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Toronto Star Tue Apr 14 2015

We heard more rich evidence yesterday that the College of Physicians and Surgeons of Ontario can't be trusted to police themselves. Case in point: Dr. George Doodnaught is still a doctor. He's not practising, since he's in jail for sexually assaulting no fewer than 21 patients who were strapped to operating tables and semi-conscious from the anesthetic he'd given them, before slipping his penis or tongue into their mouths or rubbing their breasts. After a 76-day trial, Superior Court Justice David McCombs found the evidence of his guilt "overwhelming," convicted him of 21 counts of sexual assault and sentenced him to 10 years in prison last year.

What has the college done? Nothing. Doodnaught has appealed the case, and the college is waiting for the outcome before scheduling its own hearing on whether or not Doodnaught should be stripped of his licence - which, by the way, is mandatory under the "zero tolerance" Regulated Health Professions Act. Does the college think its doctor-led panel will better understand the case than an Ontario Court judge? Two of Doodnaught's victims spoke before the two-member task force examining the sexual assault of patients, yet again, for the Ontario government. The downtown hotel conference room where the hearings are held was embarrassingly empty, again. The women who spoke were angry and upset.

Montreal Gazette Wed Dec 16 2015

The Quebec College of Physicians is defending itself against charges by two researchers that the professional order has been lax on the growing use of accessory fees in private clinics. The researchers, Guillaume Hébert and Jennie-Laure Sully, accused the College of failing to crack down on abusive fees that some physicians in private practice are billing patients.

"Over the years, doctors have gradually inflated the amounts they charge to the point of demanding significant sums from their patients for unjustified reasons," they wrote in a research paper published by the Institut de recherche et d'informations socio-économiques (IRIS). "After years of procrastination, the College of Physicians clarified its code of ethics by reminding Quebec physicians that they cannot place themselves above the law. Despite this directive, doctors have continued to impose accessory fees and the College did not choose to enforce its own code of ethics, preferring instead to negotiate reimbursements for patients who have made complaints."

THE NATIONAL Thu Mar 19 2015,

WENDY MESLEY (HOST): All that medicine isn't cheap either. Canadians spent an estimated 22 billion dollars a year on prescriptions in 2013, almost twice what they spent in 2001. One in ten struggle to afford it. It's big business and big drug companies know it, spending billions marketing it right back to you. VOICE OF UNIDENTIFIED WOMAN (ANNOUNCER): (Advertisement) Ask your doctor if Lunesta is right for you. WENDY MESLEY (HOST):

So are we over- or under-medicated? Is the high cost of prescription drugs failing to help Canadians in need? And what should we be watching for next? So we'll start with that middle question, like, who is not covered? Who is falling through the cracks? You must all see this in your practices? Danielle, what are you seeing? DANIELLE MARTIN (FAMILY PHYSICIAN, WOMEN'S COLLEGE HOSPITAL): In fact, millions of Canadians have no drug coverage whatsoever and millions more don't have adequate coverage for their needs. In my practice I see it all the time among the self-employed, people who are working in small businesses, people who are working part-time and don't have employer-based coverage. It's the taxi drivers, it's the people who are working in a part-time job, but it's also middle-income people who are consultants or working in small businesses who don't have coverage. So this isn't just a problem for the poor. It's a problem for people across socioeconomic lines.

Vancouver Sun Thu Jun 11 2015

A provincial proposal to shrink surgical waiting times by letting private surgery clinics do more complex operations could take up to two years to implement, says the registrar of the College of Physicians and Surgeons of BC. That's because of changes to legislation that may be required to allow private facilities to keep patients for up to three nights and other changes to ensure they are more like hospitals, with security guards, full meals, a variety of health professionals, labs, imaging suites and even intensive-care units. Currently, the college allows private facilities to do procedures requiring a maximum one-night stay. "We applaud the minister of health for thinking outside the box to address the issue of access to care," said the registrar, Dr. Heidi Oetter, referring to the idea of expanding publicly funded access to private facilities. The proposal is in a Health Ministry discussion paper.

In an interview, Oetter said expanding the types of surgeries the province pays for at private clinics is not easy to sort out quickly. "There's a role for the private facility sector. But this requires an extensive review," said Oetter, adding it could take from 18 to 24 months. The government has set up a Surgical Services Secretariat that will work with the college on changes to laws and procedures to enable longer stays in private facilities, if that direction is chosen.

