Quick answers

Consider the following tips when facing situations that may arise in your practice. The CMPA is standing by to provide individual advice and assistance. Please contact us.

1. I am the subject of a College complaint

  1. Contact the CMPA and speak to a physician advisor for advice and assistance.
     
  2. Determine the specifics of the complaint.
     
  3. Determine what the College is asking you to do and if you have been given specific deadlines to meet.
     
  4. Never alter a patient's medical record after a complaint.
     
  5. Respond in writing to the College in a professional and respectful manner, and objectively address the issues. Be succinct and direct, avoiding inflammatory language or accusations.

Want more information? See the article "What do when facing a College complaint."

2. I am being sued

  1. Contact the CMPA without delay and speak to a physician advisor for advice. The physician advisor will arrange for legal counsel to assist you.
     
  2. Work with your CMPA-assigned legal counsel to prepare a statement of defence which will need to be submitted to the court within a specified period.
     
  3. Never alter a patient's medical record after a legal action is initiated.
     
  4. Keep the matter in perspective and don't worry excessively — the CMPA is here to help.
     
  5. Seek support to cope with the stress of a legal action.

 

Want more information? Learn more about the legal process by completing the eLearning activity "Anatomy of a lawsuit"  See also the resources to help you manage the stress of medico-legal difficulties.

3. I am the subject of a hospital complaint or an investigation

  1. Determine the specifics of the complaint. Your hospital should formally notify you of the complaint; it is not entitled to resolve a complaint that involves you without your knowledge or approval.
     
  2. Contact the CMPA and speak to a physician advisor for advice and assistance.
     
  3. Never alter a patient's medical record after a legal action is initiated.
     
  4. If applicable, participate in the discussion with the patient (or family) to give the complainants a factual understanding of what happened, an apology when appropriate, and what improvements are being made at the hospital.
     
  5. If the hospital conducts a quality improvement (QI) review, participate and provide your opinions by focusing on the known facts of the case. Avoid blaming others.
     
  6. If the hospital conducts an accountability review, you are generally obligated to take part in a review of your professional work when requested. You may want to contact the CMPA for continued support and to help ensure your interests are protected.

Want more information? See the Quality improvement section of the CMPA Good Practices Guide.

4. My patient has threatened to launch a legal action

  1. A patient may verbally communicate the intention to initiate legal action as a result of being dissatisfied with the care you provided. Try to address the situation, when appropriate, by demonstrating compassion and respect to the patient and family, and by fully understanding the motivation for the verbal threat.
     
  2. The threat may also be communicated to you in writing, either through a formal letter from the patient or the patient's legal counsel. You should treat written correspondence of a threat seriously. Follow-up action is always required.
     
  3. Regardless of whether the threat is verbal or in writing, contact the CMPA as soon as possible and speak to a physician advisor for advice and assistance.
     
  4. Ensure the medical record is complete and up-to-date. Never alter a patient's medical record after receiving a verbal threat or a written letter indicating that legal action may be launched.

5. My patient has suffered an adverse event

  1. Take clinical care of your patient and reassure the patient his or her needs are being met.
     
  2. Communicate to restore trust. As soon as reasonable to do so, disclose the adverse event to the patient and family. Focus on the known facts related to the event and the provision of further clinical care.
     
  3. Provide emotional support to the patient and family. Express your sympathy and regret for what has happened. Continue to demonstrate compassion.
     
  4. Document your care and subsequent discussions in the medical record. Do not add to or change existing entries after learning of an adverse outcome.
     
  5. Report the event as required by your hospital, institution, and jurisdiction.
     
  6. Following an analysis of the event, convey newly uncovered facts to the patient and include what steps are being taken to prevent similar harm to others.
     
  7. Prior to expressing an apology acknowledging responsibility, you may wish to contact the CMPA.

Want more information? See the CMPA handbook "Disclosing harm from healthcare delivery: Open and honest communication with patients" and the Checklist: Disclosing harm from healthcare delivery.

6. A third party (e.g. lawyer, police) wants my patient's medical information

  1. Do not disclose patient information without the patient's express consent, unless required by law.
     
  2. Consider whether you are permitted or obligated to disclose patient information without the patient's express consent (e.g. you received a court order, or search warrant, or when there is a mandatory duty or legal obligation to report).
     
  3. If appropriate to disclose, release only the requested information. Consult with the CMPA or your legal counsel before releasing original copies of the medical record or other documents.
     
  4. Recognizing that this is complex and often specific to each situation, you may wish to contact the CMPA.

Want more information? See the articles "Physician interactions with police" and "Responding to requests for children's medical records."

7. I have a request to treat a non-resident of Canada

  1. If it is an urgent clinical matter, provide appropriate care.

  2. If you undertake to provide care for a non-resident, make reasonable efforts for the patient to sign a Governing Law and Jurisdiction Agreement  before providing treatment.
     
  3. Read the article "Treating non-residents of Canada" to help determine whether the CMPA would assist you in the event of medical-legal difficulties.