Frequently Asked Questions

The Complaints & Investigations Process

  1. What is the College of Physicians and Surgeons of Nova Scotia and what does it do?
  2. What can I do if I am concerned about a physician or a physician’s practice?
  3. What are my rights as a patient?
  4. What are my responsibilities as a patient?
  5. When should people make complaints about physicians?
  6. Who can make a complaint?
  7. Can I complain for someone else?
  8. How do I make a complaint?
  9. How does the College deal with complaints?
  10. Is there a time limit to file a complaint?
  11. Who will review the complaint? 
  12. How are complaints investigated? 
  13. If I file a complaint with the College, am I expected to appear before the Investigation Committee? 
  14. Does making a complaint cost anything?
  15. How long does the complaint process take?
  16. If I file a complaint, should I plan on seeing another physician?
  17. How do I find a physician who is accepting new patients?
  18. What should I do if I believe that a physician has engaged in sexual misconduct?
  19. What are the possible outcomes of complaints?
  20. Are the things I say and write to the College kept confidential?
  21. Does the College award financial compensation?

1. What is the College of Physicians and Surgeons of Nova Scotia and what does it do?

The College is the body that licenses and regulates the province’s physicians under the Medical Act.


2. What can I do if I am concerned about a physician or a physician’s practice??

If you feel you cannot talk to your physician or the issue is not resolved, you can call the College’s Professional Conduct Department for assistance at 902-422-5823 (toll-free in Nova Scotia 1-877-282-7767). By contacting the College you are not automatically filing a complaint against your physician. 


3. What are my rights as a patient?

Patients have the right to:

  • Be treated with respect;
  • Expect confidentiality be maintained, unless their physician explains why it has to be broken;
  • Refuse an examination or treatment;
  • Withdraw consent without obligation or harassment;
  • Expect their physician not to take physical, emotional, sexual or financial advantage of them;
  • Be kept informed, if possible, of major delays in obtaining consultations or treatments;
  • Know if there are colleagues with whom their physician will discuss their case;
  • Receive appropriate referrals;
  • Request a second opinion;
  • Be listened to carefully and supportively regarding their concerns; and
  • Have another person present during examinations.

4. What are my responsibilities as a patient?physician taking blood pressure

Patients are expected to:

  • Respect the privacy of other patients, physicians and staff;
  • Ask the physician for further information if they do not understand;
  • Let their physician know if they feel uncomfortable during an examination or treatment;
  • Cooperate and follow recommended treatment as long as they agree;
  • Inform their physician if they are unable to keep an appointment; and
  • Allow their physician to have a staff member present during an examination

5. When should people make complaints about physicians?

The College investigates any complaint regarding the conduct, actions, competence, or capacity of a physician. Anytime an individual has concerns in this regard, a complaint to the College may be warranted.

 

The College views the conduct of a physician through the lens of the Professional Standards and Guidelines approved by the College’s Council. Physicians must comply with all College standards and are recommended to follow all College guidelines. Physicians are expected to stay current with these documents.

 

If you believe your physician is not practising professionally, you are encouraged to review the standards as outlined in the College’s Professional Standards and Guidelines. You may also wish to review the Canadian Medical Association’s Code of Ethics. 


6. Who can make a complaint?

Complaints about physicians can come from anyone, including patients, patients’ families or other physicians. A person who files a written complaint with the College is known as a "complainant."


7. Can I complain for someone else?

Yes. A first-party complaint comes from the patient or a representative of the patient with the patient’s consent or consent of the legally authorized representative. Documentation is required to prove legally authorized representation. This might take the form of:

  • Power of attorney/administrator of an estate documents
  • Death certificate naming next of kin
  • Last will and testament

If the necessary signed documentation is not available, a complaint can still be processed as a third party complaint. In this case, the third party would not be able to receive any confidential information related to the complaint. All information received from a complainant during the course of an investigation by the College is copied to the physician.


8. How do I make a complaint?   

While a complaint form is recommended, complaints can also be filed without a form if they are typed or clearly printed by hand. All complaints must be submitted in writing and signed by the complainant. Complaints cannot be submitted by email. 

Complaints must contain:

  • The physician’s name.
  • A description of the events that led to the complaint (such as the date and location) and any other information that may help the College in its investigation.
  • If possible, complaints should also contain the names of people who witnessed the event or who have other useful information. 

In order to proceed with a complaint investigation, the “Authorization and Consent to Release Information” on page 1 of the Complaint Form must be signed. 