The North Bay Nugget Sat Jan 24 2015

The president of the North Bay and District Labour Council is warning against a proposed public-private partnership that could see a new sports facility constructed in North Bay. Henri Giroux issued a release Friday responding to a request for expressions of interest recently issued by Canadore College seeking a private-sector company to build, finance and operate a multi-purpose sports facility at its Commerce Court Campus. A wise per-s on studies history to avoid repeating costly mistakes," said Giroux, pointing to a recent report by Auditor- General Bonnie Lysyk. It's truly stunning that Canadore College and the city seem to have learned nothing from Ontario's P3 mistakes, even though the $8-billion history lesson just came out in November's auditor-report." Lysyk's report found that public- private partnerships have cost Ontario taxpayers nearly $8 billion more on infrastructure over the past nine years than if the government had successfully built the projects itself.

The report indicated companies pay about 14 times what the government does for financing, and that they receive a premium from taxpayers in exchange for taking on the project. The college proposes a public- private partnership to build a new sports facility. Sounds nice -a great facility without the cost and risk of building and running it yourself," said Giroux. But that myth and our reality with P3s is very different." He suggested North Bay is learning about the costs of P3s first-hand via cuts at North Bay Regional Health Centre. He said the hospital is closing beds and slashing services, in no small part because of long-term P3 agreements for mortgage payments and maintenance fees." If Canadore goes ahead with a P3 sports complex, it is the students who will pay for it through high user and tuition fees," said Giroux. If we want public infrastructure, let's do it right from the beginning and not waste money on the same old mistakes."

Orillia Packet & Times Fri Mar 4 2016

Re: "No standard for Ontario paramedic investigations," Feb. 26 Ontario patients are protected by the current triple oversight and controls on paramedic professionals. Contrary to the opinion pushed by those quoted in the story, the majority of paramedics are opposed to a regulatory college. They clearly understand that another bureaucratic layer of oversight through a new regulatory regime will actually allow others who are not working as paramedics into the college.

Front-line paramedics have consistently directed us, the Canadian Union of Public Employees (CUPE), the largest organization of paramedics in the province, representing nearly 6,000 paramedics, to oppose the creation of a regulatory college and the additional layer of bureaucratic control that comes with it. Working paramedics are already overseen by three separate organizations that can fire and discipline them.

Toronto Star Tue Oct 27 2015 Page: A1

A senior physician at Women's College Hospital who has garnered international recognition for her research on osteoporosis "manipulated" data of a study published in a leading medical journal, according to an investigation by the facility.

Dr. Sophie Jamal, who until recently served as research director at the Centre for Osteoporosis and Bone Health, and the division head of endocrinology and metabolism at the hospital, misrepresented findings of a 2011 study published in the Journal of the American Medical Association, the hospital said after an investigation that wrapped up earlier this month.

But hospital pharmacies, which also mix and supply cancer drugs to patients every day, are not subject to regular inspections by the college.

College Registrar Marshall Moleschi said outdated legislation in Ontario’s Drug and Pharmacies Regulation Act exempts hospitals and other health institutions from having to follow the same rules and regulations as community retail pharmacies.

“I was very surprised when I started working in hospitals that the college does not have any role in the pharmacy side in hospitals, especially given the types of products that are made and handled and utilized within hospitals,” Froude told the committee.

Edmonton Journal Tue May 12 2015

An encounter with a paramedic is something you rarely plan on, but in your scariest moments, the excellent care these health-care professionals provide can be the difference between life and death. Brave, committed, educated and adaptable, these women and men are vital to Alberta's health-care system. There are almost 10,000 registered paramedicine practitioners in Alberta. These dynamic practitioners now permeate all environments in which Albertans receive medical treatment. About one-third of these professionals are employed publicly; the rest work for private contractors, natural resource industries and in dozens of other work settings.

As is the case for other first responders, this daily work can take its toll. A practitioner's work is primarily defined by helping others in need, while having to ignore their own. Victims of car accidents, domestic abuse, and incidents involving children can have lasting impacts on paramedics. In Canada, it is tragically true that some first responders have committed suicide and many more struggle with depression. Post-Traumatic Stress Disorder (PTSD) has always been a health risk inherent to paramedicine.

is inappropriate for emergency service (EMS) employers to weigh-in to support college regulation for paramedics "when it is an issue for paramedics themselves to settle.

This is in addition to the oversight of the ministry of health, base hospitals and EMS employers.

