1. It is the decision of the Health Professions Appeal and Review Board to confirm the decision of the Inquiries, Complaints and Reports Committee of theCollege of Physicians and Surgeons of Ontario to issue a caution to Dr. K.I. regarding her inadequate and inaccurate report and to further recommend that the Applicant review the College policy, “Third Party Reports”.
5. The Respondent complained that the Applicant failed to provide an accurate opinion of her claim for psychological services to the Respondent’s insurer; for example, the Applicant provided an opinion that may be outside of her expertise, since she opined regarding psychological services but is an occupational medicine specialist.
8. The Committee, however, noted that the Applicant’s report contained inaccuracies with respect to the details of what happened at the time of the collision. The report indicates that the Respondent was backing out of her driveway and was hit by an oncoming car, while the information before the Committee indicated that the Respondent was hit by a car backing out of a driveway. The report omitted the fact that the police were called, the car was damaged to the extent that it had to be towed away and was written off, which the Committee wrote, “speaks to the extent of the motor vehicle accident”.
9. Further, the Committee found that the Applicant failed to address important information that supported a claim for psychological services. It wrote that the Applicant “commented that the physiotherapist did not mention psychological issues, but she failed to mention that [the Respondent’s] family physician felt that a referral for psychological services was indicated” and that it appeared she had “completely disregarded this referral from the family physician.” The Committee stated that the Applicant “completely disregarded the results of the Beck Depression Inventory and Beck Anxiety Inventory, which showed severe depression and anxiety, respectively. Without performing a psychological assessment of [the Respondent], it would be difficult to assess whether or not these conditions pre-existed the accident.”
10. The Committee determined the appropriate disposition was to caution the Applicant regarding “her inadequate and inaccurate report” and to recommend that the Applicant review the College policy, Third Party Reports.
24. Counsel submitted that the Respondent should have raised her concerns with the report under the mediation and arbitration processes provided under theInsurance Act and that the College is the wrong forum for the determination of her concerns. He submitted that having determined the Applicant was properly qualified, the Committee should defer to her expertise: if the College engages in the review of third party assessment undertaken by qualified health professionals, it will deter physicians from conducting assessments.
34. The Board has reviewed the Policy and finds the Committee’s assessment that the Applicant failed to comply with it is reasonable. The Committee concluded its analysis as follows:
Accordingly, it appears to the Committee that [the Respondent’s] report was both inaccurate and inadequate. It seems that she failed to comply with the College policy, “Third Party Reports,” which notes that when providing a third party report physicians must “take reasonable steps to ensure that they have obtained and reviewed all available clinical notes, records and opinions relating to the patient or examinee that could impact the findings of the report …” Moreover, the policy also states that physicians “should ensure to the best of their abilities that the information contained in the third party report is accurate.”
35. In her May 5, 2011 report, the Applicant referred only to a physiotherapy report written shortly after the accident and did not discuss any of the other 37 documents in the file, including the opinions of the Respondent’s physician and other health professionals that an assessment was required. She then wrote: “based on the documentation available for review, there was no evidence that [the Respondent] requires a psychological assessment …” (Board’s emphasis). The Board concludes that in light of this, the Committee’s conclusion that the Applicant failed to comply with the obligation “to take reasonable steps to ensure that they have obtained and reviewed all available clinical notes records and opinions” was reasonable.
36. Likewise, the Board finds that the Committee’s view regarding accuracy is reasonable as the Applicant made no effort to clarify the inconsistency regarding how the accident occurred. The Board does not find that the Committee’s reference to missing details regarding the apparent severity of the accident is misplaced as it is indicative of the absence of almost any factual content in the report.
37. The Board finds that that the Committee’s decision to issue a caution is reasonable. The Board notes that a caution is not a sanction. It is remedial in nature.
VI. DECISION
38. Pursuant to section 35(1) of the Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991, the Board confirms the Committee’s decision to issue a caution to the Applicant regarding her inadequate and inaccurate report and to further recommend that the Applicant review the College policy, Third Party Reports.
Read:
http://www.torontosun.com/2013/01/25/protecting-docs-reputations