A national registry for physician misconduct incidents? New study in CMAJ urges more transparency

A new analysis of physician disciplinary cases involving sexual misconduct in Canada concludes that more transparency is needed, with researchers calling for a national registry of incidents.The researchers, who published their findings in the Canadian Medical Association Journal (CMAJ) on Monday, looked at newspaper articles, legal documents and college complaints across Canada detailing incidents of gender-based harassment or discrimination that involve 208 unique physicians from Aug. 1, 2019, to July 31, 2024.The cases that were included in the analysis had a total number of 689 victims and complainants. Of these, 84.9% were women or girls and 5.8% were children. The most common offences in the analysis were sexual boundary violations and misconduct, representing 36.1% of cases, followed by sexual assault (31.3%). There were 72 cases (34.6%) that resulted in a police complaint, of which 44 led to a criminal trial. A significant rate of recidivism was among the findings from the researchers. Of the physician respondents, 29.8% had been the subject of at least one previous complaint. In some cases, subsequent offences took place while the physician was already under a practice condition. In addition, there were cases involving physicians who were free to practice in one jurisdiction despite having been sanctioned in another. In these cases, the researchers noted that it’s not clear whether the college had been aware of the concerns from the other jurisdictions.“For example, a physician respondent who received a reprimand after pleading no contest to five patient complaints related to inappropriate touching during a physical examination had had his practice permit revoked in the United States previously for an unknown reason, in addition to complaints related to sexual misconduct previously made to two different colleges,” the researchers wrote.However, the researchers also point out that cases reported in the news often motivate additional complainants to come forward upon learning about other victims, showing that more transparency can lead to positive outcomes.On top of that, the researchers found several cases suggesting inadequate self-reporting mechanisms. The analysis found 13 physicians who were criminally charged but did not have a corresponding notification on their college registration profile. In one case, a physician had been arrested and charged with sexual assault four times between 2017 and 2024, yet his college registration showed no disciplinary history.The researchers say they wish to see a national registry of physicians who have been the subject of disciplinary incidents, categorized by type of offence, the outcome and explanation. A registry, the researchers add, could also help create a formal process for law enforcement agencies to share information with medical regulators.“Though proposed, at present there are no requirements for law enforcement in Canada to share information about accusations, investigations, and criminal charges with medical regulators,” they wrote. “Public consultation should guide how regulatory bodies report cases of harassment or discrimination.” The analysis is not without its limitations. The researchers were not able to account for whether or not the physicians were ultimately found “guilty” in the incidents, although nearly 80% of the physicians in the sample did end up receiving a college disciplinary action. In addition, the researchers only had access to cases that were reported publicly and therefore could not estimate the annual prevalence of sex- or gender-based harassment or discrimination perpetrated by physicians—but this point further underscores the researchers’ calls for greater transparency.“This work demonstrates the need for standardized, transparent data collection and reporting of physicians involved in concerns related to sex- and gender-based harassment and discrimination,” the researchers wrote.

A national registry for physician misconduct incidents? New study in CMAJ urges more transparency

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