A total of 606 Canadian physicians were disciplined by their provincial medical licensing authorities between 2000 and 2009, researchers at St. Michael's Hospital found.
The majority of disciplined physicians were men (92 per cent) who had been practicing medicine for a long time (an average of 28.9 years) and were independent practitioners (99 per cent), according to Dr. Chaim Bell.
The most frequent violations were sexual misconduct (20 per cent), standard of care issues (19 per cent) and unprofessional conduct (16 per cent), he wrote in a paper published today in the journal Open Medicine.
Dr. Bell found that 62 per cent of those disciplined were family doctors, 14 per cent were psychiatrists and nine per cent were surgeons.
The three most frequent penalties were fines (27 per cent), suspensions (19 per cent) and formal reprimands (18 per cent). The median length of suspensions was four months and the median fine was $4,000. Only six per cent of disciplined physicians had their licenses revoked.
Dr. Bell said he believes this is the first time such data has been collected and analyzed from across Canada. The study did not include the three territories where such information is not publicly available.
"This data is an important first step in aggregating and understanding the extent and nature of physician discipline in Canada," he said.
"The medical profession must realize that although disciplined physicians represent a small proportion of total care providers, a single practitioner has tremendous potential to harm patients and the public. There is little doubt these practitioners diminish the integrity of the medical profession."
Dr. Bell stressed that the number of physicians disciplined represents each year represents only 0.06 per cent to 0.11 per cent of all physicians in Canada.
However, 51 physicians committed 64 repeat offenses, or 19 per cent of the total offenses. Seven of them had been disciplined three times and two had been disciplined four times. Dr. Bell said there needs to be greater monitoring of disciplined physicians.
Studies in the United States have also found that being a male and being in practice for a long time may increase a physician's risk for disciplinary actions. Those studies suggested there are differences in how male and female physicians interact with their patients and that female physicians may communicate more effectively with them. Previous studies have also found that the intimate nature of the work performed by family physicians and psychiatrists and their direct relationships with patients may predispose some of them to inappropriate behaviour and therefore to discipline.
Dr. Bell said it was concerning that a large proportion of violations by Canadian physicians involved sexual misconduct, "which is clearly a breach of trust." He said this suggests that both medical students and physicians taking continuing education need more training about sexual boundaries.