Professionals Entitled to Learn Lessons from Past Complaints

A recent decision, JRP (MD) v. VG 2016 CanLII 66783 (ON HPARB), from the Health Professions Appeal and Review Board (HPARB) acts as a reminder that health care professionals are entitled to learn from past mistakes and should be given a chance to show that they have improved their practice after completing remedial courses.

The Complaint

In 2014, a doctor had been issued advice on her record keeping and a caution regarding her documentation. The Inquiries, Complaints and Reports Committee (ICRC) of the College of Physicians and Surgeons of Ontario had determined that it would be appropriate to require the doctor to complete a course on record keeping as part of a Specified Continuing Education or Remediation Program (SCERP), addressing these concerns. Also, the ICRC directed that a summary of its decision was to be placed on public register. The doctor complied and completed the SCERP in June 2014.

In 2015, the daughter of a patient of the doctor complained about the medical care provided to her late mother (the patient). The doctor’s final medical notes for the patient were made in May 2014 (a month before she completed the SCERP). The ICRC investigated and rendered a decision in February of 2016. The ICRC found that the doctor’s monitoring of the patient’s medications and medical condition was adequate; however, the ICRC determined that the doctor should re-take the SCERP on record keeping.  The doctor sought a review of this decision.

The Review

On review, the HPARB found no basis to interfere with the ICRC’s conclusion regarding the doctor’s care for the patient and found the ICRC’s decision to be reasonable in that regard.

However, the HPARB concluded that the ICRC “erroneously assumed” that the doctor had taken the earlier record keeping course and had chosen not to adopt a better record keeping practice, when in fact the medical records for this patient pre-dated the doctor’s completion of the record-keeping course. The HPARB found that the doctor could not have utilized the practices outlined in the record-keeping course before she had attended it, and that the ICRC had erred in assuming that the doctor had ignored the record keeping concerns expressed in 2014.

The HPARB returned the decision to the ICRC and required it to reconsider its disposition to require the doctor to complete the SCERP on record keeping, but confirmed all other aspects of the decision.

Takeaway

This case confirms that health care professionals are entitled to learn lessons from past decisions before serious consequences (such as published cautions and SCERPs) are imposed for failure to do so.