Three women in Ontario speak out after complaining about their former gynecologist to the College of Physicians and Surgeons of Ontario. They say long delays, frightening legal demands, mischaracterization of complaints and lack of communication have led them to wonder whether the college is acting to protect the patients or the doctors they have to regulate.
Each of the three former patients filed their complaints with the College of Physicians and Surgeons of Ontario (CPSO) more than a year ago, and since they have been waiting for the studies to be completed and for the consultation dates to be set, more patients have emerged. with their own complaints about the same doctor.
In late December 2021, the CPSO revealed that Dr. David Gerber of Meridia Medical in downtown Toronto would face complaints from 10 patients at a disciplinary hearing, up from the six previously announced in 2020.
The College alleges that Gerber “participated in a disgraceful, disgraceful or unprofessional conduct,” including, but not limited to, his communication, failure to explain what an investigation would entail, failure to obtain informed consent, and failure to demonstrate adequately sensitivity.
Howard Winkler, Gerber’s attorney, told CBC News that “two leading independent medical experts have carefully reviewed each complaint and the related medical records. Both experts agree that the treatment Dr. Gerber provided met or exceeded any clinical standard and did not deviated from the usual. and expected practice. “
The CPSO will not comment on any specific complaint or hearing. CBC News previously reported that the college had expected to hold the hearing in 2021, but a date has not yet been set.
‘My civic duty to warn other women’
Navi, who asked CBC News not to publish her last name for fear of online harassment, claims that her complaint against Gerber constitutes a sexual boundary violation, as defined by the CPSO.
The college says a border crossing occurs when a physician does not establish or maintain the boundaries of a professional relationship with their patient. Sexual boundary violations may include a range of activities, including failure to obtain consent prior to conducting an investigation.
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Navi is among the 10 patients listed in the college’s hearing announcement, saying the fact that the college is not pursuing her complaint as a sexual boundary violation has shaken her faith in the system.
“I do this as my civic duty to warn other women,” she said. “There is no protection available to us. And the protection that says it is there, it does not work. It is broken.”
The three women interviewed for this story each want their complaints pursued as sexual boundary violations. CBC News does not know the details of all 10 complaints referred to a disciplinary hearing.
Winkler, Gerber’s attorney, says the allegation that the doctor committed a sexual boundary violation is false. He wrote that “CPSO, after careful investigation, which included reviewing the complainants’ medical records, interviewing the complainants, interviewing nurses and others, and after obtaining several expert reports,” determined that complaints of sexual border violations did not justify a referral to a disciplinary hearing.
‘The only reason is to scare’
Candice Jones, who complained about Gerber in January 2021, is not among the 10 patients listed in the college consultation report. She has been waiting 14 months for the college to process her complaint.
Ten months after filing her complaint, she received an 11-page letter from the CPSO demanding “a complete copy” of any communication she had “with anyone in relation to Dr. Gerber.” If she does not comply within seven days, she could, according to the document, risk a fine of $ 25,000 or be found in contempt of court.
Jones said the request made her feel overwhelmed and that she was unsure how to comply with such broad requirements while maintaining a semblance of privacy.
“Should I share all the details of how what has happened to me has affected my life and the conversations I have had with other people?” she asked.
“It’s hard not to get completely defensive and just feel like it’s me who’s under investigation,” Jones said.
“They have had months, over a year, to ask for this information, and all of a sudden it is of immediate importance,” said Elizabeth Adamou, whose complaint against Gerber was one of the original six referred to a disciplinary hearing in 2020.
She received a similar request to Jones’ in August 2021, though her not mentioned legal consequences.
“I think when they demand it that way, it makes you think the only reason is to scare,” she said.
‘Let’s be realistic’
The way the CPSO handles patient complaints has been criticized in the past. In the last 31 years, three independent studies have examined how colleges that regulate health care workers in Ontario treat some complainants. Each has highlighted an imbalance in the power of patients and physicians.
Those who file a complaint with the CPSO participate in the process as witnesses, not plaintiffs.
This means that they do not get their own lawyer, and have very limited access to information on how or whether it is progressing.
Physicians, on the other hand, have broad access to information that a defendant would receive in a lawsuit. Their legal representation is provided by the largely publicly funded Canadian Medical Protective Association, which employs lawyers from some of the best firms in the country.
“Let’s be realistic about who can actually move inside this system, and be able to influence it in a way that will yield the best possible results,” said Senator Marilou McPhedran, a lawyer, was chairman of all three task forces and was appointed to the Senate in 2016.
