Making a Complaint to the College of Physicians and Surgeons of Ontario (CPSO)

If you received medical treatment in Ontario, and have concerns and/or are dissatisfied with the treatment you have received, you can file a complaint with the College of Physicians and Surgeons of Ontario (the “CPSO”).

What is The College of Physicians and Surgeons of Ontario?

The CPSO governs all doctors licensed to practice in the province and sets standards for their practice. The CPSO is also responsible for responding to concerns and investigating complaints from members of the public and must act in the best interest of the public.

The CPSO does not govern other Regulated Health Professions, including dentists, chiropractors, midwives, nurses, psychologists, pharmacists, and others. Each of those professions has their own governing body which regulates their practices.

How Can I File a Complaint Against my Doctor?

All complaints to the CPSO must be submitted in writing or another permanent form (this can include a tape or a disk).

The CPSO’s complaint forms may be may be completed electronically, printed, and mailed to the CPSO.

Complaints may be submitted by e-mail, but should contain your address and phone number. If you submit a complaint by email, the CPSO will contact you by telephone or via regular mail and any subsequent correspondence from the CPSO will be sent via regular mail in order to preserve the confidentiality of the information involved.

What Must be Included in My Complaint?

Information that must be included in your complaint includes:

• The doctor’s name and address;
• A description of the events that led to the complaint;
• The date and location of those events;
• Any other information that may help the CPSO conduct its review of the situation, such as the names of any witnesses or individuals who may have helpful information.

You should state your concerns and questions as clearly as possible.

Will the Doctor I Am Filing a Complaint Against See the Complaint?

The CPSO is obligated to send a copy of your complaint to the doctor about whom the complaint is made within fourteen days of the complaint.

What If I Am Making a Complaint on Behalf of Someone Else?

If you are making the complaint on behalf of someone else, written consent is required from the patient about whom the complaint is about.

If that patient is a child or minor, is unable to sign a consent form due to incapacity, or is deceased, a Consent for Release of Medical Information form must be signed by:

• The patient’s legal guardian(s);
• The patient’s power of attorney for personal care;
• The executor of the patient’s will.

Is There a Time Limit on Filing a Complaint?

There is no time limit, but it is advisable to file a complaint as soon as possible after the event that is at issue. The earlier a complaint is filed, the fewer the problems that may arise, and the higher the likelihood that all relevant documents, medical information, witnesses, and other important evidence will be available.

What Happens Once I File a Complaint?

Once you file a complaint, CPSO staff will contact you either by telephone or by regular mail in order to discuss your concerns and obtain additional information (if more information is required). Staff will attempt to answer questions and clear up any potential misunderstandings between patients and physicians.

Staff may review your medical records, discuss your concerns with the doctor against whom the complaint is made, and ask that doctor to respond to your concerns.

Staff may also arrange a meeting with you, and potentially also with you and the doctor (as well as any relevant hospital administrator) in an attempt to discuss and clarify any concerns, questions, and issues. Such a meeting is done only when both the complainant and the doctor consent.

Such meetings are sometimes sufficient to resolve a complaint. If not, the complaint moves to the investigation stage.

What is a CPSO Investigation?

If a complaint cannot be resolved at the meeting stage, CPSO staff will begin an investigation on behalf of the CPSO’s Inquiries, Complaints and Reports Committee (the “Committee”).

What are the Steps in an Investigation?

All CPSO investigations are governed by the Regulated Health Professions Act. Some important steps in the process are:

Obtaining consent for the release of confidential medical information

• Written consent via consent form, is required from the patient, the patient’s legal guardian, the patient’s power of attorney for personal care, or the patient’s executor in order to obtain medical information;
• The physician against whom the complaint is made is able to disclose the patient’s medical information without the need for written consent from the patient, however, written consent is required to obtain personal health information about the patient from other physicians, health care professionals, and health care facilities;
• The Committee can obtain medical information without written consent, under the authority of an investigation if the information is thought to be important

Requesting a response from the doctor

• CPSO staff may ask the doctor against whom the complaint is made to respond in writing to the complaint

Obtaining relevant medical information

• The Committee may obtain any other relevant medical information required to conduct a complete investigation

Review and decision by the Committee

• Once all relevant information has been obtained and all documents have been submitted, both you and the doctor against whom the complaint is made are notified about the date on which the Committee will meet.
• Neither you nor the doctor will be able to attend the Committee meeting.

Who Sits on the Inquiries, Complaints and Reports Committee?

The Committee is made up of physicians as well as members of the public appointed by the government.

For each investigation, a panel is chosen composed of members of the Committee. The panel considers the complaint, all relevant records and documents, and the doctor’s response to the complaint.

What are the Possible Outcomes of an Investigation?

After the Committee meets and considers the complaint, the relevant documents and information, and the response by the physician, the Committee may decide to:

• Take no action, where the doctor’s conduct or the care provided is deemed to be appropriate;
• Issue advice or a recommendation, where the Committee believes the doctor would benefit from some guidance to improve their future conduct;
• Request that the doctor participate in self-study, with assistance and follow up by the CPSO to ensure that the physician has addressed the identified needs;
• Require the doctor to appear before a panel of the Committee to be cautioned about certain aspects of their practice, their conduct, or their professionalism. A summary of the caution is posted to the doctor’s profile on the CPSO registry, which is available to the public;
• Request that the doctor undertake to improve their practice or restrict their practice. This can include education or supervision/monitoring. Terms of any such undertaking are posted to the doctor’s publicly available profile on the CPSO registry;
• Direct the doctor to complete a continuing education remediation program in order to improve their skills or change practice areas. A summary of this information is posted to the doctor’s publicly available profile on the CPSO registry;
• Refer the doctor to a Committee panel where there are concerns about the doctor’s health that may affect their ability to practice;
• Refer concerns about the doctor to the Discipline Committee;
• Request an undertaking from the doctor to resign from the practice of medicine and never apply for reinstatement of their license. This information would be posted to the doctor’s publicly available profile on the CPSO registry;

When Do I Find Out the Results of an Investigation?

The Inquiries, Complaints and Reports Committee will prepare a written decision that is sent to both you and the doctor against whom you made a complaint within six to eight weeks of the Committee meeting.

What If I am Dissatisfied with the Results of an Investigation?

Almost all decisions of the Inquiries, Complaints and Reports Committee can be appealed by either you or the doctor against whom the complaint is made. Appeals are made to the Health Professions Appeal and Review Board  (HPARB), an independent government body.

The only decisions that cannot be appealed to HPARB are those which are referred further to a panel of the Committee or the Discipline Committee, as these may ultimately affect the doctor’s ability to practice.

Contact information for HPARB is included with every written decision of the Committee.

What Are the Limits on What the CPSO Can Do?

The CPSO cannot:

• Address complaints about hospitals;
• Address complaints about health care professionals that are not governed by the CPSO (e.g.- nurses, pharmacists, chiropractors);
• Provide financial compensation to patients or their families;
• Compel a doctor to apologize;
• Compel a doctor to change his or her opinion;
• Provide referrals, diagnoses, treatment recommendations, or suggestions about a patient’s care.

More information about the Complaints Process, including links to all relevant forms, can be found on the CPSO’s website.

If you have concerns about care or treatment you received from a physician, contact the Toronto-based medical malpractice lawyers at Sommers Roth & Elmaleh. We are highly respected in both the medical and legal fields and offer compassionate, knowledgeable, and skilled guidance to patients affected by medical error. Call us at 1-844-777-7372  or contact us online for a free consultation.