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Here's why B.C. doctors are upset about changes to disciplinary colleges

B.C. Health Minister Adrian Dix said the law is a necessary fix that will help patients by improving oversight of the colleges.
B.C. Premier David Eby, left, and Health Minister Adrian Dix. NICK PROCAYLO, PNG

A new law that changes the way B.C.’s health colleges are regulated is facing backlash from some doctors who say it gives the government too much power over how 130,000 health professionals like chiropractors, dentists and doctors are disciplined.

B.C. Health Minister Adrian Dix, however, said the law is a necessary fix that will help patients by improving oversight of the colleges and make sure cases of misconduct by practitioners are made public.

The B.C. Liberals, B.C. Greens, and Doctors of B.C. are concerned that the Health Professions and Occupations Act was rushed through the legislature with limited debate in late November, catching health professionals off-guard when it became law on Nov. 24.

The law will consolidate the number of health colleges in B.C. from 15 to six. One amalgamation will combine the colleges for dietitians, occupational therapists, opticians, optometrists, physical therapists, psychologists, and speech and hearing professionals into one regulator for allied health professionals. The other amalgamation will create a single college for chiropractors, massage therapists, naturopathic physicians, traditional Chinese medicine and acupuncturists.

The six colleges will be monitored by a new oversight body, an independent discipline tribunal, and a revamped complaints process that Dix says will increase accountability and transparency, and protect vulnerable people.

The oversight body, the Health Ministry said, will also ensure more consistent discipline across the professions and that the public is given information about practitioners who are found guilty of misconduct. Medical professionals guilty of serious misconduct could face fines up to $200,000 or up to six months in jail.

A major complaint from physicians is that the government will now appoint college board members, a change from the old system in which board members were elected by health professionals.

“I think the regulatory body has to at least speak the language of the people it’s regulating, and I don’t have confidence that a government-appointed board would do that,” said Dr. Jennifer Lush, a family physician in Saanich.

She said the bill could hurt the government’s attempts to recruit and retain family doctors.

“I have heard of multiple excellent physicians who are now looking into licensure in other provinces because of” the new law, Lush said.

Lush also said the law gives the government the power to seize people’s medical records in the case of a complaint against a health professional.

Dix said this is false. Only an independent investigator appointed by the oversight body can request medical records related to a patient complaint, he said.

“When there’s a complaint for example, a complaint of abuse, you have to be able to review the evidence to determine the validity of that complaint when a health-care professional has a complaint against them,” Dix said.

He said people will be appointed to the colleges through a “merit-based process” that considers a person’s expertise in regulation and an understanding of the complaints process. That means not everyone on the board will be professionals in that medical field.

Dix said that’s because “these colleges do not represent the profession. They represent public interests, they regulate the profession.”

The act is a response to a 2019 report by independent expert Harry Cayton that called on B.C. to completely overhaul the Health Professions Act. Cayton found that some colleges were more concerned with protecting their members than patient safety.

Cayton, the former chief executive of the U.K.’s Professional Standards Authority, found that many of B.C.’s professional health colleges have demonstrated “a lack of relentless focus on the safety of patients in many but not all of the current colleges.”

Cayton was appointed after concerns about regulatory practices by some colleges including how they dealt with practitioners who provided misinformation about vaccines.

Dr. Kevin Mcleod, an internal medicine specialist at Lions Gate Hospital in North Vancouver, called some provisions of the act Orwellian. Mcleod said while he supports transparency, he’s worried all complaints against medical professionals, even unfounded ones, will be “very, very public,” which could damage someone’s reputation.

“So if somebody makes a frivolous complaint, that now is investigated in a very public way,” he said.

Dr. Josh Greggain, president of the Doctors of B.C., said his association “supports efforts to hold our health-care providers, including physicians, accountable to a high standard for both public confidence and health issues.”

However, he said the “process matters as much as outcome” and many physicians have been blindsided by a process they weren’t fully informed about.

B.C. Liberal health critic Shirley Bond said by forcing closure on the bill, essentially forcing it through without a full debate, the Opposition didn’t have the chance to ask questions about hundreds of clauses in the 600-clause bill.

While Dix maintains the bill was influenced by one of the most extensive consultation processes in the government’s history, Bond disputes that.

“Physicians and others who are impacted by this bill were not aware of what the content was,” Bond said. “So now we’re seeing the reaction to a bill that is already law.”

B.C. Green Leader Sonia Furstenau is urging the government to reopen the bill “so that people’s questions can be answered and [the government] can rebuild trust and accountability.”