“It’s not the patients,” she said.
‘It feels conscious’
The legislation governing the CPSO requires that it process a complaint within 150 days of the filing, even if it allows for extensions if the patient and physician are properly informed.
After that deadline came and went for Jones without any update from the college, she undertook to contact them and was surprised by what she heard. They had sent her an email, they said, on day 150.
“Getting this statement that ‘oh yes, we sent it to you, you know, on the very last possible day’, when I do not even have a record of having received it, does not inspire much confidence and confidence,” said Jones.
“I really want to give them the benefit of the doubt,” she said, “but it feels conscious.”
Jones was told in mid-December that there would soon be a meeting to consider her case and that she would “receive the committee’s decision within eight to ten weeks.” The 10-week deadline was February 24th.
Similar concerns were raised in 2018
On March 17, the College informed Jones that, after reviewing her case, it would “publish advice [Gerber]”about thoroughly obtaining consent, explaining procedures, preparing patients for pain and discomfort, and being sensitive to patients’ expressions of pain.
“This is a pedagogical outline,” it said, “designed to offer the physician some guidance regarding an area of practice where the committee has noted concerns, to help the physician improve future practice.”
The college has previously engaged with Gerber, citing similar concerns: In 2018, it issued him a personal warning, noting “Dr. Gerber has been the subject of several previous complaints to the college, raising questions about his communication and painful investigations,” and that he “was also warned in writing to ensure proper communication with patients, including proper explanation of the procedures to be performed.”
It went on to say: “The Committee was concerned that, despite his previous involvement with the College on these issues and attempts to remedy them, Dr. Gerber was again the subject of a complaint which raised similar concerns.”
‘I have nothing to hide’
Much of the correspondence Adamou, one of the original complainants, has received from the College also includes requests that she not communicate with other complainants.
“In order to maintain the fairness and integrity of the College’s trials, it is important that you do not discuss this procedure or your evidence with other witnesses or potential witnesses,” the CPSO wrote to Adamou on 9 February.
“I’ve ignored it because I’m 110 percent sure I have nothing to hide,” Adamou said, adding that isolating witnesses in this way only serves to put them in a process that is unequal from the start. .
“That [CPSO] website grows poetic about ‘they are there to help you’, “said Adamou,” and the reality is that no one informs you about your rights at all. “she said.
In some cases, the CPSO offers to pay for three hours of independent legal advice so that plaintiffs can better understand the process. When asked, the CPSO did not answer who offered this service or when.
Jones was notified of the program the day before she received the college’s request for her communication, and the deadline to respond within seven days. Being able to clear your schedule and find a lawyer who is immediately available to conduct that conversation is not realistic, Jones said.
“In any case, the college is trying to provide support for any complaints that come up,” said Carolyn Silver, chief prosecutor at CPSO.
“There is always room for improvement,” she said, “We will always do better.”
Common for witnesses to be told not to talk to each other: CPSO
Without speaking specifically to any case, Silver noted that requests that witnesses do not speak to each other are common, to avoid any hint that the witnesses have influenced each other or each other’s memories.
“There’s a whole lot of case law about that,” she said.
“I have been holding these hearings for over 20 years now in college, these are very difficult cases for complainants. It is not pleasant to be in a hearing,” she said. Being cross-examined, challenged on their memory and faced with suggestions that they fabricate are all possibilities.
In an email from January, Dr. Gerber’s Advocate “CBC has clearly been summoned by a malicious effort by a small number of coordinated individuals who intend to ruin Dr. Gerber’s reputation for some who are perceived as wrong towards them.”
The women interviewed for this story reject these claims.
“To be in touch with [other complainants] enables us to inform each other and tell each other what their rights are, “Adamou said.
“No one understands what I’ve been through as a person who’s been through the same thing with the same doctor, and there are many of us out there.”
Complaints and warnings
According to their annual report, the CPSO received 3,483 complaints about doctors in 2020 and had a backlog of 1,104 carried over from the previous year.
That year, they dealt with 3,329 of these complaints, chose not to act on 34 percent of them, and referred only one percent to a disciplinary hearing. In less severe cases, the college could assign the doctor class work or take other steps such as issuing a formal warning.
There is no registration of involvement with the college before 2018 on Gerber’s CPSO profile. The college does not say how many complaints have been filed against Gerber in the past two years, only that 10 have been referred for a hearing.