University of Calgary study finds inconsistent tracking of disciplinary action by regulators, in addition to troubling cone of silence among doctors

More transparency is needed among those who regulate physicians to better police doctors guilty of sexual abuse and discrimination, say University of Calgary researchers.

The two physicians who led the study used media reports, legal decisions and information from regulator websites to create a cross-Canada database that identified 689 victims — 585 of them women or girls, with at least 40 being children aged over five years. Sexual misconduct complaints were the most common, followed by those involving sexual assault.

But in some of those cases, complaints weren’t listed online by physician colleges that govern and discipline practitioners, determined the study published in the Canadian Medical Association Journal.

“Our findings emphasize how the lack of transparent, consistently reported, and accessible data about physicians involved in instances of sex- and gender-based harassment and discrimination restricts assessment of current strategies to address these behaviours,” said Dr. Shannon Ruzycki.

But what Ruzycki and Dr. Kirstie Lithgow also found was a troubling absence of reports of physician misconduct targeting colleagues, particularly female ones.

“We found very few physicians who came forward with these concerns to be captured in our data,” said Ruzycki.

That’s not consistent with findings in the U.S. and U.K., which determined 65 per cent of female and 23 per cent of male health-care workers reported being victims of sexual- or gender-based harassment by colleagues, say the researchers.

“We were finding in particular women physicians were describing these whisper networks or open secrets about ‘don’t give him your cellphone number or go for coffee with him, he’s known to cross boundaries,’ ” said Ruzycki.

“Women physicians are protecting each other because regulators aren’t able to.”

Gaps and inconsistencies in colleges’ data on disciplinary matters were a serious issue confronting their research, they said, despite improvements in recent years due to legislation and greater awareness.

But what their research found was that that progress has been insufficient.

Since provincial legislation mandating penalties and greater regulator transparency came into effect in 2019, it’s impossible to know how effective it’s been in dealing with offenders, said the researchers.

“How this (data) is were collected, we don’t know, and were patients aware of these changes?” said Ruzycki.

“We don’t know because the data is not collected and reported adequately in order to analyze it. We should know and be able to study these things.”

Both white, female researchers said they’ve experienced gender-based harassment and have heard of cases frequently from colleagues.

And they said it’s shocking yet not surprising such misconduct occurs, given the opportunities and power imbalances involved.

“It’s very upsetting because we are in a privileged position, to see so many people abused is upsetting to me personally and professionally,” said Lithgow, who’s an endocrinologist.

“Most physicians want to help and don’t want to harm their patients but they see patients at their most vulnerable and there’s a potential to do a lot of harm.”

The study, which the authors emphasize is incomplete due to limits on available information, lists 208 offending physicians.

“This represents an estimated 0.2 per cent of physicians registered for practice in Canada,” states the study.

“This proportion aligns with the reported proportion of U.S. physicians who were the subject of any type of disciplinary concern in 2024, or 0.3 per cent.”

But the U of C researchers said it’s likely that more than 90 per cent of offences experienced by patients go unreported, with many potential complainants uncertain they’ve been victimized. That can also lead to lengthy delays in reporting, they said.

“And people are really reluctant to report a physician because if it’s in the middle of medical care, they need the care,” said Ruzycki.

Most troubling, they said, is that 30 per cent of the cited physicians were repeat offenders, which raised concerns about regulators’ enforcement.

“What’s most shocking and disappointing is how we saw a pattern of behaviour that despite being reported and disciplined, they were reported again,” said Ruzycki.

“As a self-regulated profession, that was the most upsetting to me.”

The website of the College of Physicians and Surgeons (CPSA) lists 101 doctors named in disciplinary cases for the past 10 years and notes that those involving sexual abuse and misconduct will appear indefinitely, while others are posted for a decade.

“Discipline decisions are posted as soon as they are available, and will remain on our website for ten years to ensure transparency and accountability to Albertans,” states the college.

In an email, the college outlined its disciplinary process, which can include mandatory sanctions or cancellation and suspension for sexual misconduct, and said details of its results are publicly available.

“If a physician is found guilty of sexual abuse or misconduct by an independent CPSA Hearing Tribunal — made up of 50% public members and 50% regulated members — the written decision is publicly available on the physician’s profile on CPSA’s website,” they said.

“CPSA also publicly reports data around sexual abuse and misconduct complaints through our annual report, including the number of complaints opened, hearings and hearing outcomes.”

They said the college has one of the strongest regulator frameworks in the country and that Alberta’s legal changes in 2019 “established a clear, zero-tolerance approach that prioritizes patient protection, accountability and transparency,” while the CPSA has created a victim support fund.

The U of C researchers say regulators should include public consultation in reporting cases of harassment and discrimination to help protect the public, while respecting physician privacy. Creating a national registry detailing disciplinary actions and outcomes could be one approach, they said.

“This isn’t about pointing fingers at individuals, it’s a call to our profession that this is a problem and we need to do better,” said Lithgow.

The college said it will carefully review the study and consider its recommendations.