Alberta doctors accused of spreading COVID-19 misinformation face unannounced inspections

The regulator ofAlberta's physicians is performing unannounced inspections at medical clinics in a bid to crack down on doctors who spread COVID-19 misinformation or prescribe unproven remedies for the disease.

The College of Physicians and Surgeons of Alberta (CPSA) said it has conducted five inspections related to COVID-19 complaints since targeted enforcement began three weeks ago.

In a statement to CBC News on Thursday, the regulator said the five cases are at various stages in the investigative process, but it declined to provide further details on the allegations.

CPSA deputy registrar Dr. Susan Ulansaid the five sites were selected to be inspected first as they had been subject to numerous complaints or were facing the most serious allegations.

She said she hopes the threat of enforcement will act as a deterrent.

"There are some physicians that are simply ungovernable and those are very rare and very much the exception," she said.

"This tool that we have is going to be effective, I hope, for the majority of physicians that have come under our radar. But there's always going to be some outliers that are more defiant."

Ulandeclined to provide further details but said "several more" inspections are already planned for the coming weeks.

"There's more to come," she said.

The CPSA announced its plan to increase enforcement in a memo issued on Oct. 14.

As opponents of vaccinations, vaccine passports, masking and physical distancing became more vocal, regulatory bodies in other provinces startedinvestigating complaints about doctors providing misinformation on COVID-19, but Alberta's use of unannounced inspections is unusual, one expert says.

False exemptions, unproven remedies

The statement detailed how inspectors would arrive, without warning, at medical practices where doctors have been subject to COVID-related complaints.

If doctors refuse an inspection, the college has the authority to apply to the Alberta Court of Queen's Bench for a court order.

"We have not encountered the need to seek a court order to force a physician to co-operate with an inspection at this point," the statement said.

The college said it is "very concerned" about the increasing number of doctors reportedly violating the CPSA's standards of practice and pandemic-related public health orders.

"An on-site inspection may occur when but is not limited to allegations arise of inappropriate issuance of COVID-19 vaccine and/or mask-exemption letters, prescribing inappropriate interventionssuch as ivermectinfor the prevention and treatment of COVID-19 and spreading of misinformation related to COVID-19," the college said.

The province's Health Professions Act gives the college the authority to conduct unannounced site inspections to investigate possible breaches of CPSA's standards of practice.

Inspectors can question witnesses under oath and gain access to documents, including medical charts, as well as substancessuch as medical samples.

Formal investigations that find standards are breached are turned over to a disciplinetribunal to determine guilt and penalty. Penaltiesinclude restrictions on a doctor's ability to practise, suspension or loss of aphysician's practice permit, a fineor a mandate for additional training.

"The actions of a very vocal few have done a lot of damage.- Dr. Vesta Michelle Warren, AMA president

In some cases, an inspection may not be necessary to trigger disciplinary action.

If there is blatant evidence, such as video recordings or social media posts "where physicians publicly attack other physicians" or "egregiously spread misinformation," the case will be directly referred to the CPSA's professional conduct department, the college said.

Alberta Medical Association president Dr. Vesta Michelle Warren said the vast majority of Alberta doctors have nothing to hide from the regulator and support the new measures.

"The actions of a very vocal few have done a lot of damage," she said. "We need to condemn, in the strongest of terms, the promotion of anti-vaccination propaganda by health-care providers."

The dangerof misinformation 'heroes'

The move is unusual, said Lorian Hardcastle, an associate professor in the faculty of law at the University of Calgary, with a cross-appointment to the Cumming School of Medicine.

She said this is the first time she's heard of a physicians'college taking this measure, adding that the CPSA's new enforcement strategy is part of a larger crackdown on COVID-19 misinformation among doctors.

Canada's medical regulators are taking on a stronger enforcement role, while attempting to distance themselves from the "dissenters," Hardcastle said.

"If they allow certain members to become voices of the anti-vaccine, anti-mask movement, then they're failing at their duty to protect the public. This shows that they're taking that mandate seriously."

Their voices can tend to be amplified over the voices of the thousands and thousands of physicians who are pro-mask and pro-vaccine.-Lorian Hardcastle, University of Calgary

Hardcastle said a small minority of defiant doctors has an oversized impact on public healthby eroding trust in proven science and the government response to the pandemic.

"Those individuals tend to become sort of heroes to the anti-vax movement," she said.

"They become these public figures, and their voices can tend to be amplified over the voices of the thousands and thousands of physicians who are pro-mask and pro-vaccine."

Doctors who oppose public health orders may also harm public health by attracting like-minded patients, Hardcastle said. She said doctors who publicly oppose COVID-19 restrictions may be sought out by people who want false exemption papers.

The threat of inspections will likely dissuade some doctors "on the fence" from breaking the rules, but Hardcastlesaid she suspects some may hold firm.

"It's difficult to know how effective it will be at targeting those people who are really the problem."

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