The College of
Physicians and Surgeons of Saskatchewan continues its statutory obligation to
review complaints registered against physicians. Complaints are accepted when a
complainant has concerns about the care provided by a physician and/or the
conduct of a physician.
complaints reported to the College are resolved by administrative staff in an
informal manner when appropriate.
Written complaints are accepted through the Complaints Resolution
Advisory process and typically represent issues surrounding physician
communication and attitude or concerns about the standard of care.
In 2013, the
College received 2,363 expressions of concern or requests for information,
the majority of which were dealt with by administrative staff.
In 2013 the
Committee met on seven occasions. The
yearly work of the Complaints Resolution Advisory Committee is comprised of
cases registered in two calendar years. The Committee completed 51 open cases
from 2012 and reviewed a portion of the 171 cases registered in the 2013 calendar
year. Of the 171 new cases registered in 2013, 36 cases are being held over to
2014; 12 cases were resolved without Committee assistance, three cases were
withdrawn and three cases were referred to the Registrar for consideration of
There were 329
individual allegations contained in the 186 closed cases from 2012 (51) and 2013
(135). These are the outcomes of the 329 allegations that were registered:
Founded – 94 Unfounded
Founded – 39 No
Determination – 22
Responsibility – 6 Resolved
Without Committee – 4
System Error –
table groups the allegation and determination for the completed cases in 2012
and 2013 into four broad categories.
2013 COMPLETED CASES
Treatment and Management
chart reveals that 11 allegations accounted for 80% of the findings. Inadequate
communication, inappropriate comments, insensitive care and incorrect/missed
diagnosis had the highest founded determinations. Inadequate communication represented 17%,
insensitive care was 14% and inappropriate comments was 7.5% of the total
the 2012 and 2013 completed files, the most frequent founded allegation was
inadequate communication. Sixteen of the
31 inadequate communication allegations were founded. This
remains a significant issue for many complainants.
the eyes of the patient or family, inadequate communication can overshadow or negate
the best technical care. It can lead to poor clinical outcomes if patients do
not understand their illness or what to expect. Generally patients and families
feel more empowered when they are included in the care process as fully informed
Of the completed
files in 2013, the second most frequent founded allegation was insensitive
care. Fourteen of the 35 allegations
Taking the time
for open, respectful and compassionate discussion with patients and families
goes a long way in avoiding complaints about insensitive care.
“In many busy
clinical practices, lack of time for in-depth conversations with patients is
likely to limit opportunities to understand patients in all their complexity.
Mutual comprehension takes time and sustained dialogue; this applies to all
patient-physician encounters and is not limited to exchanges involving patients
and caregivers from different cultural backgrounds.” Turner, L. Is cultural sensitivity
sometimes insensitive? Can Fam Physician. 2005
April 10; 51(4):
In addition, the growing cultural diversity of
Saskatchewan is requiring physicians to develop new and innovative communication
“Cultural competency in medical practice requires
that the physician respects and appreciates diversity in society. Clinicians
acknowledge differences but do not feel threatened by them . . . Awareness of
one’s own culture is an important step towards awareness of, and sensitivity
to, the culture and ethnicity of other people. Clinicians who are not aware of
their own cultural biases may unconsciously impose their cultural values on
"Culturally competent communication leaves our
patients feeling that their concerns were understood, a trusting relationship
was formed and, above all, that they were treated with respect . . . As
physicians, we must make multiple communication adjustments each day when
interacting with our patients to provide care that is responsive to the diverse
cultural backgrounds of patients in our highly multicultural nation."2
1. “Part 1 - Theory: Thinking About Health Chapter 3 Cultural Competence and Communication” AFMC Primer on Population Health, The Association of Faculties of Medicine of Canada Public Health Educators’ Network, http://phprimer.afmc.ca/Part1‑TheoryThinkingAboutHealth/Chapter3CulturalCompetenceAndCommunication/Culturalawarenesssensitivityandsafety (Accessed March 18, 2014). License: Creative Commons BY-NC-SA
2. Caron N. Caring for Aboriginal patients: the culturally competent physician. Royal College Outlook 2006; 3(2):19-23
completed files in 2013, the third most frequent founded allegation was inappropriate
comments. Seven of the 13 allegations
The use of
inappropriate words or actions by a physician is disrespectful and disruptive
to the therapeutic relationship. Professional
decorum is an essential component of physician skill and performance.
are examples of inappropriate words and comments taken from Physician Behaviour in the Professional Environment,
a policy of the College of Physicians and Surgeons of Ontario:
- Profane, disrespectful, insulting, demeaning or
- Shaming others for negative outcomes;
- Demeaning comments or intimidation;
- Inappropriate arguments with patients, family members,
staff or other care providers;
- Inappropriate rudeness;
- Gratuitous negative comments about another physician’s
care (orally or in chart notes);
- Passing severe judgment or censuring colleagues or
staff in front of patients, visitors or other staff;
- Insensitive comments about the patient’s medical
condition, appearance, situation, etc.;
- Jokes or non-clinical comments
about race, ethnicity, religion, sexual orientation, age, physical
appearance or socioeconomic or educational status.
Committee continuously strives to complete cases in a timely fashion, there are
limiting factors such as the number and timing of Committee meetings and the
increasing complexity of the files being reviewed.
The vast majority
of physicians subject to a complaint respond promptly. On occasion, a significant
delay in the receipt of a physician’s response unduly prolongs the process. Physicians
are reminded it is a College regulatory bylaw requirement to respond to a
request for information from the College within 14 days of the request being
in a timely fashion results in a more lengthy process than necessary. It also places
additional stress on all parties including the complainant and medical colleagues
who may be involved in the complaint. Complainants are more likely to be
dissatisfied with the physician’s response if it is significantly delayed or it
is perceived to be defensive and evasive.
reminded that the Complaints Resolution Advisory process is educational and non-punitive.
On rare occasions, matters that fall substantially below the expected standard
of care or that are found not to be amenable to an educational approach are
escalated to the Registrar and Council for consideration of further action.
responses are shared with the parties in an open and transparent fashion.
Physicians are advised to respond objectively to the questions posed without attempting
to blame, discredit or impugn the complainant. Responses that are prepared with
sensitivity, compassion and humility are generally well received by complainants
and are often resolved more expeditiously. Physicians are also advised to have
their responses reviewed by a trusted advisor before they are submitted to the
Medical Manager of the Complaints Process, I would like to take this
opportunity to thank the Complaints Department staff, Melissa Hoffman, Alyssa
Van Der Woude, Leslie Frey and Tracy Hastings for their ongoing support of the Committee’s
work and for their dedication and patience in assisting the public with their
questions and concerns.
would also like to thank the current Committee members for their dedication and
hard work. Non-medical public members
are Ms. A. Brayshaw, Ms. V. LaCroix of Saskatoon (chairperson), and Mrs. S. Lougheed
of Beechy. Physician members are Dr. L.
Baker, family physician in Rosthern; Dr. M. Plewes, family physician in Moosomin;
and Dr. V. Olsen, general surgeon in Prince Albert.
physician who has an interest in serving on the Complaints Resolution Advisory
Committee in the future is asked to submit their expressions of interest to OfficeoftheRegistrar@cps.sk.ca for
consideration by the Registrar.
Poulin, Medical Manager
Hastings, Regulatory Services Coordinator
Ms. Leslie Frey,
Regulatory Services Coordinator
Hoffman, Complaint Coordinator
Ms. Alyssa Van
Der Woude, Administrative Assistant