Responding to Complaints at the College of Chiropodists of Ontario: What Chiropodists and Podiatrists Need to Know
Once chiropodists and podiatrists are subject to a formal complaint at the College of Chiropodists of Ontario, they should, to some degree, familiarize themselves with the regulatory process. Working through the complaint investigation and contending with the possibility of professional consequences has the potential to bring considerable pressure, and chiropodists should consider exploring any resources that may assist them. Based on our experience, we present this introductory guide to responding to complaints at the College of Chiropodists of Ontario.
A letter from the College of Chiropodists of Ontario informs the chiropodist of the complaint against them, encloses the complaint itself, and, when applicable, attaches a summary of the chiropodist’s other complaint history. Once all supporting documentation is received and the initial investigation is concluded, a panel of the Inquiries, Complaints and Reports Committee (ICRC) reviews the chiropodist’s complaint file, and may in some cases decide that further investigation is required. Panels of the ICRC are constituted of chiropodists, podiatrists, and public members appointed by the Provincial Government, and are responsible for making an appropriate determination in the matter.
Formal investigation is generally required for any complaint against a chiropodist or podiatrist. As they are bound by a duty to cooperate with the College of Chiropodists of Ontario’s processes, chiropodists may need to participate in an interview with the complaint investigator. Regardless of whether or not they consider the allegations founded or reasonable, chiropodists should prepare a response to the complaint.
Rather than proceeding by way of a hearing, the ICRC assesses the validity of the complaint through documentary review of any relevant materials. The ICRC typically does not see the chiropodist in person, meaning that a written response is required, and may serve as the member’s only chance to explain their reasons for making their decisions. The chiropodist’s response should address every issue raised in the complainant’s statement, as failing to comment on any aspect of the complaint may ground a negative inference at the ICRC, which can potentially lead to an unfavourable disposition for the chiropodist.
The College of Chiropodists of Ontario typically requires the chiropodist’s complaint response within 30 days of notification. While a month may appear sufficient time to make a written reply to allegations, this process is likely quite involving, and often requires time and effort to complete in an effective manner. Amidst concerns of professional repercussions, the drafting of a response has the potential to itself become another source of stress for the chiropodist. It is prudent to consider retaining a lawyer who is experienced with regulatory proceedings, as this may help to reduce the chiropodist’s direct obligations. Legal counsel can assist throughout the complaint process, providing support with writing and submitting the response, and acting as the first point of contact with the College of Chiropodists of Ontario.
When deciding what information to include in their response, the chiropodist should consider anything unique in their case, including when the care was provided, the complexity of the care, and the possibility of a civil lawsuit. Organizing the response as a chronological account of all events relevant to the complaint is, in our experience, often a helpful approach for chiropodists and podiatrists.
In the right circumstances, it is often appropriate for the chiropodist to assume responsibility for any shortcomings in their care. Using the response to acknowledge the merits of the complaint, as well as demonstrating the efforts the chiropodist has made to correct their actions and better their practice, can potentially make an effective impression on the ICRC. In some cases, the ICRC may gain confidence in the chiropodist’s ability to improve without official reprimand.
Along with their finalized response, the chiropodist or their legal representative should enclose to the College of Chiropodists of Ontario the patient chart, X-rays, and any other relevant records or information. The chiropodist’s records should always remain in compliance with the Chiropody Act, 1991 guidelines, as deficient recordkeeping is an independent act of professional misconduct. The ICRC may evaluate the quality of the records regardless of the outcome of the complaint process.
Upon receipt of the finalized response, an investigator assigned to the chiropodist’s case determines what, if any, further investigation is required. All findings made by the investigator are enclosed in a report to the ICRC. Once the ICRC has enough data to adequately form a decision, it reviews the complaint file and may do any of the following: take no further action; caution the chiropodist in person before the ICRC; inquire into the chiropodist’s professional capacity; refer the matter to the Discipline Committee; or take any other appropriate action. The ICRC typically provides the chiropodist and the complainant with written reasons for each of its decisions, though this does not apply in cases of referral to discipline or to another panel of the ICRC for incapacity proceedings.
While proceedings at the College of Chiropodists of Ontario may result in professional consequences, the complaint process also has the potential to end with the unwanted public exposure of the chiropodist. In the interest of providing greater transparency for regulatory findings, the following ICRC dispositions are now posted on the Public Register: Specified Continuing Education or Remediation Programs (SCERP); oral cautions; and referrals to discipline. Anyone viewing the chiropodist’s public profile may learn of their regulatory history.
Before it is ready to fully consider the chiropodist’s matter, the ICRC is empowered by the Regulated Health Professions Act to proactively address more serious allegations with an interim order. During the course of an investigation, chiropodists are typically entitled to continue practicing, but where their alleged conduct exposes or is likely to expose their patients to harm or injury, interim orders can potentially function as a public safeguard. Taking the form of terms, limitations, or conditions on the chiropodist’s certificate of registration, an interim order may even rise to the level of licence suspension, and may last for the duration of the investigation. Either in conjunction with interim orders or separately, the Registrar may also address serious complaints by appointing a special investigator. Under section 75 of the Health Professions Procedural Code, this investigator has much broader powers of investigation than in the standard process.
In contrast to the above, complaints that are comparatively less serious are potentially eligible for the College of Chiropodists of Ontario’s Alternative Dispute Resolution (ADR) process. Serious allegations of professional misconduct, such as sexual abuse and allegations of dishonesty or fraud, are not appropriate for ADR. Complaints may only proceed to ADR upon the College of Chiropodists of Ontario’s referral and the subsequent consent of both the chiropodist and the complainant. If they have not been screened for ADR, chiropodists cannot request the process. When ADR proceeds, the College of Chiropodists of Ontario appoints a neutral facilitator to negotiate an agreement between the chiropodist and the complainant. Any potential resolution reached through ADR must be ratified by the ICRC. If ADR is unsuccessful for any reason, the ICRC returns the complaint to the formal complaint process.
Once a decision is rendered by the ICRC, the chiropodist or the complainant may request a review before the Health Professions Appeal and Review Board (HPARB). The adequacy of the College of Chiropodists of Ontario’s investigation into the chiropodist and the reasonableness of the ICRC’s decision are typically the only areas which the HPARB panel can consider. The HPARB panel reviews the documents and materials that were available to the ICRC, and anything provided to the HPARB panel is generally disclosed to the chiropodist and the complainant.
Addressing a complaint at the College of Chiropodists of Ontario is a potentially difficult experience. Chiropodists in this situation should consider retaining the services of legal counsel, as this can provide great assistance in drafting their response and working through the complaint process in general. As regulatory proceedings at the College of Chiropodists of Ontario may bring professional consequences, we recommend that chiropodists and podiatrists handle complaints attentively and with care.
Josh Koziebrocki, is the principal lawyer and founder of Koziebrocki Law. He represents chiropodists and podiatrists, and has extensive experience dealing with regulatory issues. He can be reached at 416-925-5445.
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