
Do No Harm: Doctors and Sexual Abuse continues this week online, on radio and tonight on CBC News Toronto television, starting at 5 p.m.