REGULATORY AND PROFESSIONAL DISCIPLINE IN ONTARIO

What physicians and other regulated professionals should know about complaints, investigations and hearings

A regulatory complaint can affect a professional licence, employment, reputation, insurance and future opportunities. A complaint or investigation notice is not proof of misconduct. Each matter must be assessed under the legislation and rules of the relevant regulator.

HOW A MATTER BEGINS

A matter may begin through:

• A complaint from a patient, client, colleague or member of the public;

• A mandatory report;

• An audit, inspection or regulatory review;

• Information from a court, tribunal or another regulator; or

• Concerns identified directly by the regulator.

The regulator will assess jurisdiction, limitation periods and whether further action is warranted. Some matters close at this preliminary stage. The College of Physicians and Surgeons of Ontario (CPSO) regulates physicians and physician assistants in Ontario. Other professions have their own regulators and legislation.

THE INVESTIGATION STAGE

A regulator may request documents, ask written questions, conduct interviews or seek information from others. Professionals should read every notice carefully, identify deadlines, preserve records and obtain advice before making substantive admissions or attending an interview. A response that is incomplete, late or unnecessarily argumentative can create additional risk.

POSSIBLE OUTCOMES BEFORE A HEARING

Depending on the regulator and circumstances, outcomes may include:

• Closure with no further action;

• Advice, education or a caution;

• A warning or reprimand;

• An undertaking or agreement;

• Conditions on a licence or practice;

• Remedial training or supervision;

• A negotiated resolution; or

• Referral to a formal discipline proceeding.

Before agreeing to an undertaking, restriction or admission, a professional should understand its immediate and long-term effect.

FORMAL HEARINGS

If a regulator believes there is sufficient evidence to proceed, it may issue formal allegations or a notice of application. The process may involve disclosure, procedural motions, witness preparation, a hearing, submissions on penalty and a written decision. Review or appeal rights may be available.

For physicians, allegations referred by the CPSO may be heard by the Ontario Physicians and Surgeons Discipline Tribunal. Formal proceedings may become public, subject to applicable legislation and confidentiality orders.

POTENTIAL CONSEQUENCES

Consequences may include a reprimand, fines or costs, practice restrictions, mandatory education or supervision, licence conditions, suspension, revocation or publication of the decision. A regulatory matter may also overlap with criminal, civil, employment, insurance or immigration consequences.

PRACTICAL STEPS

A professional who receives a complaint, investigation notice or hearing notice should consider:

• Keeping the original notice and attachments;

• Creating a chronology;

• Preserving relevant records;

• Avoiding discussion of the matter on social media;

• Checking notification duties to insurers, employers or licensing bodies; and

• Obtaining advice from counsel experienced in regulatory proceedings.

WHY EARLY ADVICE MATTERS

Early advice can identify the real issues, preserve evidence, address parallel proceedings and prevent an avoidable misunderstanding from becoming a larger problem. Counsel may assist with written responses, document production, interviews, undertakings, hearings and related licensing, employment, reputational or immigration consequences.

EVERY REGULATOR HAS ITS OWN PROCESS

Physicians, lawyers, engineers, accountants and other regulated professionals are governed by different statutes, codes, tribunals and appeal procedures. For Ontario physicians, the CPSO’s authority is established through the Regulated Health Professions Act, 1991, the Health Professions Procedural Code and the Medicine Act. Other professionals should consult the legislation and rules governing their own regulator.

OFFICIAL RESOURCES

College of Physicians and Surgeons of Ontario: https://www.cpso.on.ca/about/what-we-do

Ontario Physicians and Surgeons Discipline Tribunal: https://www.cpso.on.ca/public/physician-information/discipline

Regulated Health Professions Act, 1991: https://www.ontario.ca/laws/statute/91r18

Kalina & Tejpal represents professionals facing regulatory and professional discipline matters. Contact the office for a confidential discussion. This article is general information only, not legal advice, and does not create a lawyer-client relationship.