Tuesday, August 1, 2017

Hard As A Rock

Great Moments in Medical Discipline. I did not make this story up.

I've made no secret of my feelings on the College of Physicians, particularly in Ontario. The College's communication style is draconian, its goalposts for what constitutes professionalism are ever in motion, and its "mission creep" has metastasized into areas that don't directly relate to the practice of medicine, namely finance and billings. 

In some respects, though, I almost pity the College. Apart from being stripped of its independence from the government, its mandate to investigate any and all complaints often puts the College in an unenviable place. Case in point: the Ontario College has been forced to initiate forty(!) investigations into professional misconduct on social media, all at the behest of one crusading complainant. That's an awful lot of work, with little clear benefit to the public at large, for an institution that's intended to protect patients from predatory behavior and incompetence. As I said, you almost have to feel sorry for the College. Almost.

But just when you think you're ready to see the College as doing its damnedest in a lose-lose situation, along comes a story like this, from the Medical Post in March 2017, proving once and for all that the College is waaaaaay too preoccupied with sex for its own good:
The College of Physicians and Surgeons of Ontario has found a [medical specialist] guilty of sexually assaulting four patients...
In response to the set of accusations, [the doctor] not only denied that he would ever deliberately push his genitalia against a patient, but said that it was physically impossible for him to do so—even by accident. He argued that a “panniculus” or “fat apron” (the college’s words) that hung over his pants would have gotten in the way.
According to the decision, [a College-appointed expert] examined [the accused] both before and after the defendant was injected with a chemical cocktail to induce an erection. [The accused] also performed a mock examination on [the expert] on a table nearly the same height as the one in [the accused's] office. (bold added for emphasis and, well, fun)
“[The expert] concluded that it would not have been possible for [the accused] to have rubbed his genitalia, flaccid or erect, against the patient,” the decision reads. However, [the expert] “did note in his hand-written notes, ‘if he were tall, maybe penis would touch knee.’ ”  
When [a second expert] examined [the accused] there were also two college investigators in attendance. [The second expert] found that he could feel [the accused's] penis at three different table heights (the defendant had apparently lost 12 pounds since the previous exam but [the second expert] didn’t feel this would have made a difference). The college witnesses also testified that the panniculus made contact with the penis but did not cover it.
However important it is to rid the medical world of sexual predators - and I don't think there are much lower forms of life on the planet - you have to wonder what in God's name the Powers That Be at the College were thinking by letting this spectacle go forward. Did we learn nothing from OJ?

Except of course, this time we aren't talking about a pair of gloves, but rather the reach and extent of a fat man's penis, chemically treated to its maximum size, as measured by independent medical experts with College investigators as witnesses. 

Those of us still trying to practice medicine have every reason to dread the College's (largely unchecked) power over our careers. The rest of you lucky souls, however, should be doing a double-take (and really, having a laugh) at a situation so manifestly absurd, it strains the bounds of sanity that the ends - a finding of professional misconduct - could possibly justify the means.

Still, the College will keep on trucking as it always does, until someone with real influence will have the courage and fortitude to make smart, meaningful reforms, and prevent an embarrassment like this from happening again. But that's a tall order these days...unless we resort to certain forms of, ahem, enhancement.


  1. I just finished reading, "The Flame-Broiled Doctor". Blew my mind! I've been a practicing Physician for 18 years and have also been close to burnout many times. I left the inner city ER where I worked and slowly built up a very satisfying private medical/surgical practice in the 'burbs. I still seem to get a reasonable cross section of society and have been very happy. But it could very easily have been a disaster had I stayed in practice treating the "downtown crowd", as it were.

    I wanted to commend you on your book, which I consider an extremely well written and well presented body of work. It must have taken an incredible amount of courage to write that book, and I'm going to make it mandatory reading for both of my girls (who want to apply for Med school soon.....though one of them isn't sure if she wants to take the University up on their support to apply for a Rhodes scholarship). They have both watched their old man work >70 hour weeks since they were born, but they seem to both be very much "people oriented", and they love the idea of being Physicians. Can't convince them otherwise, but they both think that they will keep Law and Teaching as their 2nd and 3rd career choices.

    Anyways, I'm going to strongly suggest to my med students and Residents that they give your book a read.

    Thanks for writing it!

    I'm sure that it will make some very positive impacts on Physicians and I have no doubt that this book will even save a lot of lives (of Physicians). Maybe eventually even more lives than you did while in active medical practice!

    1. Thank you! Can't tell you how amazing it is to get feedback like that. You've made my day!!!