Is the doctor shortage stalling the Me Too movement in the medical field?
Patients may be reluctant to complain about their doctor because they're worried they won't find a new one
An independent review of how sexual misconduct complaints against doctors are handled shows that patients may be too scared to come forward with their concerns because of the doctor shortage.
The College of Physicians and Surgeons of Nova Scotia requested the review of how it handles complaints after seeing an increase in reports because of the Me Too movement.
It received four complaints of a sexual nature in 2016, and triple that number in 2018.
Already this year, there have been seven complaints, making the issue a priority for the College.
The report flagged unique barriers that may be holding complainants back.
'The elephant in the room'
If someone complains about their physician, they or their entire community may end up without a health-care provider.
"It was definitely the elephant in the room," said Nasha Nijhawan, a Halifax lawyer who chaired the independent review panel.
"It can mean that restrictions are placed on the practice of that physician while the complaint is being investigated or ultimately it may result in the removal of that physician from the community."
Dr. Gus Grant, registrar of the college, said it's important that physicians who act inappropriately are held accountable.
But he isn't sure there's a way the college can guarantee it will find a complainant a new physician while there's a provincial wait list.
"For the college to step in as it has never done before and prioritize someone on that queue, we'd have to be able to explain to the 50,000 people behind why that person is being prioritized over them," said Grant.
While the doctor shortage is a notable hurdle, Nijhawan said it's important to note that patients coming forward are in a vulnerable position, and more needs to be done to make it a less-intimidating process.
"Ultimately a person who comes forward to the college has nothing to gain by that process and so they're doing so in support of the public interest," she said.
She said one of the most prominent issues was that staff treat sexual complaints in the same manner as general issues.
While the system might be appropriate for dealing with conflicts over prescriptions, it isn't built to appropriately work with those who have been through a traumatic experience.
Investigations are currently done by a panel of physicians, which in some cases were seen as overly adversarial.
The panel suggested the college hire an external investigator who is trained in trauma-informed approaches.
College staff told the panel they felt they lacked the training and experience to process sexual misconduct reports.
Some changes could happen quickly
The panel also called on the college to make some quick, simple changes.
For example, when someone calls to report an issue, the number they're given is a general office line and a voicemail box, instead of a private, dedicated phone line for sexual complaints.
Currently, patients are also told their complaint has to be in writing, which can be mailed or faxed to the college.
"I don't know the last time I've mailed or faxed anything, frankly," said Nijhawan. "I think a lot of people would, for example, be forced to go to Staples in order to fax their very sensitive complaint about an act of sexual misconduct by a physician, so that alone might pose a barrier."
Nijhawan was quick to point out that it's rare to see a governing body like the college take the initiative to ask for the review, and she applauded the staff for being up front and engaged.
Grant said they have already started working on implementing some of the recommendations.