The Discipline Process

From time to time, an Optometrist does not meet the College’s standards of practice or breaches regulations. When this happens, it is the College’s job to protect the public’s right to quality eye care. We do this first by investigating complaints and reports through the Inquiries, Complaints and Reports Committee (ICRC). 

If the ICRC has reasonable and probable grounds to believe that there has been professional misconduct or incompetence, it refers allegations to the Discipline Committee.

The Discipline Committee

The Discipline Committee is the only committee of the College that has the authority to discipline optometrists. This authority is granted under the Regulated Health Professions Act, 1991 (RHPA) and the Optometry Act, 1991. The RHPA’s Health Professions Procedural Code sets out the procedures to be followed by the Discipline Committee in Sections 36 to 56.

The Discipline Committee is authorized to hold hearings about allegations of professional misconduct and incompetence. If the allegations are proven, the committee can make an order. This could include rehabilitative steps the optometrist must take or measures to restrict their practice. The most severe penalty the committee can impose is to revoke the optometrist’s certificate of registration.

Defining Professional Misconduct and Incompetence

Professional misconduct is defined as:

• Sexual abuse of a patient
• Acts of professional misconduct defined in the College’s Professional Misconduct Regulation
• Being found guilty of an offence that is relevant to an optometrist’s suitability to practise
• Being found guilty of professional misconduct by a regulatory body outside of Ontario, if the same act would be considered professional misconduct in Ontario
• Failing to cooperate with the Quality Assurance Committee or its assessors.

Incompetence is defined as patient care that displays a lack of knowledge, skill, or judgment. The nature or extent of the optometrist’s actions could show that they are unfit to practise or that their practice should be restricted.

The Discipline Hearing

What is a hearing?

A discipline hearing is a formal process, much like a court of law. It is conducted by a panel composed of three to five members of the Discipline Committee. The panel must include at least two public members of the College Council. The College works with the  Discipline Chairperson to ensure that the members appointed to a panel are free from bias and have no prior knowledge of the allegations (charges) being heard.

Who attends the hearing?

Hearings are open to the public unless there is a public safety issue or other reason why an open hearing would not be in the public interest.

Each panel member must be present through the entire hearing and hear all of the evidence.

The College and the optometrist are the parties to the proceedings. The person who made the original complaint (the complainant) is not a party at the hearing. This is because the College is acting in the broader public interest.

The College is represented by legal counsel (the prosecutor). The optometrist (the defence) can choose either to represent themselves or retain a lawyer (defense counsel). If an optometrist chooses to act as their own defence, they have the same procedural rights as a defence counsel.

The onus of proof is on the prosecution. This means the role of the prosecutor is to present the College’s evidence against the optometrist to the Discipline Committee. 

At least ten days before the hearing, the College must disclose all relevant information from the investigation to the optometrist and their lawyer. This includes:

• Written and documentary evidence that will be introduced
• names of any expert witnesses and summaries of the evidence they will give
• names of any other witnesses who will appear.

The defence is not obliged to share information before the hearing.

What happens at the hearing?

The panel hears the evidence from both sides and determines the facts of the case. The panel then decides:

• Whether the evidence proves the allegations
• Whether the optometrist has engaged in professional misconduct or is incompetent
• What penalty to impose if there is a finding of misconduct or incompetence.

Deciding on a penalty

If the panel finds that there was professional misconduct or incompetence, Section 51 of the Health Professions Procedural Code gives it the power to do any of the following:

• Direct the Registrar to revoke the optometrist’s certificate of registration.
• Direct the Registrar to suspend the optometrist’s certificate of registration.
• Direct the Registrar to impose terms, limitations, or conditions on the optometrist’s certificate of registration for a specified or indefinite period of time.
• Require the optometrist to appear before the panel to be reprimanded for professional misconduct.
• Require the optometrist to pay a fine to the College.
• Require the optometrist to reimburse the College for money it spent on counselling, if the case involved sexual abuse.
• Require the optometrist to pay the College’s legal, investigation, and hearing costs.

Before it decides on a penalty, both the prosecution and the defence have a chance to say what they think the penalty should be and why.

In deciding on the penalty, the panel has to consider three things:

1. The effect of the penalty on the optometrist and its appropriateness (reform, rehabilitation, specific deterrence)
2. The effect of the penalty on future conduct of the profession (general deterrence)
3. The need to show regard and concern for the public interest (punishment)

Written decisions

At the end of the process, the panel will issue a written decision with their reasons.

The College is required to publish a summary of every discipline decision and reasons in the College annual report and on the College website, including the College register.

Appeals

Both the optometrist and the College have the right to appeal the decision to the Divisional Court of Ontario.

Attending a Discipline Hearing

If you would like to attend a discipline hearing, you can do so online.  Contact Coordinator, Investigations and Hearings.  Be sure to review the guidelines for discipline hearings and the rules of procedure.

For more information, call us at 416-479-9295 or email complaints@collegeoptom.on.ca.