These and related offences recently have been pushed to the top of the agenda of the provincial college, which recently asked physicians to vote on what kind of self-referral regulations they prefer. Physician self-referral, fraud and conflict of interest are causing increasing concern in Ontario, where a record 100 physicians are currently being investigated for such activities. Public concern is growing because of the number of media reports about fraud and other illegal activities involving doctors, Jim Maclean, the CPSO's director of public affairs and communications, said in a February report to the college's council. In response to criminal and unethical practices outlined in the report, council directed its public-complaints office to continue its 100 investigations. Under the RHPA, the doctor is a fiduciary, the patient a beneficiary.
Conflict of interest is a complicated concept that takes up three pages within the RHPA regulations.
In practice, conflict of interest is virtually impossible to avoid at all times. Issues like these, he told CMAJ , are also being studied by the committee. Maclean's report briefly outlines the most serious cases under investigation by the complaints office. Other cases are directly linked to the generous benefits available under Bill 164, Ontario's no-fault auto insurance scheme. This type of activity suggests criminal conspiracy.