“Medical Suspensions”

It may interest to those of you who have had their licence suspended due to medical reasons that any ER intern can file a report, even if you present at a hospital looking for help with a drug or alcohol issue, and your licence will be suspended. It's no fun trying to get it back, either ...

And, I'm told "off the record" that every doctor who does so is paid $30.00 by the MOT -- a paltry sum to wreck your life ...

I can appreciate you're probably not thrilled with your suspension, but the Highway Traffic Act states all medical practitioners and Optometrists have to file such reports, there is no discretion. They must do this for all persons who are 16 years of age or older, regardless if they're licensed or not. And you're correct, the Ministry does pay doctors for filing these rather simple forms.

The Globe & Mail had a story last month on this very topic. Search their website for the topic "How a retired teacher lost her licence for drinking at home". The article states that reporting has gone up since 2006 when the Ministry started paying doctors $36.25 per report filed. It also mentions that Ontario doesn't allow for any discretion on the Doctor's part unlike other Provinces. The article quotes one medical journal which came to the conclusion that "mandatory reporting in Ontario does not achieve its stated purpose".

You can't really blame the Doctors for following the law. It sounds like more of a problem with the law itself and a poor appeal/review process.

Stanton wrote:I can appreciate you're probably not thrilled with your suspension, but the Highway Traffic Act states all medical practitioners and Optometrists have to file such reports, there is no discretion. They must do this for all persons who are 16 years of age or older, regardless if they're licensed or not. And you're correct, the Ministry does pay doctors for filing these rather simple forms.

The Globe & Mail had a story last month on this very topic. Search their website for the topic "How a retired teacher lost her licence for drinking at home". The article states that reporting has gone up since 2006 when the Ministry started paying doctors $36.25 per report filed. It also mentions that Ontario doesn't allow for any discretion on the Doctor's part unlike other Provinces. The article quotes one medical journal which came to the conclusion that "mandatory reporting in Ontario does not achieve its stated purpose".

You can't really blame the Doctors for following the law. It sounds like more of a problem with the law itself and a poor appeal/review process.

Taking this a step further one might say that at the very least the following recommendations should be put in place by way of protection for the individual. But given the previous comments here we wont be holding our breath:

Procedures should be outlined, in detail, in the form of concrete guidelines to be provided for, and followed by, all physicians, when faced with the need to consider such action as declaring a diagnosis of alcohol dependency.

The patient must be seen by a physician and details discussed with the patient concerning the results of blood tests and other factors which the physician deems pertinent to such a diagnosis.

Such a diagnosis should never be allowed strictly on the basis of a recommendation made solely by the nurse in attendance. (reported on at least one occasion.)

A copy of the information destined to be sent to the Ministry of Transportation must be provided to the patient at the time of the diagnosis.

Where visits to a hospital are involved, all patients presenting with withdrawal symptoms should, at Triage, be provided with an information sheet outlining policies, procedures and potential outcomes for one's standing with the Ministry of Transport associated with a diagnosis of alcohol dependency. This should be provided prior to treatment.

All sections of the questionnaire should be examined in detail and corrected for examples of ambiguity. Modification should be made for questions which in their present form may not apply to the individual in question (Perhaps extra space for comments which may be required to expand on pertinent circumstances). This is particularly true for multiple choice questions. Answers may be lacking in the area of being adequately comprehensive. There is often a wide disparity in the circumstances between individuals underlying this kind of diagnosis. Also the questionnaire should qualify the difference between the general term "drink" and the actual amount of alcohol consumed. For example, a glass of wine is not the equivalent of a drink (e.g. a "double" ) containing 3 ounces of whiskey in terms of the amount of alcohol involved.

A formal suspension of a drivers license should be delivered either by registered mail or hand delivered. With many or most important correspondence carried out "online" today many people simply visit mailboxes sporadically to clear out advertising pamphlets and the like. Or unsuspecting of what is to come, he or she leaves town to visit, driving there and perhaps returning by automobile, a day or two after the suspension comes into effect. This puts the individual, through no fault of his/hers in an untenable position should they be stopped by police. A hefty fine may be levied. When a person is faced with a license suspension in other instances the suspension and related charges are delivered by hand. To do otherwise without previously advising the individual, puts that person in jeopardy. I am sure that this would, by rights, engender a totally justified challenge in a court of law.

Perhaps if enough people wrote their mp's suggesting, that at the very least, these be put in place, some sanity may be brought to the process

But this issue of medical suspensions just gets better and better. The following was sent to me by a friend who had it sent to him. The originator is a retired police officer who has provided his name and other particulars, but in order to allow him this discretion, should this be requested I can put the request to him.

