Sault-area doctor had right to drop patient due to mom's behaviour

A Sault-area specialist had the right to refuse to take on a patient because of the abusive behaviour of the patient’s mother, an appeals tribunal has ruled.

But the Health Professions Appeal and Review Board also said that it’s important for physicians to carefully document negative interactions with caregivers in case there are complaints.

The case began in June 2020 when the patient, who is non-verbal, was taken to the emergency department at Sault Area Hospital. It was believed at the time that he had lymphoma, according to the board’s decision.

It later turned out that he had a rare condition, but not lymphoma, which took some time to diagnose.

The specialist, a hematologist, met in-person with the patient and his mother twice in the summer of 2020, as well as some phone conversations.

The delay in getting the correct diagnosis upset the patient’s mother. The doctor said she was “aggressive, argumentative, intimidating, bullying, angry, sarcastic and demeaning.”

She told him that he was “failing” at his job and he told the board he considered her behaviour “abusive.”

“(The specialist) did not document these interactions, which he found highly upsetting,” the board’s decision said.

“He stated that he was unsure if information should be included in a patient’s chart about a patient’s mother.”

About a year later, a hematologist in Toronto who was treating the patient sought a specialist in the Sault to take over when he was transferred back to northern Ontario.

“The (specialist) declined taking the patient on, as he had experienced what he perceived as disruptive behaviour from the (patient’s mother) during their prior interactions,” the decision said.

As the specialist wrote after meeting with hospital administration in October 2021:

“I described my discomfort in being involved with the patient’s mother again. In the end I refused to participate in the patient’s care in light of the ongoing antagonistic behaviours of the patient’s mother.”

But he did provide “suggestions for other hematology providers in Toronto and Sudbury who would have had access to virtual care for the patient.”

That decision prompted the mother to lodge a complaint with the College of Physicians and Surgeons of Ontario (CPSO). She claimed the doctor’s behaviour was “unprofessional” because he refused to accept her son as a patient.

He did so, the mother said, because of his “perception that the (mother) was ‘rude and combative,’ despite knowing that there were no other hematologists available in their city to opine on this care.”

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The CPSO rejected her complaint in April 2022, a decision that she appealed.

The board affirmed the original decision last month, again reminding the hematologist of the importance of documenting difficult interactions with patients and families.

While sympathizing with the mother, who has advocated for her son all of his life, the board said everyone deserves to be treated with respect.

“It appeared to the committee that the applicant was a very devoted mother who has had to navigate medical care since her son’s birth,” the board said.

“(But) physicians also have a right to be treated with respect and not be subjected to verbal abuse, as the respondent felt had happened in this case.”