The Canadian Union of Public Employees (CUPE) and the Ontario Public Service Employees Union (OPSEU) collectively represent 6500 certified Ontario paramedics already extensively regulated under the Ambulance Act

Contracting Out Hospital Work to Private Clinics – Backgrounder For years CUPE has been concerned the Ontario government would transfer public hospital surgeries and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility some years ago with a tour of the province by British Health Secretary Frank Dobson who talked about the disastrous British experience with private surgical clinics.Unfortunately, the provincial Liberal government has now moved in this direction. The door opened a few years ago with the introduction of fee for service hospital funding (sometimes called Activities Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization, with the government finally announcing Request for Proposals for the summer of 2014.

Hospitals are the main focus of the government’s health care cuts. They do not see community hospitals as providing a broad range of services to the local ... [Read More]population, but instead wish to remove an untold range of services from local hospitals and transfer them to specialized private clinics. The proposal would remove the most lucrative, high volume and easiest procedures from community hospitals. The remaining community hospitals would be left with the most difficult services. If they chose to compete with the private clinics, they would have to specialize in a narrow range of services. The government’s plan is the opposite of one-stop, integrated public health care. This proposed privatization of surgeries and diagnostic tests is in addition to the aggressive attempts to remove non-acute care services from hospitals (e.g. outpatient clinics, complex continuing care, rehabilitation, long-term care, primary care, etc.). As acute care currently accounts for only about 1/3 of current hospital funding, these attacks are a grave threat to the viability of community hospitals, and in fact we are now seeing a wave of hospital shut-downs that is somewhat reminiscent of the Mike Harris era. Despite the government’s rhetoric about keeping care non-profit, services that are being cut from local hospitals now are being privatized to for-profit owned corporations. Even if the private clinics did start out as non-profit (which has not been the case so far) the whole system of private clinics could be privatized with a stroke of a pen.

Ontario Health Care Privatization: The push for health care privatization in Ontario picked up in 2001 when Ontario Health Minister Tony Clement announced two privatized P3 hospital projects, the Royal Ottawa and the Brampton Civic (part of William Osler Health Centre). Spirited community-based campaigns, including P3 plebiscites in many towns, forced the Liberal government to greatly narrow the scope of the privatization of support jobs (i.e. CUPE jobs) in subsequent P3 hospitals. Nevertheless privatization of the hospital financing continues, despite revelations by the provincial Auditor General that confirmed claims by CUPE and others that the Osler project cost hundreds of millions more due to the P3.

She said she didn't realize at the time that the doctor was not entitled to charge for the services.She's not alone. Two of her friends say they also paid $10,000 to the same surgeon to fast-track the same procedure. Their surgeries were also done at the Royal Victoria Hospital.

All three women fear reprisals and losing access to medical care.

None of the women have complained to the Quebec College of Physicians.

Posted on 2/3/2015 1:30:00 PM by Tina Tenneriello

Just a few days before Quebec's health minister Gaetan Barrette is expected to rush in Bill 10 Friday, the College of Physicians says it has concerns with the new health care reform. At a press conferenceTuesday morning it presented 5 key issues.  The first, transparency. "We want to know the big picture of the reform, that's the main thing we are asking for, transparency," Dr. Yves Robert, the secretary of the College of Physicians said. Dr. Robert said they're not as concerned about Bill 10.

"It's more about saving money by taking off a slice of bureaucratic administration, that's less our business, once it's set up, we don't want the quality of services to be affected, that we'll check, that's my job, but for Bill 20 and 28 it concerns us because it's about the quality of practice," Dr. Charles Bertrand, the head of the College said. He says Bill 20 will impose quotas on family doctors, which Quebec has tried before and it didn't fix the problem.  "It is another coercive measure, we've faced many in the past also with incentives and it didn't solve the problem.  We want every stakeholder to find solutions," Dr. Robert said.

Toronto Star Wed Apr 15 2015

An Ajax obstetrician and gynecologist who was twice found guilty of professional misconduct for sexually abusing female patients had his medical licence reinstated by the College of Physicians and Surgeons of Ontario Tuesday. It's a case that exemplifies why the medical regulatory body should report potentially criminal cases to police, critics say. Dr. Sami Karkanis's licence was revoked nearly two years ago when a disciplinary committee found he had committed an act of professional misconduct by sexually abusing a Toronto-area woman he treated between 2002 and 2006. Those allegations were formally withdrawn by the College Tuesday, months after a divisional court judge overturned the committee's decision.