9. How does the College deal with complaints?

When the College receives a written complaint about a physician:

  • All complaints are subject to a preliminary review by Investigations staff.
  • Complaints are triaged by the Manager of Professional Conduct. Any issue that involves public safety would be reviewed immediately by the Registrar.
  • The complaint is sent to the physician, who has 30 days to respond. Occasionally, the physician may require additional time in order to access medical records.
  • The complaint and response are reviewed by Professional Conduct Staff and the Registrar as part of the preliminary investigation.
  • Any additional medical records, documents or statement which would be helpful are requested.

Physicians may sometimes need more than 30 days to respond to a complaint. If this happens, the Professional Conduct Department may grant an extension to the physician in order to prepare and submit a written response.  

Once a preliminary investigation is conducted and the findings reviewed by the Registrar, the Registrar then can:

  • Dismiss a complaint, at which point the physician's response to the complaint is forwarded to the complainant.
  • Refer the matter to the Investigations Committee, at which point the physician's response to the complaint is forwarded to the complainant.
  • Authorize the resignation of physician - with consent.
  • Refer a physician for capacity assessment - with consent.

10. Is there a time limit to file a complaint?man writing

There is no time limit to file a complaint, but the College recommends that complaints be submitted as soon as possible. The earlier a complaint is received, the sooner any possible risks to the public can be addressed. If a complaint is received long after an event, it may be more difficult to obtain medical records or other information necessary to investigate the complaint.


11. Who will review the complaint?

You receive a letter from the College acknowledging receipt of your complaint. The Professional Conduct Department staff conducts a preliminary investigations ensuring that all required documentation is submitted. The Registrar then reviews the complaint. The matter may then be reviewed by an Investigation Committee.


12. How are complaints investigated?

Your complaint undergoes a preliminary investigation by the Registrar, in accordance with the Medical Act. The preliminary investigation will gather information to determine the appropriate means to resolve this matter. Complaints can be resolved in many ways. In the event this matter is resolved as a result of this stage, you will be provided with a letter explaining the decision or outlining next steps.

If a matter is referred to an investigation committee, the investigation committee may appoint an investigator to conduct or to further an investigation.

When investigating a complaint, an investigator may do any of the following:

1. Request additional written or oral explanation from the complainant, the respondent or a third party.

2. Request an interview of the complainant, the respondent or a third party.

3. Investigate any matter relating to the respondent that arises in the course of the investigation in addition to the complaint that may constitute any of the following:    

  • Professional misconduct.
  • Conduct unbecoming the profession.
  • Incompetence.
  • Incapacity.

A respondent (physician) may submit any information relevant to the complaint to an investigator, including medical information or patient records.

 

When an investigator has completed their investigation, they must prepare a report of the investigation and provide a copy of the investigation report to the investigation committee.

 

Investigation Committees are composed of physicians and members of the public, trained for this purpose.  At any time during an investigation, if the committee believes there is concern for public safety and intervention is required prior to final decision of the matter, the committee may direct the Registrar to suspend the physician’s licence to practice, impose restrictions or conditions on the practice or suspend the ability of the physician to obtain a licence if not currently licensed.

 

The Investigation Committee cannot impose disciplinary sanctions against a physician without his/her consent but may provide advice for improvement or Caution the physician (warning). If the physician does not consent (agree to the discipline), the matter would be referred for formal adjudication by a Hearing Committee.

 

Hearing Committee

In cases where there is evidence of professional misconduct, incompetence or conduct unbecoming, the Investigation Committee may refer the complaint to a Hearing Committee. At this point, the College becomes the formal complainant and charges are filed against the physician. The hearing process is similar to a trial, with sworn evidence and legal submissions by a prosecutor acting for the College and a lawyer representing the physician. Complainants may be called to testify as witnesses. In some cases, the matter may be resolved with a settlement agreement. Hearing Committee decisions can range from dismissal of the complaint to removal of the physician from practice.

 

Appeal Process

The Medical Act allows a complainant to appeal the dismissal of their complaint by the Registrar through an Independent Review Committee (IRC). A request for appeal must be submitted in writing within 30 days of the date of the dismissal. The Independent Review Committee may uphold the dismissal, conduct its own investigation, or refer the matter to an Investigation Committee. The decision of the IRC is final.

 


13. If I file a complaint with the College, am I expected to appear before the Investigations Committee?

The complainant may be asked to meet with the Investigation Committee reviewing the complaint if committee members require additional information or clarification of the complaint. If so, the complainant may be accompanied by a friend, a family member or some other support person. The physician will not be present if the committee wishes to meet with the complainant.


14. Does making a complaint cost anything?

There is no fee for filing a complaint.


15. How long does the complaint process take?

The College makes every effort to resolve complaints as quickly as possible. While the length of the process can vary, most complaints are resolved within six months. 


