Ontario regulators examine surge in complaints

Pandemic-era rise now declining as new strategies seem to tamp consumer concerns

December 8, 2023 (published)
Photo by Santana Bellantoni
Regulators with the College of Veterinarians of Ontario are responding to a sharp uptick in consumer complaints.

Ontario regulators are striving to understand the factors behind a surge in consumer complaints that have grown so numerous, they're taking years to process.

Between 2019 and 2022, complaints rose by 30%. They peaked in 2021, at 348 complaints, according to figures from the College of Veterinarians of Ontario, which oversees the province's 5,300 licensed veterinarians. Since 2021, the figures have been trending down.

The rise coincided with the onset of the Covid-19 pandemic, a period that saw long wait times for appointments and heightened dependence on remote care. 

Results of an investigation so far by the CVO suggest that telemedicine is not a major factor in the surge in complaints. The CVO's top official told the VIN News Service that the issue is nuanced and likely involves client angst and expectations concerning wait times for care. 

"I think people on both sides of the equation have been stressed and getting chippier," said Jan Robinson, CVO registrar and chief executive officer. "When people ask us, 'Have we had a complaint about telemedicine,' that's tough to answer. What we consider is whether the complaint itself speaks to the delivery method. For example, if someone complains about communication with the veterinarian, it may not be about telemedicine at all, even if the appointment was remote. It all depends."

Among other things, the CVO has deviated from the widely adopted principle that establishment of a veterinarian-client-patient relationship cannot be initiated without a hands-on physical exam. In veterinary practice, a VCPR is necessary before diagnosing and prescribing treatments.

The change was intended to provide care options for underserved and sparsely populated regions. It proved beneficial in 2020, when clinics closed in response to Covid-19, and telemedicine became a predominant method for delivering care. 

"We were very well positioned for when the pandemic hit because it was already in existence and people really started to use it," Robinson said. 

The rise in consumer complaints occurred simultaneously.

"Pre-pandemic, we had about 220 complaint cases a year, and we were dealing with most of them within nine months," Robinson said. "We currently have a backlog of roughly 600 cases, and it's taking about two years for cases to move through the system. This is not where we want to be."

The CVO is collecting data

Complaints by calendar year

The cause of the increase in complaints is not completely understood, Robinson said. Data is still trickling in. 

"It could be how the adverse event was handled or the fact that they weren't offering after-hours care for someone who needed to be seen," she said. "It could be about any number of things. What I can tell you is that so far, in the last six years, we've had two concerns come in directly about telemedicine."

In fact, one of the two involves a practitioner not offering telemedicine as an option for care. The other concerns a veterinarian charging for an online consultation. Neither is a complaint about the quality of care provided.

Generally, the CVO dismisses roughly 70% of complaints due to a lack of sufficient evidence or because the allegation is frivolous, according to Robinson. "In cases where there's an unanticipated or tragic outcome, it doesn't necessarily mean the care failed to meet the standards."

A new system for fielding complaints

In 2022, the CVO began changing the complaint process to help unclog the system. The agency hired an administrator to summarize cases so the Complaints Committee, a 10-member panel comprised mostly of veterinarians, can more quickly assess them. A navigator was hired to provide complainants with information on the process and its potential outcomes and to set reasonable expectations. 

One change the CVO implemented is voluntary mediation. Each complaint is reviewed for potential referral to mediation. Suitable cases typically involve standards-related concerns or communication breakdowns. Mediated resolutions are submitted to the Complaints Committee for approval.

Potential outcomes include the veterinarian acknowledging the incident or apologizing.

The CVO is also offering counseling through a third party to help complainants who have lost an animal through the grief process, Robinson said.

Robinson indicated that the changes seem to be working. She reported: "Our pilot ran for 10 months and connected with over 600 people. We noted a significant reduction in the number of complaints filed. Actually, only 14% of complainants moved forward with their concerns."

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