Investigations overwhelm body that oversees doctors

WINNIPEG — The regulatory body that’s responsible for protecting Manitoba patients, by holding doctors to account, has more than 225 open investigations — but only one investigator.

A 54-year-old Winnipeg man said the “deeply troubling” revelation was made by the College of Physicians and Surgeons of Manitoba last week in response to his inquiry about why his complaint of “severe harm caused by medical neglect” has taken more than a year to move forward.

“We are currently managing over 225 open investigations, the vast majority of them also involving serious matters,” assistant registrar of complaints and investigations Dr. Guillaume Poliquin replied to him on Sept. 15. “At present, we only have one investigator while we continue training a second.”

Manitobans should be alarmed the college has just one investigator to handle the high number of investigations, the complainant said in an interview Tuesday.

The Winnipeg Free Press is not identifying the man, who has a rare and painful urological condition.

He documented his years-long struggle to get proper medical treatment, the impact of a surgery that failed, and has since been diagnosed with post-traumatic stress disorder. He said he reached out to the Free Press over his concern about staffing at the college, which oversees Manitoba doctors, and the potential risk to patients.

“It suggests that serious complaints of medical negligence, misconduct, or harm are effectively stalled,” said the man who had received only form letters and reassurances from the college about the delay.

Poliquin, who leads the college’s 10-member complaints and investigations department, confirmed Wednesday it had more than 225 open investigations and one investigator, with another undergoing training.

“It is only a snapshot in time — it doesn’t really give the full story of the broader departmental function,” he said.

Since joining the department in the past year, he has been working to realign its focus and resources to maximize the investigator’s time, Poliquin said.

A research analyst position was created “to do a lot of the background heavy lifting: get the record, get the documents, figure out who the witnesses are, get summaries put together so that the investigator’s time is focused on the investigation and not the administration of the investigation.”

The department is being restructured to make it more efficient, Poliquin said.

“Historically, we allowed a lot of complaints to enter the queue and then we would sort them out after, and figure out ‘maybe this one was vexatious’ or, maybe, ‘there wasn’t much here,’” he said.

Two complaints were dismissed last year. Sometimes complaints are about the health system as a whole or about nurses or other allied health professions that have their own regulatory body, he said. The college redirected 131 such complaints last year, Poliquin said.

Complex complaints require more time in the department’s “analytics unit” to “tease apart” what can actually be investigated by the college, he said.

“We are working as diligently as we can,” and patient safety “is top of mind,” Poliquin said. The college implemented a priority assignment system that triages complaints, he said.

“Things such as serious boundary violations, sexual impropriety, grossly negligent care will get handled on a priority basis,” he said. “We have metrics and timelines for how quickly we respond to those. Sometimes those are the types of cases where, before the investigation is even complete, we have to bring in interim restrictions on the physician practice,” the assistant registrar said.

“The unfortunate reality of that approach is that if you get three or four of these in close succession, it does mean that less serious matters will be temporarily affected because we need to redirect our focus on these really impactful, high-priority cases,” Poliquin said.

He said he can’t comment on individual complaints, but he understands the complainant’s frustration.

“I know where he’s coming from and I would be frustrated if I was in his boots as well,” he said.

“Part of the reason we’re making all these changes is because timeliness has been an issue. We’ve restructured in the past year to focus on being able to respond in a timely fashion to those high-priority, high-complexity, high-impact complaints.”

“I’m excited about the direction, but I also am cognizant and sympathetic to the fact that this complainant and some others have also experienced a slowdown in processing as we’ve been making all these changes,” Poliquin said.

The complainant asked Health Minister Uzoma Asagwara in a Sept. 17 letter to ensure that the college can provide timely investigations.

“If Manitoba’s medical regulator cannot fulfil its mandate, then every patient in this province is left unprotected,” it said.

In a statement Wednesday, Asagwara said, “Manitobans deserve confidence in their health system, and that means knowing regulators are protecting patients.”

The minister said the college is a self-governing body that has a clear mandate to protect patient safety. “We expect them to meet it.”

Doctors Manitoba, which advocates on behalf of physicians, said that “with millions of interactions between patients and their doctors every year, in a health system that has been quite stretched historically, there is sometimes room for improvement.”

It encouraged patients to first raise their concerns with the physician or the facility — where most are quickly resolved — before taking them to the college.

» Winnipeg Free Press