16. If I file a complaint, should I plan on seeing another physician?physician holding stethoscope

Complaint investigations can take up to six months and sometimes longer. During an investigation, the College recommends that patients involved in complaints avoid contact with the physician named in the complaint. For this reason, patients should plan to see another physician while the College is investigating their complaint, and perhaps permanently. In rare circumstances, it may be necessary for the physician-patient relationship to continue. You are encouraged to contact the College before doing so.


17. How do I find a physician who is accepting new patients?

To find a family physician who is accepting new patients, please call 811 or visit needafamilypractice.ca to be added to the provincial waitlist.


18. What should I do if I believe that a physician has engaged in sexual misconduct?

People who suspect sexual misconduct by a physician are encouraged to contact the College. The following are examples of sexual misconduct by a physician: 

  • Sexual contact between a physician and a patient
  • Unnecessary viewing of all or part of a patient’s body by a physician, which may happen if the patient is not permitted to undress in privacy or if the patient is not properly covered when being examined or treated
  • Inappropriate comments about a patient’s sexual orientation by a physician
  • Sexualized comments by a physician, including inappropriate remarks about a patient’s body or clothing
  • Inappropriate and unnecessary requests by a physician for details of a patient’s sexual history
  • Failure by a physician to get permission from a patient before examining private areas of a patient’s body
  • Inappropriate examination of a patient by a physician especially when it involves the breasts, genitals or anus
  • Inappropriate body contact between a physician and a patient, including kissing and hugging of a sexual nature

Such situations can be very uncomfortable and stressful for patients. The College can arrange for staff members to meet confidentially with patients or other individuals to discuss the matter and to answer questions about filing a written complaint. Patients are always welcome to bring a support person to this meeting.

 


19. What are the possible outcomes of complaints?

Dismissal of Complaint:

  • Dismissed by Registrar
  • Dismissed by Investigation Committee

Caution. A warning from an investigation committee that a person may have breached the standards of professional ethics or practice in circumstances that are not determined under the regulations to warrant a licensing sanction.    

Reprimand (Consensual). A disciplinary sanction against a physician with the consent of the Physician, as a result of a finding of professional misconduct, incompetence or conduct unbecoming and approved by an Investigation Committee.  This may include permanent conditions or restrictions on the physician’s practice or prescribing, repayment of costs to the College, and/or a requirement to undergo additional training.

Reprimand. A disciplinary sanction imposed against a physician as a result of a finding of professional misconduct, incompetence or conduct unbecoming.  This may be reached through a settlement agreement between the physician and a Hearing Committee, or imposed by a Hearing Committee. This may include permanent conditions or restrictions on the physician’s practice or prescribing, repayment of costs to the College, and/or a requirement to undergo additional training.

Sanctions may include the following:

Licence Suspension. The physician remains licensed however is not permitted to practice temporarily. The physician may be required to complete additional training or undergo assessment prior to privileges being reinstated.

Licence Restrictions and Conditions. Limitations put on a physician’s practice or prescribing. This may come about with agreement between the physician and an Investigation Committee, or may be part of a reprimand and imposed by a Hearing Committee.    

Revocation. The physician’s licence to practice has been revoked, either by a Hearing Committee or with consent of the physician.


20. Are the things I say and write to the College kept confidential?

The College takes great care to ensure that complaint information is kept confidential. Staff and Investigation Committee members are bound by confidentiality agreements and information in the College’s possession is strictly protected by a number of security measures. The College also asks complainants and physicians to avoid speaking publicly about a complaint while it is under investigation. 

All complaints received or under investigation, all information gathered in the course of the professional conduct process and all proceedings and decisions of an Investigation Committee and a Hearing Committee that are not open to or available to others in accordance with the Medical Act or the regulations must be kept confidential by any persons who possess such information.


Meetings of Investigation Committees are not open to the public and their decisions (with the exception of consensual reprimands) are not made public. Proceedings before Hearing Committees are usually open to the public, except in cases where sensitive information is involved. Decisions of Hearing Committees are published, but in some cases, publication bans may be imposed on portions of the evidence and the decision. Hearing Committee decisions do not ordinarily identify patient names. 

 

During the course of an investigation, it may be necessary for College staff to obtain a copy of a patient’s medical records to assist the Committee in its investigation. If this is the case, a copy of the records is usually given to the complainant and to the physician in question. If the complainant is not the patient involved in the complaint, this person will not receive a copy of the records. 


21. Does the College award financial compensation?

No, the College does not award financial compensation. People seeking financial compensation should seek legal advice.