Can Health Professionals Provide Opinions About People They Have Not Assessed?

Introduction

We previously wrote about the need for health professionals to complete proper assessments of their patients prior to offering medical advice or treatment (see “Failing to Complete a Proper Assessment of a Patient Could Lead to Professional Misconduct”). On a similar note, we are now writing about health professionals facing regulatory discipline for providing opinions about the health of non-patients.

Professional Misconduct

In a recent case before Hearings Tribunal of the College of Physicians & Surgeons of Alberta (the “Tribunal”), a retired psychiatrist (the “Physician”) was asked to write a medical report by his patient’s lawyer. His patient was going through a divorce at the time. The Physician wrote a medical letter, where he speculated on the behaviour of an individual who was not his patient and who he did not examine. In the letter, the Physician drew conclusions and provided potential psychiatric diagnoses; as a result, the individual (the “Complainant”) made a complaint to the College of Physicians and Surgeons of Alberta.

The Physician argued that he did not intend to diagnose the Complainant but rather describe information that his patient had shared with him.

Hearing Tribunal of the College of Physicians and Surgeons of Alberta

Merit Decision

The merit hearing (the hearing on liability) before the Tribunal took place in May 2024 and was closed to the public. The Tribunal found that the Physician displayed a lack of knowledge, skill or judgment in providing professional services, by speculating in a medical letter on the behaviour and potential psychiatric diagnoses of an individual who was not his patient and whom he did not examine. The Tribunal found this conduct to constitute unprofessional conduct.

The Tribunal noted that the Physician’s letter went beyond the scope of relaying his findings, assessments, advice and treatment given to the patient and that he accepted as facts the information that had been relayed to him by his patient. He speculated about the Complainant’s behavior and provided potential psychiatric diagnoses. He could have instead declined to answer questions that were asked of him, refused to speculate or provide a diagnosis on the Complainant.

This conduct was found to undermine the integrity of the profession and was inconsistent with the expectations of the College for physicians and what the public has a right to expect. Despite the conduct only affecting a small number of people, the Tribunal found it was serious unprofessional conduct considering the risk it had in misleading many and damaging the reputation of the entire psychiatry profession.  

Sanction (Penalty) Decision

The Physician was retired at the time of the hearing and had no intention of returning to practice. In this circumstance, the Tribunal reprimanded the Physician and ordered him to pay a portion of the investigation and hearing costs. The Tribunal found this sanction to be sufficient, given that the Physician was unlikely to resume practice. However, if the Physician was a practicing physician, the Tribunal noted that it would have considered a more “meaningful suspension”, as well as remedial coursework, on professionalism, ethics and/or report writing.

Conclusion

Health professionals should be careful not to opine or speculate on behaviour, draw conclusions and/or provide potential diagnoses for individuals who are not their patients. In some circumstances, this can be a fine line, but professionals must tread carefully and seek advice as necessary to ensure that the line is not crossed.

It is important for health professionals to know how to properly write medical reports and provide medical opinions on matters where they have neither assessed nor treated the individual. In fact, in this case, one of the Physician’s arguments to the Tribunal was that there was a lack of guidance from the College on how physicians should prepare expert reports for court cases. If you require training or information on how to properly draft a medical report, provide evidence at a hearing or trial, or generally act as a medical expert in a litigation matter, you may contact us for support or guidance.