The Ontario Ministry of Transportation introduced discriminatory

something as a public service.

People today use the phrase, "Nanny State" to describe initiatives such as this. I have heard it used on talk shows by those who recognize this creeping malaise. The powers that be start with issues or practices in society which have poor optics. These issues allow legislators and the courts. at times with the support of special interest groups who support the introduction of legislation which supports their views, to introduce legislation which impinges on the freedoms of a small segment of society. This introduces precedents into case law which can later be presented in court to apply in all cases. In Canada, when our constitution was repatriated a Charter of Rights and Freedoms was included. Premier Rene Levesque would not sign for this unless a clause be put in to allow a province to opt out of any provisions of the Charter as Quebec's legal system was different from the other provinces. So they put in section 1. Now unknown to the public at large this section is being used for other purposes than which it was intended.

For example, back around 2000, The Supreme Court took a principle from civil law and introduced it into the criminal code using section one of the charter. The principle was called "Balance of Probability." This pulls an end run around e.g. section 11(d) of the charter - innocent until proven guilty. Anyway, without rambling on, the elements of actus rea and mens rea are no longer the only elements for proving a crime. This was introduced into the "Care and Control" legislation. Drunk and sitting in the front seat of your car with the keys is the same as driving drunk. Now most people would have little sympathy for this. But it is the climate of "probability" which slowly infects society and may be used in other areas. In my opinion, that with this in mind, it just may be that this whole dementia thing is headed to the principle that somebody with even a suspicion of dementia is probably or liable to cause an accident.

I can hardly wait for the next issue being considered for medical suspension. Just off the top of my head I can think of where all females who have given birth be tested for post partum depression - a very dangerous condition for any driver in control of an automobile. I would be willing to bet there are more issues out there where the "Balance of Probability" can be applied. This whole business is beginning to look like a real stretch But then many Canadians are often prone to do as they are told without in depth scrutiny and objection. One can only hope more will speak up in future.

Thought I would dedicate the following song (video) composed by Garth Brooks; It would seem to be about as serious as the mto efforts (or the lack thereof).

WE'LL BE HERE FOR AWHILE FOLKS. DON'T FORGET TO TIP YOUR WAITER! AND DON'T FORGET TO WRITE YOUR MP!

retep6 wrote:It may interest to those of you who have had their licence suspended due to medical reasons that any ER intern can file a report, even if you present at a hospital looking for help with a drug or alcohol issue, and your licence will be suspended. It's no fun trying to get it back, either ...

And, I'm told "off the record" that every doctor who does so is paid $30.00 by the MOT -- a paltry sum to wreck your life ...

The following is taken from the MTO website:

In Ontario the law requires that physicians report patients who, in the opinion of the physician, may be unfit to drive for medical reasons. The mandatory reporting requirement for physicians is found in Section 203 of the Highway Traffic Act. The requirement states:

The report referred to in subsection (1) is privileged for the information of the Registrar only and shall not be open for public inspection, and such report is inadmissible in evidence for any purpose in any trial except to prove compliance with subsection (1). R.S.O. 1980, c. 198, s.. 203.

To make a long story short, if what you say is true, then doctors can make any call they like without repercussions and pocket $30.00 for each call. Now I don't know the volume of this kind of thing where ER's are concerned but sounds like the potential for a pretty sweet deal to me. If true then would not this kind of arrangement encourage physicians to label things like panic attacks, hangovers, borderline cases etc. as alcohol dependence? And would this not also have the potential to be classed as a conflict of interest. Isn't that kind of thing against the law? Or did I miss a step here? Now I don't want to falsely accuse the medical profession of a lack of integrity but something just doesn't seem right here.

Looks like the MTO is just making a great impression all over the place. Note the following article from The National Post Newspaper, October 2012:

Stringent laws requiring doctors to report people whose medical conditions might impair their driving are unfairly penalizing many heart patients who likely pose little danger on the roads, a major cardiac-medicine conference heard Tuesday.

Those medical reports lead to licence suspensions, which in turn can cause people to lose their jobs, stop trusting their doctor or even lie about dangerous symptoms, two cardiologists said after a debate on the issue at the Canadian Cardiovascular Society annual meeting.

Physicians also must deal with the wrath of patients whose lives have been disrupted, they said.

"We all have this sinking feeling that were reporting all these patients and causing them all this distress and hardship, and theres no proof it is doing any good," said Christopher Simpson of Queens University in Ontario.

"Most of the people were removing from the road, never would have had a problem. Its really very difficult for us to try to predict who is destined to have a medical illness behind the wheel."

