Defending a CPSO Complaint

Most of what decides a College matter happens before anyone mentions a hearing. The screening stage is documentary, and the document that matters most is your first written response.

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ICRCCautionsInterim OrdersHPARB

Investigation | Screening | Discipline | Review

The dates that govern a complaint.

The Registrar must notify you within 14 days and provide the material.

You have 30 days to make written submissions, and that window can be shortened.

An interim order can suspend or restrict you before any finding, on 14 days notice.

A caution or a remediation order stays on the public register indefinitely.

Quick Answer

What happens when a patient complains to the CPSO?

The College is governed by the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991. On receiving a complaint the Registrar must notify you within 14 days and give you the material, and under section 25.2 you have 30 days to make written submissions, a period that can be shortened where patients may be exposed to harm. The Inquiries, Complaints and Reports Committee then investigates and disposes of the matter under section 26(1). It has four options: refer specified allegations to discipline, refer you for an incapacity proceeding, require you to appear to be cautioned, or take whatever action it considers appropriate. That last, residual power is where remediation programs, advice and negotiated undertakings all come from. Alternative dispute resolution under section 25.1 is available where both sides consent, though not where sexual abuse is alleged. Section 28 sets a 150 day target for disposition, but it is a notice and escalation provision rather than a deadline with consequences: nothing becomes void if it is missed.

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THE FIRST 30 DAYS

The Response That Decides the File

The screening stage is conducted on paper. There is no hearing, no oral submission and no opportunity to explain yourself in person, so the written response under section 25.2 is not a preliminary step. For most physicians it is the only substantive submission they will ever make.

The Registrar must notify you within 14 days and provide the complaint together with the material the Committee will consider, including any prior decisions available to it. You then have 30 days. That period can be shortened where the Committee considers patients may be exposed to harm, so the assumption that there is a month is not always safe.

What goes into that response is a strategic decision rather than a narrative one. It has to address the allegation, but it also has to anticipate what a referral to discipline would look like, because the same document will be read by the Committee deciding whether to refer. A response written as an explanation to a colleague and a response written as a submission are different documents.

THE OUTCOMES

Four Statutory Options, and What They Actually Mean

Section 26(1) lists four dispositions. Two are referrals, to discipline or for an incapacity proceeding. The third is a requirement that you appear before a panel to be cautioned. The fourth is a residual power to take whatever action the Committee considers appropriate.

Almost everything a physician is offered short of a hearing sits inside that fourth option. Specified continuing education and remediation programs are expressly authorised as an exercise of it by section 26(3). Advice and recommendations letters have no statutory name at all. Undertakings are not section 26 orders in the first place: they are agreements you negotiate and sign.

That distinction is the negotiating map, and it is why the register consequence matters more than the label. Under section 23(2) only cautions and remediation programs are register entries, and they stay there indefinitely. An undertaking appears only while it is in effect. A resolution reached through the alternative dispute resolution process is not posted at all.

INTERIM ORDERS

Restricted Before Any Finding

Section 25.4 allows the Committee to suspend a certificate or impose terms, conditions and limitations at any time after a complaint is received or an investigator is appointed, where the conduct exposes or is likely to expose patients to harm or injury. It came into force on 30 May 2017.

The ordinary process requires notice of the intention and at least 14 days for written submissions. Where urgent intervention is needed the order can be made without notice at all, with the submissions coming afterwards. Once an interim order is in place the matter must be prosecuted expeditiously and given precedence.

For a practising physician this is usually the most serious thing that can happen in the whole process, because it takes effect before any finding and it is public. The College does not publish how often interim orders are made, so anyone quoting a figure is guessing. What can be said is that the 14 day window is short and that responding to a notice of intention is a different exercise from responding to the complaint itself.

IF IT IS REFERRED

The Tribunal, the Penalties and the Costs

The Discipline Committee has operated under the name Ontario Physicians and Surgeons Discipline Tribunal since 1 September 2021, and sits within a shared services arrangement with a number of other health colleges. The rename does not change the law: the Code still refers to the Discipline Committee and the statutory machinery is unchanged.

Panels are drawn under section 38 and hearings are public by default. On a finding of professional misconduct the orders available under section 51(2) run from a reprimand through terms and conditions, suspension and revocation, and include a fine of up to $35,000 payable to the Minister of Finance. Findings of incompetence under section 52 attract a narrower list, with no fine and no reprimand.

The financial exposure is usually costs rather than the fine. Section 53.1 allows a panel to order a member found to have committed misconduct or to be incompetent to pay all or part of the College’s legal costs, investigation costs and hearing costs. There is a mirror provision: where a panel considers the proceeding was unwarranted, section 53 allows it to order the College to pay yours.

REVIEW

What HPARB Can and Cannot Do

A complainant or a member who is the subject of a complaint may ask the Health Professions Appeal and Review Board to review the Committee’s decision. Its scope under section 33(1) is limited to two questions: whether the investigation was adequate and whether the decision was reasonable. There are no witnesses, no transcript and no cross examination.

Its powers under section 35(1) are exhaustive. It may confirm the decision in whole or in part, make recommendations to the Committee, or require the Committee to do anything it could have done. It cannot vary a decision itself and it cannot substitute its own outcome.

Three limits catch people out. It cannot review a decision to refer to discipline. It cannot review a referral for incapacity. And it has no jurisdiction at all where the matter began as a Registrar’s report rather than a complaint, which is a growing proportion of College files and a route that carries no review right and no notice of one.

Common Questions

Frequently Asked Questions

How long do I have to respond to a CPSO complaint?

Thirty days from receiving the notice, under section 25.2 of the Code. The Registrar must notify you within 14 days of the complaint being filed. The 30 days can be shortened where the Committee considers patients may be exposed to harm, so do not assume the full period is guaranteed.

Is a caution the end of it?

It resolves the complaint without a hearing, but it is a register entry under section 23(2) and it stays on the public register indefinitely. Descriptions of a fixed posting period of six years are wrong and come from misreading a different provision. That permanence is why the difference between a caution and a non-postable outcome is worth negotiating.

Can the College make me compensate the patient?

No. There is no power to award compensation to a complainant at any stage. The only patient-directed money in the Code is funding for therapy and counselling in sexual abuse matters, which is available on the allegation alone, is expressly not a finding against the member, and is paid to the therapist rather than the patient.

What is the 150 day rule?

Section 28 sets 150 days for the Committee to dispose of a complaint, but it is a notice and escalation regime rather than a limitation period. If it is missed, notices go out and new dates are set, and eventually the Board may be asked to intervene. Nothing becomes void, nothing is dismissed, and no remedy accrues to you.

Do I have a right to a lawyer during the investigation?

There is no express statutory right to counsel at the investigation stage in the Code. That is not a reason to go without one. The written response and any negotiation over undertakings happen at exactly the point where representation makes the most difference, and long before any right to counsel at a hearing is engaged.

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Defending a CPSO Complaint

What happens when a patient complains to the CPSO?

Speak to a Regulatory Defence Lawyer

The Response That Decides the File

Four Statutory Options, and What They Actually Mean

Restricted Before Any Finding

The Tribunal, the Penalties and the Costs

What HPARB Can and Cannot Do

Frequently Asked Questions

Speak to Us About a College Matter

Lexaltico LLP

Ready to Talk? Start My Enquiry

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