"The complainant in this matter ... has informed the College she is not willing to participate in a second hearing," prosecutor Amy Block told the College's current disciplinary committee at a short hearing Tuesday morning. It was the second time Karkanis had been disciplined by the College; in 2010, his licence was suspended for six months and he had a gender-based restriction put on his practice after he admitted to a consensual sexual relationship with a different patient. A third allegation of sexual abuse in 2007 was never heard by a disciplinary committee. Karkanis's lawyer, Jenny P. Stephenson, told the Star her client currently lives in Sudan. She would not say whether he has plans to return to Canada, but said he welcomes the College's decision. "We're happy the allegations are being withdrawn. He's pleased."

Montreal Gazette Fri Apr 17 2015

The number of Quebecers filing complaints about excessive fees charged by doctors in private practice has soared by 374 per cent during the past five years, according to newly-released figures by the Quebec College of Physicians. In some cases, ophthalmologists have charged hundreds of dollars for eye drops that should cost as little as $20. Increasingly, physicians who perform vasectomies outside of hospital are invoicing patients "accessory" fees that are not permitted under the law. In one flagrant example, the disciplinary board of the College of Physicians suspended a Westmount physician for three months and fined him $10,000 in 2013 after ruling that he charged patients "excessive and unjustified" fees.

Dr. Charles Bernard, president and executive director of the College, acknowledged that some physicians have "exaggerated" in the amounts they bill patients. But he blamed the problem on the provincial government for not updating the list of fees that are allowed in private practice since 1970. "The College is receiving more and more complaints about fees charged by doctors," Bernard said Thursday, citing statistics that the number of such grievances has jumped from 31 in 2010-11 to 147 in 2014-15. About 80 per cent of the complaints were resolved after mediation between the physician and patient. But nearly 30 complaints in 2014-15 were not settled to the patients' satisfaction. "What we believe is that the accessory fees should be clear," Bernard told reporters following a news conference. "We don't want (doctors) to exaggerate and that's why we want detailed invoices. "Although the College has taken steps to modify its Code of Ethics, the problem is not entirely resolved," he added.

"Marchese Hospital Solutions does not have a licence," as an accredited pharmacy, Lori DeCou, manager of communications for the Ontario College of Pharmacists, said Wednesday.

There also questions about federal jurisdiction regarding whether Marchese was operating as a drug manufacturer.

"We're looking into the activities that Marchese Hospital Solutions performs, and we're looking to see which activities of which part of this company actually falls under provincial versus federal jurisdiction," said Dr. Supriya Sharma, a senior medical advisor at Health Canada in Ottawa. "We're still in the process of finding that out."

Both the college and Health Minister Deb Matthews say they want to change the bylaw under the Regulated Health Professions Act. Fair enough, but the loophole never should have existed in the first place, and it should be correctly immediately. It won't happen, however. Not with the legislature prorogued until sometime in the new year.

The situation becomes more urgent because the Liberals have been encouraging physicians to provide these services in clinic settings, and they've been only too happy to oblige.

"That's the direction that health care is clearly going," Windsor Regional Hospital CEO David Musyj said. "If that's the direction its going to go, you have to make sure the oversight of these out-of-hospital services is beefed up."

Toronto Public Health, which revealed the outbreaks when pressed by the Star, said 11 patients were infected and tainted sedative injections were the “possible” cause in all cases.

By: Theresa Boyle Health, Published on Sat Sep 27 2014

Three Toronto colonoscopy clinics have had hepatitis C outbreaks since 2011, the Star has learned.

CMAJ February 17, 2015 vol. 187 no. 3 First published January 12, 2015, doi: 10.1503/cmaj.109-4972

Dane Wanniarachige

In light of Quebec legalizing euthanasia and Canada’s aging population, the quality and availability of palliative care is emerging as a crucial issue, say experts in the area. But while the conversation has often centred on the number of palliative care specialists, that’s only part of the solution.

March 17, 2016

Quebec’s College of Physicians has issued an ethics bulletin to its members after learning that some doctors were allowing suicide victims to die when life-saving treatment was available.

The bulletin says the college learned last fall that, “in some Quebec hospitals, some people who had attempted to end their lives through poisoning were not resuscitated when, in the opinion of certain experts, a treatment spread out over a few days could have saved them with no, or almost no, aftereffects.”