The Justice Cory Report - A Civil Rights Proposal for Ontario Doctors

The Coalition of Family Physicians of Ontario is truly grateful that Justice Cory's report has recognized and addressed all the injustices inherent in the former MRC structure. The contributions of the COFP and several dedicated organizations and individuals lead to the Ontario government's moratorium on the Medical Review Committee (MRC) audits and Justice Peter Cory's review and report on Ontario's doctor audit system.

Accordingly, the COFP is delighted that his Honour appears to have adopted all major recommendations requested by the COFP. In particular, our most significant recommendation was to establish an independent audit tribunal similar to other public tribunals that protect civil rights under established statutes. Remarkably, the report includes a total of 118 separate recommendations. Indeed, we believe this affirms the billing audit process was flawed; a process that was still being defended by both the Ontario Government and the College of Physicians and Surgeons of Ontario (CPSO) until just a few short months ago.

Billing audits be removed from the jurisdiction of the CPSO
The creation of a new and truly independent Physician Audit Board, which should operate within the terms of the Statutory Powers Procedure Act
(http://www.e-laws.gov.on.ca/DBLaws/Statutes/English/90s22_e.htm)
Doctors should be afforded all of the usual and commonly understood legal rights and safeguards of an established course for judicial proceedings; in other words “due process” including:

Full disclosure
The presumption of innocence (“innocent until proven guilty”)
The onus of proof of wrongdoing is upon OHIP
A one-year limit from the date of payment on the scope of the audit process; except during the transition process or where fraud is alleged
No extrapolation, except in cases of repetitive wrongdoing
No immediate retroactive interest on amounts deemed owing
No imposed penalty of costs
The removal the ability of the General Manager of OHIP to garnish payments from current or future billings
Compensation if no wrongdoing is found

There are many other recommendations that must be accurately and promptly implemented by the Ontario Government to restore physician confidence in the audit process.

What goals must be achieved to have these recommendations implemented to restore the civil rights of Ontario doctors?

In the wake of Justice Cory's report, it is clear that the work of the COFP must continue. There are several major outcomes that must occur:

The Minister of Health and Long Term Care must act expeditiously to implement all recommendations.
Unlike the opinion of the College of Physicians and Surgeons of Ontario, this report does not exonerate the actions and policies of some of our representative and governing medical bodies. We believe Cory's report is a serious criticism of the CPSO and the overly close and unequal relationship that exists between government and some of the representative and governing medical bodies. We recommend that the governors of the CPSO review the structure and personnel of their organisation to determine what went wrong.
Although the issue of redress was briefly discussed, it is regrettable that Justice Cory's terms of reference did not extend to the issue of restitution for those unfairly penalized by the Medical Review Committee. We believe that if this issue remains unresolved, it would continue to be a barrier to the restoration of the confidence of the profession in any audit system. To this end, the COFP pledges to work with all colleagues especially the Specialist Coalition of Ontario (SCO), the Ontario Doctors for Fair Audits (ODFFA), and the Ontario Medical Association (OMA) to maintain pressure on the Ontario Government for restitution. The Coalition of Family Physicians of Ontario recommends that the Ontario Government authorize the proposed Physician Audit Board to review the cases of all physicians over the past several years that have been subjected to the MRC audit process.

We wish to thank all our members for your tremendous support and offer special thanks to all of you who have already pledged your commitment for 2005. We ask that you now encourage one or two of your colleagues to do the same.

For those of you who have not yet joined or renewed with us, the greater your support, the greater we can achieve the goals to provide our profession with better working conditions in order to provide the best care to our patients.

We rely upon each new and current member to support our work – it cannot be left for others to carry the ball.

Campaigns, media and public education efforts, submissions to government committees, and expert legal and political advice are costly. The COFP board voluntarily contributes thousands of hours each year to represent and protect your interests.

Visit our website at www.cofp.com to link to the full Cory report that includes organisations and individuals presenting to the Cory Review.