Professional regulation in healthcare: Exploring trends, predictors, and the disciplinary action process for health professionals in Canada

Abstract

Background: Health professionals in Canada are governed by provincial regulatory bodies, whose mandate is to protect the public. Regulatory bodies license and register professionals, and handle complaints and disciplinary action processes when warranted. In recent years, jurisdictions internationally and in Canada have been undergoing regulatory reform. More research is needed on current processes to inform future improvements. Objectives: The overall goal of this thesis was to describe the disciplinary action process for health professionals in Canada. Methods: This thesis is comprised of five studies. The first study was a scoping review to describe the research on disciplinary action outcomes for health professionals, and to describe the research on characteristics or predictors of health professionals subject to disciplinary action. The next three studies reviewed disciplinary action outcomes for Canadian pharmacists, dentists, and nurse practitioners, respectively. Characteristics of professionals subject to disciplinary action were also studied. The fifth study sought to compare and contrast disciplinary action processes across professions and jurisdictions in Canada and to describe regulatory body perspectives of the disciplinary action process. Results: The scoping review found that most research focuses on physicians, originates from the USA, and has been conducted from 2010 – 2020. A variety of demographic factors and predictors of disciplinary action have been studied, including gender, age, years in practice, practice specialty, license type/profession, previous disciplinary action, board certification, and performance on licensing examinations. The reviews of pharmacist, dentist, and nurse practitioner disciplinary found differences in reasons for disciplinary action between professions. All professions had low rates of disciplinary action, with nurse practitioners being the lowest. In the final study, interviews with regulatory bodies identified possible explanations for the differences observed in the reviews of disciplinary action. Conclusion: This thesis has generated new knowledge about disciplinary action for Canadian health professionals. This research will guide regulators and other stakeholders in improving health regulation and ensuring protection of the public.