Canada: Review Board States That Doctors Are Supposed to Ensure The Patient Is Aware of What Examination Comprises
An inquiry committee decided to take no further action after conducting a sufficient probe into a patient’s complaint that a physician had inappropriately grabbed her breast during her physical examination, as per the tribunal ruling.
In January 2022, the patient went to the doctor’s office, for a consultation regarding a thyroid cyst. During the appointment, she claimed the following things happened. She was called into the doctor’s office and told to take off her jacket. After looking over her test results, he moved his chair over to face her and reassured her that everything would be fine.
He inserted a wire into her nostril and then covered her thyroid area with a stethoscope. The stethoscope was then moved towards her chest, then her stomach, and finally beneath her left breast. He did not provide her an explanation for these inappropriate actions.
The patient was scared and anxious about what had transpired since she felt that she should not be alone with a doctor because of her cultural beliefs. She complained about the doctor in writing. She provided detectives with more information during an in-detail phone interview with the assistance of an interpreter.
The doctor responded by outlining his action plans for the day. He examined the patient’s oropharynx, oral cavity, oropharynx, and ears. Upon palpating her thyroid area and her neck, he felt for any nodes or lumps. He put a stethoscope over her upper back over her clothes, over her trachea in the anterior neck, and above the clavicles. Using a flexible nasopharyngoscope, he examined her vocal cords and upper respiratory tract.
The doctor denied placing a stethoscope beneath her clothes or anyplace else on her body, such as her lower chest or breasts. The College of Physicians and Surgeons of Ontorio’s Inquiries, Complaints, and Reports Committee investigated the complaint and decided not to continue further with him.
However, they did explain that it was expected of all doctors to get consent first, before carrying forward any examination and to make sure that the patient knew what was happening to him.
The patient asked for a review of the committee’s decision. She argued that the committee ought to have investigated her complaint more thoroughly and that they had mistrusted the doctor.
Doctor Wins Over Review Board
Under Section 35(1) of Ontario’s Health Professions Procedural Code, 1991, the Ontario Health Professions Appeal and Review Panel upheld the committee’s decision to take no further action in Betzoo v. Katyal, 2023. CanLII 111770 (ON HPARB).
The Board also noted that doctors were required to get consent before performing a medical examination and to make sure the patient understood what would happen during this procedure. The review board agreed that the patient was dissatisfied with the result. Nonetheless, it concluded that the committee carried out a sufficient investigation and reached a reasonable decision.
The review board concluded that the inquiry adequately documented the incidents and gathered relevant data from the patient, doctor, and his administrative assistant, to analyze the complaint about his deeds and behavior. Medical records and contemporaneous medical notes from the medical examination by the doctor were included in the above documents.
The administrative assistant, who confirmed that there were no odd occurrences or events and that the patient did not appear unhappy upon leaving the office, that day, was also interrogated by the committee and transcribed. The review board stated that the decision of the committee demonstrated a cogent and logical relationship, between the existing facts, the process and the conclusion of reasoning, have led to that conclusion.
Hence, the decision was intelligent, understandable, clear-cut, and well-reasoned overall. The ruling answered the questions posed, explained the criteria considered, and provided thorough citations to the documentation that supported the findings of the committee.
The patient’s deeply held belief was acknowledged by the review board. It did, however, consider the material in the record and found that it was in line with the findings of the committee. The review board further stated that the committee acknowledged its expectations for doctors and replied to the complaints of the patient.
