I was skimming through The Hamilton Spectator this morning during a quiet moment at work and came across an article by Steve Buist that made my stomach turn. The headline: Physicians all over Ontario are committing sexual offenses while practicing medicine and their governing body is protecting them.

“An extensive analysis of the College of Physicians and Surgeons of Ontario’s disciplinary decisions since 1989 shows that there have been 64 medical licenses revoked out of 126 disciplinary cases involving sexual impropriety. Half of the doctors found guilty of sexually related professional misconduct in Ontario have kept their licenses to practice medicine.” -Steve Buist, The Hamilton Spectator

In a few rare cases, physicians convicted in Ontario courts of sexual offenses have not had their medical licenses revoked by the college. Since when does the this College of Physicians and Surgeons of Ontario (CPSO) trump the law?

I have included a couple of cases the article highlighted. The question to remember when considering the conduct of these physicians are, how many women have been traumatized and victimized by those that held the power in the context of their relationship? And how many will ever be able to lay down on an exam table again? I will say that if I were one of these women, I don’t know if I could.

• Dr. STANLEY DOBROWOLSKI, practicing in London Ontario
  Dobrowolski has been disciplined four times by the college between 1994 and 2004 for a range of sexual misconduct and inappropriate behavior during the 1980’s. The incidents ranged from inappropriate touching during breast exams, to the sexual assault of a patient. The victims were female university students.

  On one occasion, Dobrowolski’s license was suspended for twelve months, with nine months dismissed if he complied with conditions (none of which would be disclosed to the public). On another occasion, he was suspended for six months, with three months knocked off if he complied with conditions. On the other two occasions, he had conditions placed on his license and was ordered to write letters of apology.

• Dr. KUNWAR SINGH, practicing in Sarnia, Ontario
  Singh, a pediatrician, pleaded guilty in Ontario court in 1991 to ten counts of sexual assault and six counts of indecent assault. The charges covered a sixteen-year period and involved sexual assaults against nurses and the mothers of some of his patients. Singh was given a suspended sentence and two years probation for touching and squeezing women’s breasts, buttocks, legs and groin areas. Nurses’ picketed two Sarnia hospitals in an effort to have Singh’s hospital privileges revoked.

  At his discipline hearing, Singh’s lawyer said that taking away the doctor’s license could have disastrous consequences because a psychologist determined that Singh was suicidal at the thought of losing his career. The college handed Singh a six-month suspension.

  Three years later, Singh was disciplined by the college for altering his Ontario medical record by removing any reference to his 1991 assault convictions. For this, Singh was suspended six months, with three months knocked off if he complied with certain conditions.

I wanted to dig a little deeper so I ‘googled’ the college and searched for Dr. Singh’s name. The website automatically directed me to the summary page which made no mention that he has a history of sexually abusing his patients. I had to click through the tabs to find out his history. Even then, there is reference only to “Professional Misconduct” and a reference to “Section 27(32) of Ontario Regulation 448/80″. So I went a step further and ‘googled’ the section of the regulation, only to find a giant PDF file that made no reference to Dr. Singh. So after all of this searching, one would still not know that Dr. Singh is (according to Canadian Law), a serial rapist currently accepting new patients. For the average healthcare consumer looking for a doctor, the legwork to find out if the physician is a rapist or pedophile appears to be near impossible.

What blew me out of my seat further is that during the time Dr. Dobrowolski was assaulting women in London, the college was operating under a Zero Tolerance policy of sexual abuse by doctors of patients (The policy was adopted in 1991 as per direction of the Task Force on Sexual of Patients).

The article further states that,

In 1993, the Ontario government amended the Regulated Health Professions Act (RHPA) to toughen the provisions dealing with sexual impropriety committed by physicians.

Under the revised Procedural Code of the RHPA, doctors found guilty by the college of certain types of specific sexual abuse of patients — such as intercourse or masturbation — face mandatory revocation of their license to practice. Doctors can apply for reinstatement five years after mandatory revocation.

The RHPA defines sexual abuse as sexual intercourse or other forms of physical sexual relations between the doctor and the patient, touching of a sexual nature, or behavior or remarks of a sexual nature by the doctor toward the patient.

Marilou McPhedran, law professor and chair of the sexual abuse task force states:

“The law isn’t the problem, it’s the implementation. Over and over again, the analysis is clouded because it’s the needs of the professionals that trump all other needs. As long as we — as members of the public, members of the media, members of government — allow ourselves to be persuaded by that point of view then we are not really approaching this issue primarily as a patient safety issue.”

A prime example:

• Dr. Brian Nagahara, practicing in Ajax, Ontario
  Nagahara, a general practitioner was convicted in 1993 in an Ontario court of sexually assaulting a patient at a walk-in clinic in June 1991. During the course of an examination, Nagahara fondled and squeezed the woman’s breasts. He also touched and fondled her during a pelvic exam.

  Nagahara was sentenced to six months in jail and three years’ probation. He ended up spending 51 days in prison and another 20 days in a halfway house. At the sentencing, the judge suggested it could be a “great many years, if at all, before Nagahara is allowed to practice medicine again in Ontario.”

  But at his disciplinary hearing before the college — which wasn’t held until three years after his criminal conviction — Nagahara’s license was suspended for just 90 days. Despite his criminal conviction and time spent in jail, the college noted that the doctor continued to deny his guilt.

Since the start of 2004, only five doctors have had their medical licenses revoked for sexual misconduct in Ontario. In that same period, there have been 11 other disciplinary cases of sexual misconduct that have resulted only in suspensions or reprimands.

At this point I think it would be fair to say that the college is not anywhere close to zero tolerance.

When I deeply consider the magnitude of sexual abuse that is happening within our healthcare system I can’t help but reflect upon the many women I’ve heard from on the crisis line over the years that have expressed their abuser is someone that has the power and control in the relationship. What is even harder to swallow is that the governing body put into place to provide the checks and balances are simply slapping wrists and in even more cases, turning a blind eye.