Twenty-four of those are outstanding from last year, while 40 were received in the first quarter of 2023, the April bulletin indicates.

It's the first public update from the regulatory body since February 2022, and less detailed than previous versions.

The update was posted last week, shortly after CBC News inquired about the lack of public information from the self-regulating profession on complaints against doctors and any disciplinary actions.

"Our website is currently under construction as it is being updated and we are switching over to a new website provider," registrar Dr. Laurie Potter said in an email. She expects it to be finished in two to three months.

   Dr. Laurie Potter, registrar of the College of Physicians and Surgeons of New Brunswick, did not agree to an interview. (College of Physicians and Surgeons of New Brunswick)

"While this is happening, we will continue to update our content on the existing site and will be adding in the most recent newsletters shortly which contain more information on the professional conduct department activities."

Potter became registrar a year ago, replacing Dr. Ed Schollenberg, who retired after 30 years in the position.

Potter did not agree to an interview or respond to followup questions about how long the website has been under construction, or how soon updated information would be available. The April bulletin was, however, posted a couple of days later.

No disciplinary actions have been posted since 2019, when two doctors were suspended.

'A little surprising and maybe disappointing'

Richard Myers, who was a lay representative on the college's board about 15 years ago when he was a professor of political science at St. Thomas University and vice-president academic, described the lack of regular updates as "a little surprising and maybe disappointing."

"That wouldn't be in keeping with past practice. … One would expect the bulletins to be more frequent than that," said Myers, who is now the principal of United College at the University of Waterloo.

The bulletins let the public know when "there are problem cases, where there have been investigations and, you know, findings of guilt," he said.

They also let the public know "that there is a process that it is operating, if people do have concerns, there's somewhere they can go and they will be dealt with professionally and properly."

Number of open files 'very high'

The number of open files also seems "very high" to Myers — about three times more than when he served, he said.

"So you've got two things from what you're telling me there that, you know, seem worth thinking about. The number of open cases seems very high and then the reporting over the last couple of years hasn't been there. So, you know, you might speculate that there's … a fair backlog."

He could not offer any possible explanations. While the COVID-19 pandemic seems to account for backlogs in many walks of life, it "wouldn't necessarily explain this one," he said.

In 2020, the college had a total of 45 complaints, with four pending, the website shows. In 2021, the complaints nearly doubled to 89. None were outstanding. Last year, there were 68 complaints and of those, 24 were pending.

                                            Richard Myers, a former college board member, said regular updates from the college give the public confidence the complaint process is working as it should and that the college is doing its job. (University of Waterloo)

Myers is less concerned about the lack of any recent disciplinary action against physicians. It's historically been "relatively infrequent," typically every couple of years.

Just because somebody files a complaint doesn't mean it's a valid complaint, he noted.

"Has there been no disciplinary action in New Brunswick over the last four years? I guess it's conceivable, maybe a little surprising. I suppose if that's the case, that's a good thing."

Summaries dropped

The former bulletin format included a summary of the complaints that did not result in any disciplinary action, but the most recent bulletin has "a completely different look and feel," said Myers. It provides few specifics and more generalizations.

Although other provincial colleges, such as Nova Scotia and Ontario, don't provide summaries either, Myers contends the N.B. summaries had provided transparency and accountability.

They gave "the public confidence that, OK, so the college is doing its job, It's hearing complaints, these are the sorts of complaints they hear."

The February 2022 bulletin, for example, outlines seven complaints, including the case of a patient with abdominal pain who was initially diagnosed was pancreatitis. Only a CT scan was done, not an ultrasound, and as a result, gallstones were missed, it says.

"The patient alleged that the physician had failed to make a timely diagnosis. The committee did feel that the patient's presentation warranted an earlier ultrasound than had been done. The physician was cautioned."

These summaries could also be educational for physicians.

"Maybe it makes you think, 'Oh, well, I should be more attentive to this, or, you know, more careful to avoid that.'"

Family medicine garners most complaints this year

Of the roughly 40 complaints the college received in the first quarter of 2023, just over half were in family medicine, a bar graph in the bulletin indicates. This is no surprise, said Myers, since the bulk of medical work in the country is done by family physicians.

 Family medicine saw the highest number of complaints in the first quarter of 2023, followed by emergency medicine, according to the latest bulletin from the College of Physicians and Surgeons of New Brunswick. (College of Physicians and Surgeons of New Brunswick)

Emergency medicine had the next highest number, at about five, followed by rheumatology, at around three, according to the graph.

The remainder of the complaints were evenly distributed among pathology, psychiatry, ophthalmology, palliative care and occupational medicine.

No details about the 24 complaints left over from last year are provided.

Trend of complaints about patient privacy

The nature of the 40 new complaints is "varied," the bulletin says, with "quality of care" representing nearly half.

"Attitude," and "abandonment" appear to be the next largest categories, followed by "consent." No numbers or percentages are provided.

"Prescribing,""sexual,""withdrawing treatment," and "rejection of patient," make up the remainder of the complaints and appear to be equally weighted.

Quality of care was the most common complaint against New Brunswick doctors in the first quarter of 2023, according to the College of Physicians and Surgeons of New Brunswick's latest bulletin. (College of Physicians and Surgeons of New Brunswick)

No definitions or descriptions are provided, but there has been a recent "trend" of complaints dealing with patient privacy and followup care after surgery or tests, according to the bulletin.

The complaints committee offers some "learning points" and "helpful tips" to members.

Get written consent before disclosing info to employers

The committee advises doctors to always obtain clear written consent from the patient before disclosing any diagnosis, prognosis, or treatment plan to their employer.

It also recommends doctors refrain from commenting on Google reviews or RateMD reviews, "as this may lead to breaches of privacy as the patient may be identified in the initial review or in the physician's comments."

In addition, doctors should ensure their office staff are "aware of privacy obligations, such as the use of personal emails to send patient charts."

No information about the complaints that triggered the advice is provided.

"Is this an increasing problem because, you know, doctors are becoming, you know, less concerned about privacy issues?" said Myers. "Or is it a function of the fact that [society's] expectations around privacy, you know, have tightened up? I suspect it's the latter."

Followup care essential to best outcomes

Similarly, it's unclear what prompted the committee to advise that proper followup care after surgery or a test is "essential to ensure the best possible outcomes" for patients.

"Do not rely on the patient to schedule a followup appointment following surgery or investigations," the committee says. Physicians have to be proactive in reviewing results and ensuring patients are seen "in an appropriate period of time following interventions."

The physician who requests an investigation has the obligation to "direct care as appropriate," while specialists should inform patients of any symptoms to watch for that may require a new or urgent appointment and how to contact them, the committee says.

It goes on to say that receiving a complaint can be "stressful and time-consuming," but urges all physicians to prioritize "timely and compassionate" responses to ensure all issues are thoroughly investigated and resolved.

Failure to respond within 60 days can itself constitute professional misconduct.

Province, medical society won't comment

The Department of Health declined to comment.

"As the College of Physicians and Surgeons of New Brunswick is the professional body responsible for licensing doctors and regulating the province's medical profession, you should contact them," spokesperson Clarissa Andersen said in an email.

The New Brunswick Medical Society, which represents the province's more than 2,000 practising, future, and retired physicians, also declined to comment.

The Canadian Medical Association, the Royal College of Physicians and Surgeons of Canada, and the Medical Council of Canada all also declined to comment, while Healthcare Excellence Canada said no one was available to comment this week.