Patient Safety - Reality Check

Silence Excerpt

The unkindest cut

Abstracted from the Toronto Star, March 17, 2007

Patients about to undergo surgery with Toronto obstetrician and gynecologist Dr. Richard Austin have no way of knowing that more than a dozen women have claimed they suffered physical and emotional harm under his care.

They wouldn't be aware that some of Austin's complication rates and unintentional cuts to internal organs are beyond what are acceptable, according to medical experts.

A search of the website of the College of Physicians and Surgeons of Ontario – the doctors' self-regulatory body – shows an unblemished record. And The Scarborough Hospital where he has surgical privileges does not make data on doctors available to the public.

No Ontario law compels physicians or hospitals to reveal details of a surgeon's performance, such as the number of operations performed, complaints, malpractice suits, settlements or complication rates.

But after searching public records at the Toronto courthouse, the Star discovered 14 women have filed suit against Austin since 1991. We don't know whether the cases were more complicated than usual, or whether the conditions in the operating room were less than ideal. The Canadian Medical Protective Association, a publicly funded defense fund that pays patient compensation on behalf of physicians, doesn't disclose figures on lawsuits by medical specialty.

There is a wall of silence surrounding what are called adverse events in Ontario hospitals, and there is no public transparency or accountability built into the system. In this case, the hospital won't comment, the college won't say anything and Austin, 63, declined repeated requests for an interview.