Ontario health critic calls for mandatory alert systems when physicians are criminally charged

Ontario's health critic is calling on the province to legislate a requirement that police, the courts and health-care employers automatically report cases of physicians who face criminal charges to the College of Physicians and Surgeons of Ontario (CPSO).

Such a change is urgently needed, as the case of a Hamilton cardiologist facing charges of domestic violence-related offences - charges the CPSO was unaware for years - clearly demonstrates, said France Gelinas, NDP health critic.

Currently, the CPSO relies on physicians to report their own charges to the physician watchdog - a requirement laid out in the Regulated Health Professions Act (RHPA). The CPSO also says it works with our partners in police and court services to report any and all criminal charges."

Still, for years, it was unaware that Hamilton cardiologist Dr. Amin Mulji was facing multiple domestic violence-related charges.

Until December 2021, the CPSO was aware of just two charges, uttering a threat to cause death or bodily harm and assault causing bodily harm, despite Mulji facing 10 charges, including sexual assault. Most were laid in 2018. In January, the CPSO confirmed The Spectator had alerted it to the missing charges, all of which have now been added to Mulji's public CPSO member profile.

Neither Mulji nor his lawyers have responded to multiple requests for comment.

Mulji is now on leave from Hamilton Health Sciences (HHS) and McMaster University, where he was an instructor. Neither HHS nor McMaster will say why he is on leave. The CPSO will also not confirm if Mulji is under investigation for any potential breaches of the RHPA. It will also not confirm that Mulji did not report all charges.

In an interview, Gelinas said she has long called on the province to legislate measures to empower the CPSO to better do its job.

I have written to the minister (of health) to make sure that she listens to the CPSO and grants them the power to access information," Gelinas told The Spectator. And so far, it's been dead silence since 2019."

Relying on physicians to report their own charges is clearly not enough," as the Mulji case suggests, she said. She wants to see mandatory reporting from other less self-interested stakeholders.

Why don't the police automatically notify the CPSO? Why doesn't the court automatically notify the CPSO? Why doesn't the employer - most of the time, hospitals - notify the CPSO?" she asked.

In a statement, the Ministry of Health said: Physicians must be aware of and comply with the legal, professional and ethical reporting obligations relevant to their practice."

In addition, a person who terminates the employment or revokes, suspends or imposes restrictions on the privileges of a regulated health professional for reasons of professional misconduct - amongst other things - is required to file a report with the professional's health regulatory college," read the statement.

Colleges are also often informed by the Crown or police when significant charges" have been laid.

In an email, CPSO spokesperson Shae Greenfield said: The CPSO is always prepared to work with our partners in police and court services, as well as with the Ministry of Health and MPPs to consider any additional steps or improvements that will improve the integrity of information for the public and enhance our ability to serve the public interest."

HHS would not say if it informs the CPSO of criminal charges. Spokesperson Wendy Stewart would only say physicians are required to report such charges to HHS through routine hospital credentialing processes."

Hamilton police said while reporting physicians charged with criminal offences is not required under the Police Services Act regulation, the common law recognizes a duty to warn in circumstances where there is risk to an identified class of persons."

If investigators believe there is a risk to patients, for example, then they would report to the CPSO," said Jackie Penman, police spokesperson. Police would confirm charges if the CPSO reached out to police." Penman would not speak to the Mulji matter nor say if police informed the CPSO of his charges.

The Ministry of the Attorney General did not respond to a request for comment.

Trudo Lemmens, a health law and policy expert at the University of Toronto, said issues of timely and accurate reporting have long plagued the CPSO. He pointed to the Toronto Star's 2018 Medical Disorder investigation, which revealed the CPSO was among other regulatory bodies that allowed doctors convicted of crimes to quietly criss-cross the Canada-U.S. border and keep working.

There are certainly suggestions that the college could be more proactive and tends to be too ... protective of individuals," Lemmens said. You can see the tension between being a self-regulated profession and setting up a system where it is primarily the physicians or colleagues driving the investigations."

And while alert systems the likes of which Gelinas is proposing are important," Lemmens said such alerts are only valuable insofar as the CPSO makes the information public. Commitment to timely and transparent reporting is integral to maintaining public trust in the physician watchdog, he said.

Katrina Clarke is a reporter at The Spectator. katrinaclarke@thespec.com