What do you call the person who graduates last in med school? It's a set-up to a joke that is anything but. Of course, you call that person 'doctor.' There are incompetent people in every job, and doctors are no exception. We don't have any good statistics on how many incompetent doctors are currently in practice. A few years ago, a report in the US estimated that up to 5 percent of doctors aren't up to snuff for reasons that include substance abuse, cognitive impairment, and just not keeping up with developments in medicine.
Dr. Charles Smith, former chief forensic pathologist for the Province of Ontario, may be the most egregious example of incompetence that's been made public. His error-filled autopsy conclusions and expert witness reports resulted in wrongful convictions and lives ruined. The week of January 28, he gives testimony before a provincial inquiry set up to look into problems in pediatric forensic pathology in the province.
This week and next week on White Coat, Black Art, we take a close look at how doctors are supposed to maintain their competence and the system that's supposed to protect the public. As you'll see, the news is not very reassuring. Provincial regulators are just beginning to realize they can't simply trust doctors to maintain competence. Only two provinces -- Nova Scotia and Alberta -- have mandatory checks on doctors. Ontario will soon follow, once the province passes enabling regulations.
In the meantime, the only comfort the public should take from all this is that the majority of doctors care about their competence and take pride in maintaining it.