A Physician’s Guide to the Complaints and Investigations Process 

1.  Responsibilities of the College

Physicians who practice in Nova Scotia are required to be registered by the College of Physicians and Surgeons (College). The Province has given the College the responsibility for self-government of the profession through the Nova Scotia Medical Act.

The College has two fundamental powers that it employs to protect the public: 1) it establishes and enforces the licensing standards that determine who practices medicine in the province; 2) it regulates and maintains standards of conduct and competence of physicians who practice here.

2.  Purpose of the Complaints and Investigations Process

As a self-regulating profession, the College has the responsibility to investigate, where appropriate, complaints concerning the conduct of physicians.

The objectives of the discipline process are the protection of the public and the preservation of the reputation of the profession.

3.  The Complaints and Investigations Process

When the College receives a complaint against a physician, the usual process is for a copy of the complaint to be forwarded to the physician who has 30 days to respond. In some cases, where there are valid reasons for a delay, an extension may be granted by the Investigations Department. The physician may wish to seek legal advice before responding.

Where appropriate, the Registrar (or designate) may attempt an informal resolution of the complaint or may expedite the complaint process if the allegations against the physician are serious.

When responding, it is advisable to deal with the issues raised in the complaint, provide copies of all relevant documents, and refrain from personal attacks on the complainant. A calm rational response can often assist resolving a complaint.

A copy of the response is sent to the complainant for comment. If additional comments are submitted, these are forwarded to the physician for final response. At this point, the complaint is forwarded to an Investigation Committee for review. Most complaints are resolved by this Committee.

The Committee reviews the written submission, health records and other relevant information. The Committee may require the physician to have a practice audit, submit to examinations for competency, or may request additional information from the physician, complainant, third parties, or experts.

After thoroughly reviewing the matter, the Committee may dismiss the complaint, attempt to resolve the matter informally, offer mediation, counsel and/or caution the physician, require the physician to undergo re-education or treatment (with consent), reprimand the physician (with consent) or send the matter to a Hearing Committee. Only a small number of complaints are considered serious enough to be referred to a Hearing Committee. With the exception of a consensual reprimand, the Investigation Committee cannot make a finding of professional misconduct, conduct unbecoming or incompetence. These findings can only be made by a Hearing Committee.

The Hearing is usually public. The Hearing is a quasi-judicial process involving formal charges of professional misconduct, incompetence or conduct unbecoming. If the charges are upheld by a Hearing Committee, it can impose penalties ranging from a reprimand to removal of the physician from practice. In some cases the matter may be resolved by means of a Settlement Agreement, in which case a Hearing is not necessary.

4.  Publication of Decisions

When members of the public contact the College to request information about a complaint or any other disciplinary matter concerning a physician, they are advised that the physician is in good standing unless the physician’s license has been revoked or suspended, or some limitation or condition has been placed on the license.

The College will neither confirm nor deny that a complaint has been received or that an investigation is underway. The only exception is where a disciplinary matter is already known throughout the community because of media exposure. In these cases, the College may confirm that an investigation is taking place but the College’s normal policy of confidentiality regarding the disciplinary matter remains in effect. Otherwise, the College only releases disciplinary information to the public after a physician complained about has consented to a reprimand or after a complaint has been dealt with by a Hearing Committee.

5.  What Are Complaints?

The issues raised by complainants range from access to records to sexual misconduct. The majority of complaints concern the competency of clinical care. Communication problems are a common element in most complaints.

6.  Physician Reporting

If a physician has reasonable grounds to believe another physician may be guilty of sexual misconduct with a patient, is impaired, or engaging in unethical practices, there is an ethical obligation to notify the College.

7.  What are the rights of patients?

Patients have the right to:

• be treated with respect
• expect confidentiality be maintained, unless their doctor explains why it has to be broken
• expect their doctor not to take physical, emotional, sexual or financial advantage of them
• refuse an examination or treatment or withdraw consent without obligation or harassment
• be kept informed, if possible, of major delays in obtaining consultations or treatments
• know if there are colleagues with whom their doctor will discuss their case
  receive appropriate referrals
• request a second opinion
• be listened to carefully and supportively regarding their concerns
• have another person present during examinations

Patients are expected to:

• respect the privacy of other patients, doctors
  and staff
• ask the doctor for further information if they do not understand
  let their doctor know if they feel uncomfortable during an examination or treatment
• cooperate and follow recommended treatment as long as they agree, and inform their doctor when they don’t
• notify their doctor or staff if they are unable to keep an appointment
• allow their doctor to have a staff member present during an examination

College of Physicians and Surgeons of Nova Scotia
5005-7071 Bayers Road, Halifax, NS B3L 2C2
Telephone: (902) 422-5823
Toll-free: 1 (877) 282-7767
Fax: (902) 422-5271