One important responsibility of the College of
Physicians and Surgeons of Ontario is to respond to
concerns and to investigate complaints from members of
the public about doctors licensed to practice medicine
in Ontario. In all that we do, the College must act
first and foremost in the best interest of the public.
The following are answers to commonly asked questions
about the College’s complaints process.
What should you do if you wish to
file a complaint?
If you have a concern about communication,
records, or if you have questions about the
treatment you’ve received, we strongly encourage
you to first speak with your doctor or hospital,
if possible, before contacting the College. This
is often the most direct way to get the answers
that you need. If this is not possible or
successful, then we urge you to contact the
College for assistance.
Please call our Public Advisory Department at
416-967-2603 or 1-800-268-7096 extension 603. If
your concerns or questions are about the quality
or appropriateness of care received, you may
need to speak with a College staff member in the
Investigations and Resolutions Department who
has experience in health care. Staff may be able
to answer questions about your care; clarify
which questions to take back to your doctor;
and/or answer questions about how the health
care system works.
If this does not address your concerns,
please follow the steps below.
How do you begin the complaints process?
The College must receive your complaint in
writing or in another permanent form, such as a
tape, film or disk. Please include the doctor’s
name and address, a description of the events
that led to the complaint, the date and
location, and any other information that may
help the College in its review. A complaint form
which may be completed electronically, printed
out and mailed to the College is provided here
for your convenience.
Link to Complaint formComplaints can be
sent by e-mail, and should contain your contact
information and your telephone number. After
receiving the first e-mail correspondence, we
will communicate with you by telephone and/or in
writing. All correspondence from us will be sent
by regular mail to preserve confidentiality.
Please state clearly your questions or
concerns. You can add the names of people who
witnessed the events or who may have useful
information. We are required to send a
copy of your letter to the doctor you are making
the complaint about. Once we review
your concerns, College staff will contact you
either by telephone or letter to discuss your
concerns, answer questions, and/or obtain
additional information. Where appropriate, we
will try to address your concerns.
How are complaints addressed?
College staff often try to answer questions and
clear up misunderstandings between patients and
doctors.
In order to answer your questions and address
your concerns, staff may review your medical
records, discuss your concerns with the doctor,
and ask him or her to respond to them.
College staff may also arrange to meet with
you, and possibly with you and the doctor(s) –
perhaps even hospital administrators – to
communicate and clarify issues. This gives you
the opportunity to tell the doctor and others
about your concerns.
This process provides a forum for you to have
your concerns heard and acknowledged by the
doctor and/or hospital representatives, and is
done only with both your and the doctor’s
agreement. Occasionally, an improvement to the
way in which health care is delivered has come
about as a result of these discussions.
What happens if my complaints cannot be
addressed?
College staff will begin an investigation on
behalf of the Inquiries, Complaints and Reports
Committee. The Regulated Health Professions
Act (RHPA) sets out the complaints process,
including that the doctor will be told that a
complaint has been received. The doctor will
also be given an opportunity to respond.
Following are important steps in the
investigation process:
1. Obtaining consent for the release of
confidential medical information
Because all medical information is
confidential, consent is needed from the person
who is authorized to release it, to assist us in
our review. A consent form must be signed by one
of the following persons: the patient
himself/herself; the legal guardian of the
patient; the power of attorney for personal
care; or the executor of the patient’s will.
Consent is required to obtain information from
the doctor who is the subject of the complaint,
other doctors or health care professionals, and
health care facilities.
Even without consent from the appropriate
person, the Inquiries, Complaints and Reports
Committee of the College (whose task it is to
direct the investigation) can obtain medical
information under the authority of a Registrar’s
investigation, if it is thought to be important.
2. Requesting a response from the doctor
Staff may ask the doctor to respond in
writing to your complaint. This is an
opportunity for the doctor to provide an
explanation of his or her care or conduct.
3. Obtaining relevant medical information
Any other relevant medical information needed
to conduct a complete investigation will be
obtained. This may include asking other
physicians and health care facilities for
information.
4. Review and decision by the Inquiries,
Complaints and Reports Committee
When the pertinent information has been
obtained, the documents are submitted for review
by the Inquiries, Complaints and Reports
Committee. Both you and the doctor will be
notified by letter of the date when the
Committee will meet. At that time, the Committee
decides whether additional information is
required or makes a decision if it has enough
information to reach a conclusion.
Do you or the doctor meet with the Committee?
The Inquiries, Complaints and Reports Committee
is authorized to conduct a review of the
documentation only. Neither you nor the doctor
are required or allowed to meet with the
Committee.
Who sits on the Inquiries, Complaints and
Reports Committee?
