A chill in the air

Issue: BCMJ, vol. 59 , No. 9 , November 2017 , Pages 446 Editorials

As I put my thoughts down in writing, the seasons are changing and there is a chill in the air. Many of the physicians in our hospitals are also feeling a chill in the air with respect to our hospitals and health authorities.


As I put my thoughts down in writing, the seasons are changing and there is a chill in the air. Many of the physicians in our hospitals are also feeling a chill in the air with respect to our hospitals and health authorities. A new policy, “Respectful Workplace, Professional Conduct, and Discipline,” appears, on the surface, to establish and maintain a safe and respectful workplace for all. However, the devil, as they say, is in the details of how the policy is managed and enforced by those in the health authorities who are in positions of leadership, authority, and power.

In recent months and years, a few of our colleagues have suddenly disappeared from the corridors of our hospital. While allegations of misconduct made against them are being investigated, they are removed from their work in the hospital, sometimes with no warning. If one is given the choice of being suspended or requesting a “voluntary” leave of absence, I think most physicians would try to avoid having a permanent blemish on their record. Requesting a leave of absence under these circumstances is as voluntary as the quadriceps muscle contraction following a swift blow to the patellar tendon by a reflex hammer. The physician’s request for a leave of absence under these circumstances is coerced, not voluntary, according to a common definition of the word coerce, which is “to compel by force, intimidation, or authority.”

Don’t get me wrong. I respect rules and I appreciate order. However, it feels like the health authorities are acting in a heavy-handed and one-sided manner. There is no transparency and there appears to be no accountability. The basic principle of fairness doesn’t appear to be applied to physicians. The health authorities don’t appear to adhere to a reasonable time frame for resolving the allegations against physicians. Why should they, considering the physician has requested a “voluntary” leave of absence? 

Last time I checked the website, it is the College of Physicians and Surgeons of British Columbia that has the mandate to regulate the practice of medicine in our province (www.cpsbc.ca/about-us/mission). The College also assumes full responsibility for the actions they take and are committed to transparency. They promise to conduct their business in a manner that promotes fairness and due process, and that supports individual rights and freedoms within the rule of law, and they believe in respect, compassion, and trust. I may sound like a fan of theirs, but I like to keep my distance from the College as much as the rest of you. I get quite worried when I receive any envelopes bearing the College’s coat of arms, especially those peach-colored ones we all dread receiving. 

If the health authorities want to decide which physicians should be allowed to work in their facilities, then they could take a page out of the College’s book on this topic. They could treat us with more respect and offer us a safe work environment, as is the stated purpose of their new policy. The health authorities’ current disciplinary process of preventing a physician from continuing to work in the hospital while he or she is being investigated is more severe than if the College were doing the investigation, and it can have a negative impact on a physician’s health and feeling of safety. Worst of all, in my opinion, is that there seem to be no consequences for health authority executives if they got it wrong. This is not about whether a physician is in the wrong or not. It is about the health authorities acting appropriately and fairly to address the complaint.

Having hospital privileges doesn’t seem like such a privilege anymore. At present, many of us do not feel respected or safe within our health authorities. Who will be next to disappear from our hospitals?
—DBC

David B. Chapman, MBChB. A chill in the air. BCMJ, Vol. 59, No. 9, November, 2017, Page(s) 446 - Editorials.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

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