After five miscarriages, and with the odds of ever having children stacked against her, Lee Dix was glad to get a second opinion. It was the summer of 2000, and the Toronto woman had been referred to a gynecologist based at Scarborough Hospital, Dr. Richard Austin, whom she hoped would eventually deliver her first baby. But far from feeding her optimism, Austin told Dix she had a benign tumor called a fibroid in her uterus, and made a provisional diagnosis of endometriosis, a painful disorder where cells on the uterine wall grow out of control. Between 2002 and 2005, the greying physician performed two operations on Dix—one a total abdominal hysterectomy, the other to remove her remaining ovary (she’d had one taken out in a previous operation). “I just went with what he said,” Dix now recalls. “I trusted doctors, and I thought that if anyone is going to work on me, they must have the proper schooling and knowledge.”
With that, her dream of having children ended. By 36 she was entering menopause, and thus began a medical nightmare she now blames on mistakes and misjudgments committed by Austin. She missed months of work in her job as a receptionist, suffered depression and still deals with bowel control issues because, she alleges, Austin twice perforated her large intestine while she was under the knife. More stunning still, the 41-year-old has since learned that the surgeries may have been wholly unnecessary.
In a civil suit recently filed in Ontario Superior Court, she cites the results of ultrasounds and other tests performed before and after the procedures showing no evidence of endometriosis or fibroids, raising the question of why Austin suggested surgery at all. The whole experience has left her heartbroken—and downright fearful of anyone in a white jacket. “I haven’t even gone for my yearly physical,” she says. “I don’t want to see any doctors. I don’t know who to trust.”
Dix’s allegations have not been proven in court, and Austin has not yet filed a statement of defence (his lawyer declined to comment). But she’s not the only one telling horror stories about doctors these days.
From the pathology scandals in Newfoundland and Windsor, Ont. to an O.R. slip-up that nearly cost former NHL coach Jacques Demers his life, highly publicized medical errors are taking a big bite out of Canadians’ confidence in the medical profession, leaving many suspicious before they so much as take a seat in the examination room. In a poll taken last week for Maclean’s, 40 per cent of respondents said they believe Canadian doctors care less about their patients than they did 10 years ago; only six per cent said physicians care more. One in five said doctors are more likely to make errors than they were a decade earlier, and the MDs didn’t score well on questions of honesty, either. More than half the respondents to our poll said they believe doctors do not readily acknowledge their mistakes.
This is not about respect, so much as trust—92 per cent of those surveyed said they hold doctors in high esteem, and an overwhelming proportion of Canadians believe their own GPs do a good job. But there’s no denying the impact of the recent high-profile cases, given the disproportionately large number of people affected. The doctor at the centre of the Windsor controversy, for example, went on interpreting cancer tests for thousands of patients despite suffering from cataracts that hospital officials acknowledge may have compromised her work. In Newfoundland, pathology mistakes between 1997 and 2005 resulted in wrong test results going out to nearly 400 breast cancer patients, 108 of whom have died while untold others lost breasts only because they started treatment too late. In Saskatchewan, a government review of 68,360 images interpreted by Yorkton radiologist Dr. Darius Tsatsi uncovered 1,988 mistakes that will affect patients’ treatment. In Toronto, Austin has faced complaints from scores of his former patients, at least 38 of whom have filed civil suits like Dix’s, claiming unnecessary surgery or botched procedures.
These horror stories have made Canadians wary, says Mario Canseco of Angus Reid Public Opinion, who oversaw the Maclean’s poll. “Not only do they worry that there will be mistakes, but they assume so,” he says. “Even if you’re happy with your GP, you see what’s happened to those around you. You think it may be your time next.”
For doctors, this is an unaccustomed, and not especially pleasant, spot to be in. For generations, physicians have enjoyed greater public respect and appreciation than practically any professionals—a reflection, perhaps, of their status in many communities as the most educated people in town. That’s changing, however, as post-secondary education becomes the norm and Canadians in general grow less deferential. “There used to be a very paternalistic relationship between doctors and their patients,” says Dr. Rocco Gerace, registrar of the College of Physicians and Surgeons of Ontario. “It worked both ways. Patients would essentially give doctors the decision-making ability, as opposed to considering options and then consenting. It’s changed dramatically, and I think for the better.”