Transparency—the new gateway to public trust
We live in a world that is increasingly exposed and connected. Technology has vested us with new ways of thinking and new ways of sharing information. Call it Pandora’s box if you will—a jar that has been opened with far-reaching consequences. This new way forward calls for greater transparency. It reflects a growing world-wide recognition that the public has a right to know. Public institutions, including the College, are being called upon to be more accountable and more transparent in order to sustain public trust.
Thirty years ago, regulatory bodies were not required to provide information about physicians to the public. Colleges chose what, when and how to communicate with registrants, government and members of the public. Patients had no choice but to trust the regulator and the profession without being given an opportunity to ask questions, or seek information about a physician’s credentials or discipline history.
In the 1990s, new legislation was enacted across Canada, which specifically set out the “duty and objects” of a college to be more accountable and transparent. The Health Professions Act, RSBC 1996, c183 is the legislative framework that governs the College and mandates what information must be made public by way of a register, most of which is accessible via the College website. This register includes the registrant’s name, registration status, contact information, limits and conditions imposed under the Act, notation of cancellation or suspension of registration, and any additional information required under the regulation of the minister. In its online register, this College also offers courtesy information about registrants to the public such as languages spoken and whether or not a family physician is accepting new patients.
Those who are interested in the work of the College are currently able to access the Board’s three-year Strategic Plan, as well as statistical information about the College’s registration and complaints processes, which are published in the Annual Report.
At a recent board meeting, the Board endorsed making more information available to the public about its meetings, registrants, and private surgical and diagnostic facilities. In the near future, the public will be able to access details about upcoming hearings, and can download agendas, minutes and materials provided at open portions of board meetings. The online register will contain registrants’ practice restrictions, and will indicate whether or not a registrant holds privileges at a public hospital or private surgical facility.
My counterpart in Ontario, Dr. Rocco Gerace, said in Dialogue Magazine, Issue 3, 2013, “In our case, the public protection work of the regulator must not only be done, it must be seen to be done.” I would add that information provided by regulators needs to be straightforward, useful and easy to access.
Providing transparent information necessitates that the College conduct relevant evaluations and collect meaningful data that both physicians and the public trust. The Board has made this a strategic priority over the next three years, and envisions that both the public and the profession will be part of this initiative. At present, the College has rigorous and fair processes in place to protect patients through effective regulation. They include: setting stringent standards for entry to independent practice; investigating complaints; accrediting diagnostic facilities and private surgical facilities; and administering quality assurance programs that proactively assess and educate physicians to ensure they meet high standards of practice throughout their professional lives. These processes and programs are intrinsically linked to the collection and output of data.
However, while regulators are increasingly challenged by the public and government to be more transparent and open, and to disclose more information about physicians, this demand must always be weighed against physicians’ justified rights to privacy under law. To be sure, this new way forward requires thoughtful and measured planning.
H.M. Oetter, MD
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