A new study on physician misconduct using publicly available data on 208 physicians involved in cases of sex- or gender-based violence, harassment, or discrimination found gaps in how physicians were monitored and sanctioned. The research is published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.251179 .
Using media stories, legal decisions, and information from physician regulatory body websites, researchers identified 689 victims, of whom 585 were women or girls and at least 40 were children, over 5 years from 2019 to 2024. Sexual-boundary or sexual-misconduct complaints were the most common (75, 36%) followed by sexual assault (65, 32%), although definitions sometimes differed.
In some cases, the researchers found complaints that had not been reported on physician college disciplinary websites.
"[T]his study highlights the limitations of current data-management processes by Canadian medical regulatory bodies and raises concerns about the efficacy of current remediation strategies and monitoring practices," writes Dr. Shannon Ruzycki, Cumming School of Medicine, University of Calgary, Calgary, Alberta, with coauthors. "Our findings emphasize how the lack of transparent, consistently reported, and accessible data about physicians involved in instances of sex- and gender-based harassment and discrimination restricts assessment of current strategies to address these behaviours."
The rate of repeat behaviour was about 30%, a figure consistent with data from the United States.
The researchers suggest regulatory bodies should incorporate public consultation in the way they report cases of harassment and discrimination to help protect the public, while respecting physician privacy.
"The need for accountability and transparency from the colleges must be balanced with principles of due process and rights to physician privacy, especially since accusations of sex- or gender-based harassment or discrimination can have considerable personal and professional consequences," they caution.
A national registry listing incidents by type, explanations, and outcomes and disciplinary action is a potential approach.
"The findings help to highlight an important problem for the medical profession in Canada: the tendency of its leadership and regulators to conceal sex- or gender-based misconduct perpetrated by physicians," writes Dr. Kirsten Patrick, editor-in-chief, CMAJ in a related editorial https://www.cmaj.ca/lookup/doi/10.1503/cmaj.260574 .
However, the study has some gaps as it found only a handful of complainants who were physicians or other medical personnel.
According to Dr. Patrick, this doesn't track with the findings of recent high-profile surveys of physicians and medical learners from the United Kingdom and US, in which reported rates of experiencing sex- and gender-based harassment in clinical workplaces were as high as 65% and 23% among those identifying as women and men, respectively. Data from Canada show similarly high rates of interprofessional misconduct.
Dr. Patrick calls for attention to address this issue in the medical profession.
"The medical profession in Canada needs to address its poorly hidden problem of sex- and gender-based discrimination, harassment, and assault. To do so will take a culture change in which the profession openly acknowledges the importance of the problem, owns its failure to address it, and takes steps to change regulatory and academic systems to prioritize believing victims, remediating offenders, and setting enforceable standards for behaviour."
