The Characteristics of Psychiatrists Disciplined by Professional Colleges in Canada

Abstract

BackgroundThe identification of health care professionals who are incompetent, impaired, exploitative or have criminal intent is important for public safety. It is unclear whether psychiatrists are more likely to commit medical misconduct offences than non-psychiatrists, and if the nature of these offences is different.AimThe aim of this study was to compare the characteristics of psychiatrists disciplined in Canada and the nature of their offences and disciplinary sentences for the ten years from 2000 through 2009 to other physicians disciplined during that timeframe.MethodsUtilizing a retrospective cohort design, we constructed a database of all physicians disciplined by provincial licensing authorities in Canada for the ten years from 2000 through 2009. Demographic variables and information on type of misconduct violation and penalty imposed were also collected for each physician disciplined. We compared psychiatrists to non-psychiatrists for the various outcomes.ResultsThere were 82 (14%) psychiatrists of 606 physicians disciplined in Canada in the ten years from 2000 through 2009, double the national proportion of psychiatrists. Of those disciplined psychiatrists, 8 (9.6%) were women compared to 29% in the national cohort. A total of 5 (6%) psychiatrists committed at least two separate offenses, accounting for approximately 11% of the total violations. A higher proportion of psychiatrists were disciplined for sexual misconduct (OR 3.62 [95% Confidence Interval [CI] 2.45–5.34]), fraudulent behavior (OR 2.32 [95% CI 1.20–4.40]) and unprofessional conduct (OR 3.1 [95% CI 1.95–4.95]). As a result, psychiatrists had between 1.85–4.35 greater risk of having disciplinary penalties in almost all categories in comparison to other physicians.ConclusionPsychiatrists differ from non-psychiatrist physicians in the prevalence and nature of medical misconduct. Efforts to decrease medical misconduct by psychiatrists need to be conducted and systematically evaluated.

Characteristics and rates of disciplinary findings amongst anesthesiologists by professional colleges in Canada

“…3 It has been postulated that these specialties face a greater risk of discipline because they practice mainly in isolation, have frequent patient interactions, and can develop intense physician-patient relationships. 7 Such intimate relationships can potentially blur physical and sexual boundaries, which may account for the fact that psychiatrists and family physicians are more likely to receive discipline for sexual improprieties and boundary issues.…”

“…7 Such intimate relationships can potentially blur physical and sexual boundaries, which may account for the fact that psychiatrists and family physicians are more likely to receive discipline for sexual improprieties and boundary issues. 4,8 Apart from the subspecialty of chronic pain medicine, the nature of the relationship between an anesthesiologist and patient is much different and may account for the observed disciplinary rates. The patient usually meets the anesthesiologist on the day of the surgery, and the interaction revolves around information gathering and education.…”

“…As a result of compiling these CPS case summaries into a database, we determined that family physicians, psychiatrists, and surgeons were subject to the highest disciplinary rates in Canada. 3 Anesthesiologists, on the other hand, composed approximately 2% of physicians facing discipline while accounting for 4% of the total physician workforce. 3 Despite a low disciplinary rate in Canada, further analysis is needed to identify and understand factors involved in discipline within the specialty of anesthesiology.…”

“…3 Anesthesiologists, on the other hand, composed approximately 2% of physicians facing discipline while accounting for 4% of the total physician workforce. 3 Despite a low disciplinary rate in Canada, further analysis is needed to identify and understand factors involved in discipline within the specialty of anesthesiology. By comparing this group of specialists with other physicians in Canada, we hope to identify any major characteristics of this cohort and determine areas within medical practice that require closer attention within this speciality.…”

“…The same methodology has been documented in our previous publications where we examined disciplinary findings amongst other physician groups from 2000-2009. 3,4 Each disciplinary action was reviewed and grouped according to the following categories: conviction of a crime; fraudulent behaviour/prevarication; inappropriate prescribing; mental illness; failure to meet a standard of care; the physician's use of drugs or alcohol; sexual misconduct; unprofessional conduct; unlicensed activity/ breech of registration terms; miscellaneous findings; and unknown/unclear findings. Miscellaneous findings were mainly breaches of confidentiality, improper disclosure to patients, and improper handling or maintenance of medical records.…”