Information underload: Public starved for details when health professionals misbehave
'It's not best practice at all, and that I can say with absolute certainty,' says FOI advocate
When it comes to the misbehaviour of healthcare professionals, it's sometimes a maddening process for regular British Columbians to find thorough information about how serious and widespread the offences were.
The 23 professional colleges that regulate health workers in B.C. take inconsistent approaches to how much information they reveal in disciplinary decisions. And for anyone who wants to know more, the process for filing a Freedom of Information request can be frustratingly opaque.
Unfortunately, the lack of information from many of these colleges leaves the public in the dark on the details we need to make critical decisions about our healthcare.
This week, it took reports in the media for the public to learn about the suspension of Dr. Patrick Nesbitt, a West Vancouver general practitioner with a long history of disciplinary actions. For reasons that haven't been explained, the College of Physicians and Surgeons of B.C. didn't issue a public notification about his suspension.
In another case last month, the College of Dental Surgeons of B.C. divulged that Dr. Karim Lalani had been fined and suspended for providing unnecessary treatment to patients.
But some crucial details were missing in the brief public notice: What kind of unnecessary treatments? How many patients were affected? How much extra money did he make?
Without those answers, all we can do is speculate — and for many people, that could mean assuming the very worst of Lalani.
For Mike Larsen, president of the Freedom of Information and Privacy Association, public discipline notices from many colleges look more like press releases than genuine efforts to keep people informed.
"I don't think, and FIPA doesn't think, they're doing as good a job as they could be," Larsen told CBC News.
Protecting the public
According to Larsen, the Law Society of B.C. exemplifies the best practices for transparency from professional regulators in this province. The society doesn't just publish detailed disciplinary decisions, it also posts a breakdown of all the allegations against a lawyer before they've even attended a disciplinary hearing.
Things work a bit differently at most of the province's health regulators.
In Lalani's case, the college's public notice came after the dentist signed a "consent order" — in other words, he'd admitted to the allegations against him and agreed to be disciplined.
Numerous colleges in B.C. publish only vague details about a professional's offences if they've signed a consent order. That includes the regulators for physicians, registered nurses, chiropractors, psychologists, and massage therapists, to name a few.
Eric Wredenhagen, registrar for the College of Massage Therapists of B.C., explained that full details are only published if the complaint goes to a hearing. Otherwise, the college views a short summary as sufficient.
"In a sense the details are not necessary, because the summary of the details is sufficient to explain the outcome, to achieve our main goal, which is to protect the public," he said, comparing the content of consent orders to that of disciplinary hearing decisions.
If a complaint goes all the way to a disciplinary hearing, on the other hand, the college will post lengthy decisions with full details of what the massage therapist did wrong.
But for regulators of other professions, the equivalents of consent orders are much more detailed. The law society and the B.C. Commissioner for Teacher Regulation both publish comprehensive documents even when someone has admitted their transgressions.
Take, for example, the case of high school teacher Scott Naegali, whose four-page consent resolution agreement lays out, step by step, how he invited a student to bring a pellet gun to school to shoot some annoying pigeons.
It's an odd case, but plenty of parents probably want to know this stuff about their kids' teacher.
Why wouldn't similar details be available for their kids' doctor or psychologist?
Depending on the college, it can sometimes be a struggle to find any records of wrongdoing by a healthcare worker.
Most colleges maintain easy-to-find online lists of recent disciplinary measures, but the College of Physical Therapists of B.C. does not. Members of the public have to to have the patience to search through a database to find anything about professional wrongdoing.
'Not best practice at all'
After spending some time combing through the websites of the various colleges, Larsen believes most regulators err on the side of withholding information.
"I would like to see something that looks a lot more like a formal legal document, along the lines of what the law society would put out in one of their cases," he said.
Meanwhile, few if any of the colleges have explicit instructions on their websites about how members of the public can file Freedom of Information requests to get more comprehensive answers.
"It's not best practice at all, and that I can say with absolute certainty," Larsen said.
As public bodies governed by the Freedom of Information and Protection of Privacy Act (FOIPPA), the regulators are all required to make appropriate records available through FOI requests.
But the colleges seem to have different ideas about how people can file those requests.
When contacted by CBC News, some provided fax numbers and email addresses, one simply referred a reporter to the Freedom of Information and Protection of Privacy Act and one suggested filing through the B.C. government website, which only accepts requests meant for provincial ministries and the premier's office.
And sometimes, the regulators will refuse to release information to those who've figured out the FOI process.
Twice in the last two years, the College of Physicians and Surgeons of B.C. has gone before the commissioner to argue for the right to suppress information. On both occasions, adjudicators ruled against the college.
If these regulators want to uphold their duties as public organizations to keep people informed about the professionals we trust with our bodies, it won't take much to make significant changes.
All it would take is a commitment to being more transparent every time a practitioner is disciplined.
As Larsen says, "It doesn't take rocket science to change a website."
- This story has been updated to clarify the difference between consent orders and disciplinary hearing decisions at the College of Massage Therapists of B.C. It also clarifies the attribution of the conclusion that the Law Society has the best transparency practices to FIPA.Apr 11, 2018 2:30 PM PT