Doctors sue MUHC over delivery quotas they say threaten babies

Four doctors with the McGill University Health Centre are suing for discrimination and $50,000 each in moral damages as new quotas limit the number of deliveries they can perform.

Specialists risk suspension if they don't refer patients to other hospitals once monthly quota reached

Pregnant women are being referred to other hospitals if their obstetrician at the Royal Victoria has reached their delivery quota for the month. (Pixabay)

Four doctors with the McGill University Health Centre are suing for discrimination and $50,000 each in moral damages as new quotas limit the number of deliveries they can perform.

Doctors Alice Benjamin, Robert Koby, Dawn Johansson and Andrew Mok are not part of the hospital's pool of on-call obstetricians and gynaecologists. They say that makes them targets for discrimination.

These doctors have 35 to 40 years experience and follow high-risk pregnancies, but according to the new rules once they reach their quota of 14 deliveries per 28 day period, they are expected to refer their patients to another institution.

If they don't, they could be suspended for up to two weeks.

In the lawsuit, the four specialists claim patients "are forced to experience undue stress when they announce last-minute changes at a critical time to them."

The rules were adopted in June as part of budgetary measures by the MUHC.

Different rules for in-house doctors

The 14-person group of in-house doctors in the division of obstetrics have similar quotas imposed on them, but if they go over their delivery quota they are not threatened with suspension the way the four specialists are.

The in-house doctors can perform 2,400 deliveries per year, or 171 deliveries each. Meanwhile, the four obstetricians who are not part of the in-house group can perform 700 deliveries per year, or 175 each. 

So far, three out of four plaintiffs have been sent written warnings for exceeding their quota.

The doctors say they have already reduced the number of deliveries they are performing by between 45 to 63 per cent compared to the 2013-2014 fiscal year.

According to their lawyer, Christine Kark, these doctors are being penalized for looking out for their patients' welfare.

"Every time [these doctors] tell a patient that they cannot respect their choice to deliver at the Royal Vic, their reputation is at stake and they suffer from harm. Not only the doctor, but the patient and her future child," Kark told CBC News.

Lawyer Christine Kark says it's not fair that the in-house obstetricians and gynaecologists are not penalised if they exceed their quota while her clients are. (Elysha Enos/CBC)

First lawsuit, ongoing issue

According to Jean-Pierre Menard, a lawyer specializing in patients' rights, these quotas were never up for public debate and violate a patient's right to choose their institution.

He says quotas at the MUHC are increasingly becoming an issue but that this would be the first time quotas enter into litigation.

"The MUHC is trying to reduce the level of service it is offering to the population, what you are seeing in this suit is one case of that," Menard told CBC News.

Menard said he's in touch with several doctors from this hospital, as well as user committees to address this issue.

The MUHC has come under fire for its quotas but according to lawyer Jean-Pierre Menard this is the first time the health centre is sued over them. (Graham Hughes/Canadian Press)

Overbooked into November

The doctors say they need the court to approve an injunction which would block the application of these quotas until a ruling can be reached on these new rules.

The urgency of the injunction comes down to timing. When the quotas were adopted in June the four specialists had deliveries booked until November. Now with three out of four of them already having received a written warning, if they honour those commitments they could face suspension.

The MUHC would not comment on this case since legal action is ongoing.

A spokesperson for the health centre, Vanessa Damha, told CBC News communications about this matter began in 2014 between the physicians.

Damha said the MUHC's clinical plan as a tertiary and quaternary care academic healthcare centre calls for a commitment to increase the volume of high-risk pregnancies, while reducing the number of low-risk ones.

Kark said that for now the proceedings have been suspended for two weeks to allow the parties to talk.