The Inquiries, Complaints and Reports Committee
is made up of physicians and government
appointed public members. A panel from among the
members of the Committee is selected to direct
each investigation, consider the doctor's
response to the complaint, and make a reasonable
effort to consider all relevant records and
documents.
What are the possible outcomes?
When all the information has been reviewed, the
Inquiries, Complaints and Reports Committee will
decide to do one of the following:
- take no further action, if the doctor’s
conduct or the care provided was
appropriate;
- remind, counsel, or caution the doctor
in writing, if the Committee believes the
doctor would benefit from some advice or
direction as to how to conduct him or
herself in the future;
- require the doctor to appear before a
panel of the Inquiries, Complaints and
Reports Committee in Toronto to be
cautioned. At that appearance, the Committee
will discuss with the doctor the steps it
believes the doctor must take to avoid
future difficulties. Doctors who are
required to appear before the Committee are
often asked to prepare for the meeting by
making practice changes, reviewing relevant
literature or taking other steps;
- direct or accept the doctor’s agreement
to participate in training or educational
programs to improve his or her practice;
- refer the doctor to a panel of the
Committee if there are concerns about the
doctor's health that may be affecting her or
his ability to practise;
- refer the concerns about the doctor to
the Discipline Committee; or
- decide not to investigate because the
complaint is frivolous, vexatious, made in
bad faith or is an abuse of process.
Are you and the doctor given the Committee’s
decision?
The Inquiries, Complaints and Reports Committee
prepares a written decision that is sent to you
and the doctor within six to eight weeks of its
meeting unless the matter is referred to the
Discipline Committee or the doctor is referred
to a panel of the Committee because of concerns
about the doctor's health that affect her or his
ability to practice.
Am I allowed to appeal the Inquiries, Complaints
and Reports Committee’s decision?
Almost all complaint decisions of the College’s
Inquiries, Complaints and Reports Committee can
be appealed by you or the doctor to an
independent government body, called the Health
Professions Appeal and Review Board. The only
decisions that cannot be appealed are those in
which the matter is referred to the College’s
Discipline Committee or the doctor is referred
to a panel of the Committee because of concerns
about the doctor's health. The College sends
contact information for the Health Professions
Appeal and Review Board with every Inquiries,
Complaints and Reports Committee decision.
Does the Inquiries, Complaints and Reports
Committee investigate all complaints?
The Inquiries, Complaints and Reports Committee
investigates the majority of complaints
received.
The law permits the Committee to decline to
investigate complaints it considers to be
frivolous, vexatious, made in bad faith or an
abuse of process. This decision rests solely
with the Committee.
In such cases, the Committee provides notice
to the complainant and the doctor that it
intends not to investigate. Both the complainant
and doctor have the right to make written
submissions to the Committee within 30 days of
being given such notice. If, after considering
any written submissions, the Committee is
satisfied that a complaint is frivolous,
vexatious, made in bad faith or an abuse of
process, it will not investigate. Only a very
small percentage of complaints meet the
requirements for this exception.
As stated above, your concerns may be
addressed during the investigative process by
the investigator with information from the
physician and/or upon review of the medical
records. If your concerns are addressed during
the investigative process, the Inquiries,
Complaints and Reports Committee will decide
that no further action is required for the
investigation.
Are there limitations to the complaints process?
The College cannot compel a doctor to change his
or her opinion or report. Corrections to a
medical record may be made by the physician to
ensure accuracy of the information and must be
done according to the College’s policy on
Medical Records.
The College cannot compel a doctor to
apologize (although once a matter is brought to
their attention, some doctors do).
The College does not have the authority to
award financial compensation.
Is there a time limit to filing a complaint?
There is no time limit, but the College
recommends that concerns or complaints be made
as soon as possible after the event. The earlier
a complaint is received, the fewer problems are
encountered in the investigation. For example,
it is more likely that relevant documents still
exist, witnesses can be more easily located,
memories have not faded, and evidence is not
missing.
How long does it take to complete the complaints
process?
In the vast majority of cases, the process takes
from three to 10 months to complete.
Can information gathered by the College be used
in Court?
No. In accordance with Section 36(3) of the
Regulated Health Professions Act, no report
or decision of a proceeding is admissible in a
civil proceeding.
Contact the College
If you would like to talk to someone about the
care or conduct of a physician or about the
complaints process, please contact our Public
Advisory department:Telephone: 416-967-2603
or 1-800-268-7096 ext. 603
E-mail:
ir@cpso.on.ca
Mail:
The Registrar
c/o Investigations and Resolutions
Department
College of Physicians and Surgeons of
Ontario
80 College Street
Toronto, ON, M5G 2E2