Oversight of doctor conduct falls short in Manitoba — B.C. may offer solution

Health Minister Uzoma Asagwara will need to do better than “deeply concerned and disgusted.”

The minister was responding to the College of Physicians and Surgeons of Manitoba decision that found Dr. Earl Minuk had pursued an unwanted sexual relationship with one female patient and saw a second female patient without a required chaperone, both in contravention of restrictions placed on him from previous misconduct complaints.

The college conceded that based on Minuk’s lack of contrition, it was concerned about his capacity to adhere to “future compliance.” Remarkably, the college did not revoke or suspend Minuk.

The college noted the lack of other physicians who perform the same procedures made it impractical to revoke Minuk’s licence. Along with purely cosmetic medical services, Minuk treats vascular lesions and manages moles, skin cancer and pre-cancerous lesions.

Following the finding, Asagwara mustered some tough talk.

“Patients must be able to trust that their physician will respect professional boundaries and put their care and safety first. The details outlined represent a serious abuse of that trust,” the minister said.

The minister didn’t say that the NDP government would do something about a self-governing system for the professional conduct of physicians that allows many to continue practising medicine despite repeated, egregious behaviour.

The comments are part of a well-worn tradition in Manitoba in which health ministers howl about seemingly indefensible decisions made by the college without proposing any kind of alternative for adjudicating physician misconduct. It’s a tradition embraced by both NDP and Progressive Conservative governments.

You can tell Asagwara has been schooled in how to condemn a physician’s behaviour without condemning the college’s decision to continue giving misconduct-prone doctors more leash to continue practicing.

In other words, Asagwara was disgusted by Minuk’s behaviour. On the college’s decision to allow Minuk to continue practising medicine, the minister had nothing to say.

The maddening part of this story is that Asagwara — like those who have served in the health portfolio in the past — surely knows there is a sickness in the broader regulatory system that allows physicians to keep their licence even after it’s been proven they are unworthy.

The reporting on physician misconduct is still rather spotty; you really need to be more lucky than good to find out if your physician has been sanctioned. But there does seem to be a pattern that determines when the college revokes a licence and when a physician is allowed to continue working, but with restrictions or a reduced scope of practice.

The college will, for example, typically pull a medical licence when a physician is found guilty of a criminal act relevant to “their suitability to practise.” That was certainly true in early 2024 when Arcel Bissonnette lost his licence several months after he was found guilty of sexually assaulting five patients over 16 years.

However, that trial was not the first time the college had been alerted about Bissonnette’s behaviour. In 2018, a female patient complained that Bissonnette had assaulted her. However, rather than suspending him while an investigation took place, he was allowed to continue practising medicine with certain restrictions in place to ensure there was a chaperone present whenever he treated a female patient.

A look back through college disciplinary cases shows an overpowering deference to the interests of physicians over the interests of patients. Particularly, it seems, when the misconduct involves sexual harassment and assault of female patients.

Even in instances where it has been proven a physician engaged in unwanted touching and harassment — offences that have claimed more than one powerful man in business, academia and politics — physicians are regularly allowed to continue practising with some restrictions.

On the other hand, there is a sense the college saves its harshest and swiftest punishment for physicians who are involved in generally shabby treatment or defrauding the health-care system.

In 2022, Leonard Lockman, a physician who owned a St. Vital walk-in clinic, was stripped of his licence after he pleaded guilty to improper prescribing, billing and record keeping. There were numerous instances of improper care, including inadequate examinations, making unsupported diagnoses and keeping inaccurate patient records.

Like the other examples listed above, the incidents that led to Lockman’s banishment were not the first time he had run afoul of professional standards. He was similarly disciplined by the college in 2015 for sending patients to the ER without proper assessment.

Is there something else the NDP government could do? All eyes in Manitoba should be trained on British Columbia, which this spring brought in legislation that takes disciplinary matters away from the B.C. college and delegates them to an independent tribunal.

The new system has not been in place long enough to be instructive to other provinces that might want to get rid of the traditional self-governing model.

However, it is safe to conclude that trying something else — anything else — is better than crying crocodile tears whenever a patient is abused by a physician — who is then allowed to continue practising medicine.

dan.lett@freepress.mb.ca