He said it might be preferable if doctors simply urged patients not to drive when the danger seems real, or if at least there was no legal obligation on physicians to report.

Officials with safety organizations and provincial licensing authorities could not be reached for comment on Tuesday.

Seven provinces have laws that force doctors to report patients whose medical problems could lead to an accident while they are behind the wheel; in Alberta, Quebec and Nova Scotia, it is left to the physicians discretion whether or not to report.

About 20% of those reported are heart patients. Dr. Simpson said he alerts Ontarios Transport Ministry to as many as 150 of his patients a year.

Carlos Morillo, a cardiologist at McMaster University in Hamilton, Ont., said he has to turn in more than 200 patients annually, though his numbers may be unusual because his practice specializes, in part, in patients who suffer syncopy, or fainting. He admitted the laws probably do prevent some bad collisions, but said he generally shared Dr. Simpsons concerns.

The Cardiovascular Society publishes guidelines indicating which patients should be reported often people who are at risk of blackouts or even sudden death because of certain heart arrhythmia's and other ailments. On the surface, that would seem to make for a compelling case to pull their licences, said Dr. Simpson.

But there is virtually no scientific evidence indicating such measures prevent crashes, and the chances are very slim that any individual patient, especially when under treatment, would cause an accident, he said.

In fact, some research suggests that 95% of drivers who lose control of a vehicle because of a heart condition did not even know they had a problem.

Licence suspensions can have major impact on patients. Dr. Simpson said many of his patients, especially those in rural areas, lose their jobs because their jobs involve driving, or they have to be able to drive to work.

The response from patients is "universally negative," he said. "No one thanks us for doing it."

At the same time, it can leave the medical relationship in tatters, with patients reluctant to tell their cardiologist that, for instance, they are still having fainting spells or seizures, the physicians said.

"I don't know if they're fainting or not," said Dr. Morillo. "The patients learn very rapidly, I better just keep my mouth shut, because otherwise, there goes my licence. "

Sooner or later someone in this province is going to die from something that wasn't prevented because he or she didn't see a doctor because there is no doctor patient privilege. Whatever happened to doctors trying to help patients instead of working for Big Brother.

Medical suspensions are also employed where visual acuity is concerned. The following account at

is a glaring example of the excesses and downright high handedness of the MTO Medical Suspension Division. Somehow they have managed to get themselves and medical personnel protected from challenges and even litigation under the Charter or Human Rights. Now the last time I checked we are not living in a "banana republic" and unregulated power tripping is not a function we allow our governments to employ. Yet what this gentleman had to endure at the hands of the MTO is completely unacceptable. It is well worth the read..........

It seems that public outcry does have influence with government attempts to promote the agendas of the media and the general public who blindly subscribe to the hype. It seems that government has found it prudent to reverse their irrational stance on the rather severe standards for dementia testing for seniors. It further seems that the premises (i.e. statistics) upon which it was based were faulty as was reported in the quote (account) which I posted above. The Following is taken from publications on the CARP website: http://www.carp.ca/2014/01/29/ontario-c ... l-program/

Starting April 21, 2014, drivers aged 80 and over will no longer have to complete a written knowledge test, according to the Ministry, and will participate in a shorter and simpler renewal program that includes, a vision test, a driver record review, an improved in-class Group Education Session, and two short in-class screening exercises. This announcement disproves the circulating rumor that Ontario was going to implement the SIMARD Test, a costly, intrusive computer-based testing program with little evidence to support claims of effectiveness. The changes reflect many of the concerns CARP raised about the outgoing seniors licencing program, which unduly relied on age to determine licencing, rather than experience, driving record, and ability to drive. In an open letter last February and meeting last March, CARP called on the Minister of Transportation to end outdated licencing protocols that unfairly target older drivers and instead implement driver improvement programs and interventions that pro-actively increase safety measures for all drivers. CARPs message was heard the new changes provide balanced approach to ensuring the publics safety and protecting peoples ability to drive. - See more at: http://www.carp.ca/2014/01/29/ontario-c ... Mm5DU.dpuf

There is no question that the practices presently endorsed by the MTO to assess medical suspensions need serious review. The rights of all Ontarians would, at present, seem to be in jeopardy unless some serious revisions are enacted. Where the optics are bad (for example, in the case of alcohol dependence) there just may have to be a process followed which will ensure anonymity for those taken advantage of because their need for suspension may be in question (and apparently there is a significant number of these). There just may be no revisions made without an outcry somewhat similar to that of the elder crowd. I will be posting, in the near future, some of the egregious excesses practised at present. Serious reform is sorely needed.