Doctors are no strangers to making headlines, so it's hardly surprising that the Toronto Star splashed a humdinger of a scoop on the front page of its website this past week. Yes, the College of Physicians, making it abundantly clear that cyber-bullying will not be tolerated in the medical profession, dropped the hammer on nine doctors for varying levels of cyber-abuse. The charges of unprofessional behavior date back to the story in the Star I wrote about back in February, a story that itself stems from the bitter intraprofessional fight over the misbegotten Physicians Service Agreement in summer 2016.
Naturally, there's plenty of cheering and jeering to be found on social media about this. Justice has been served, the College went too far, the Star went too far, yada, yada, yada. Between this story, the interminable bickering over tax legislation (that's now gone meta - fighting over how it's been fought about), and arguing for its own sake. Tempted, but not convinced.
Instead, I'm going to set aside the argument over "how far" the College went in stamping out digital insults (which is entirely subjective), and propose something - I can hardly believe it either - useful.
The first thing I want to point out is that the College decisions were reported on at the end of November 2017, regarding investigations that began in February 2017, for actions dating back to the previous summer. Sixteen months to come to a resolution? For an e-mail, a tweet, or a Facebook post? How many hours of investigators' time went into this effort? Do they not have more important issues to devote time to, like the lapses in protecting patients from sexual assault by sociopathic physicians? How many billable hours did this generate for lawyers paid with Canadian Medical Protective Association dues, dues that are underwritten by the taxpayer?
As College investigations have been known to degenerate into, these cases also fell into absurdity:
Is the distinction between "son a bitch" and "son of a whore" all that important? How much of "much consultation" was needed to determine that the post was rude and unprofessional? More to the point, are College investigators remotely conscious of the anxiety and headaches created by a wait of nearly a year before a complaint is resolved? What happens if the doctor in question applies for a coveted position? Or a license in another province? If an ongoing investigation doesn't hinder a doctor's career in the near term, what about once the issue is resolved? What's accomplished by publicizing the fallout of a doctor's rude online comments?The post was cited in the earlier Star feature. After much consultation, it was translated as: “P---y, you son of a w---e. Why don't you go and suck...”There are a number of Spanish dialects with slightly varying translations and [the doctor] told the college that in his native Ecuadorian Spanish, his post actually means: “F---! Son of a bitch! Go get drunk...”
So here's an idea that will save a lot of time, a lot of money, a lot of grief, and serve the purpose of deterring doctors from unprofessional conduct in communications and social media:
Develop a clear set of criteria for what's acceptable and what's not. No meaningless, convoluted jargon like "doctors must at all times recognize the integrity of self-regulating professions as role models to society and servants of the public, and frame any electronic communication mindful of that". Clear criteria for what's okay and what's not:
No foul language directed at individuals, or no foul language period
No naming for the purpose of impugning reputation
No discrimination
No threats of retaliation (employment, evaluation of trainees, committee work, etc.)
Plus whatever else makes sense and can be illustrated by an example
Violations should be treated like traffic tickets or bad behavior by pro athletes. If a violation on the part of a doctor is brought to the College's attention, it's a $100 or $200 fine plus a letter of apology. No investigations, no appeal, done. Second offense, $200-$300. Third offense, or if the first or second offense is egregious? $500 plus an online module on professionalism. At the fourth offense or second major offense, move onto sanction. Throw in sensible expiration dates for past violations, and you've got yourself a policy.
Doctors should not accept "open season" for insults on social media, and this is coming from someone who's quite accustomed to the taste of his own foot. But no doctor should have a College investigation hanging over his or her head for months, or see his or her name in the paper, simply for sending somebody an e-mail telling them to F off. Even if the profession holds itself to a higher standard, there must be an acceptance that we're as human in our interactions as we are in our practices. Even the best of us make mistakes.
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Saturday, December 2, 2017
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accountability,
College of Physicians,
doctors,
medical associations,
politics,
professionalism,
social media,
swearing
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