f you have been seriously harmed by medical care in Ontario, one of the first questions you may face is whether to file a complaint with the College of Physicians and Surgeons of Ontario, the regulator that oversees physicians in the province. The question is not always straightforward, and the answer depends on what you are trying to accomplish.
This is a strategic question I am asked often by prospective clients. The short answer is that in most cases, yes, a complaint is worth making. But the reasons why are different from what most patients expect, and there are real tradeoffs to weigh before filing.
What the CPSO does, and what it does not do
The College of Physicians and Surgeons of Ontario regulates the practice of medicine in the province. Every physician practising in Ontario must be a member. When a patient files a complaint, the College’s Inquiries, Complaints and Reports Committee will review the care provided, request the medical records, invite a written response from the physician (almost always prepared with assistance from the Canadian Medical Protective Association and its lawyers), and in some cases obtain an independent expert opinion.
The Committee then issues a written decision. It may take no further action, deliver a caution, order remediation such as supervised practice or additional training, or refer the physician to formal discipline.
What the Committee will not do is award you compensation. It does not exist to compensate patients. Its role, set out in the Regulated Health Professions Act, 1991, is to protect the public interest by regulating the conduct and competency of physicians.
There is also a critical legal point that often surprises patients. Section 36(3) of the Regulated Health Professions Act provides that the records, reports, and decisions of a College proceeding are not admissible in a civil proceeding. The courts have applied this strictly. Whatever the College finds about your doctor cannot be filed as evidence in a malpractice lawsuit. What happens at the College stays at the College.
That fact alone leads many patients to ask why a complaint is worth making at all. Here is why.
Why a complaint can still be worth it
It is a low-cost screening tool. A medical malpractice lawsuit is expensive and time-consuming. A CPSO complaint is free and you can file it yourself. The College will obtain the medical records, summarize them, and offer its view on whether the care met the standard expected of a reasonable physician. For a case that is not obviously meritorious, that screening can save a patient years of effort and a lawyer many hours of investigation.
It surfaces the physician’s defence early. A doctor faced with a complaint will, through their CMPA lawyer, prepare a written explanation of the care they provided. That explanation is not admissible in court, but reading it tells you, often years before discovery in a civil action, what the defence theory is going to be. That intelligence is valuable. It allows a plaintiff’s lawyer to test the defence theory with their own experts before significant money has been spent.
It can identify problems you did not know about. Sometimes the College will identify a standard-of-care issue the patient never noticed. Patients are often poor historians of their own care, particularly when the records run to hundreds of pages and judgment calls are involved. The Committee’s review can flag concerns that the patient and the lawyer might have missed on their own.
It has been part of my standard advice to potential malpractice clients to file a complaint, even when I am not retained, and to come back to me with the decision. Often it confirms my early sense that there is no viable claim. Occasionally it shows there is something worth investigating further.
What to weigh before filing
There are three real downsides that deserve to be considered before a complaint is filed.
The Committee will not address causation. The College’s job is to assess physician conduct, not to determine whether negligent conduct actually caused the patient’s injury. Even when the conduct was clearly poor, the Committee will rarely say in plain language that it caused the outcome. For a case where causation is the central issue, and many medical malpractice cases turn entirely on causation, the College’s review may not advance the analysis much.
It almost always ends the doctor-patient relationship. A physician who receives a complaint will usually treat the relationship as broken and write to confirm that they will no longer provide care. If you still rely on that physician for ongoing treatment, that consequence has to be planned for, and alternative care arranged, before the complaint is filed.
The limitation period keeps running. In Ontario, there is generally a two-year limitation period to commence a medical malpractice action, running from when the patient knew or ought to have known the essential facts of the claim. The CPSO process typically takes between eight and twelve months, sometimes longer. If your limitation period is going to expire before the College finishes its work, waiting for the College’s decision before issuing a claim is a serious risk. Patients sometimes assume that filing a complaint pauses the limitation period. It does not.
The bottom line
For most patients with a serious concern about their care, filing a CPSO complaint is worth doing. It costs nothing, the College does the document gathering for you, and the result, whatever it is, helps you make a more informed decision about whether to pursue a civil claim.
For patients whose case turns entirely on causation, or whose limitation period is close to expiring, the calculus is different. In those cases, the better course is to consult a malpractice lawyer first, before filing the complaint, so the strategy and the timing can be considered together.
For more on the broader complaints landscape in Ontario, including hospital complaints, the Patient Ombudsman, the Office of the Chief Coroner, and the regulatory colleges for nurses and other practitioners, see A Patient’s Guide to Making Complaints About Health Care in Ontario. For the legal framework of a malpractice action, see Suing for Medical Malpractice in Ontario: What You Need to Know.
The first conversation is free and strictly confidential. The earlier we look at the records, the better.
