A physician holding a “Border Area License” allowing him to work in both the United States and Canada was suspended by the College of Physicians and Surgeons of New Brunswick for allegedly prescribing to patients that were not attended by him. Rather than replying directly to the College, the physician sought a judicial review of the College’s decision to suspend. In reviewing the College decision, the court concluded that in urgent circumstances the College has the jurisdiction to effect an immediate suspension of a physician’s license. The court held that the College should be given a great deal of deference in determining which circumstances constitute “an urgent matter requiring immediate action” and that their decision to suspend was reasonable. The application for judicial review was dismissed.

Administrative law – Physicians and surgeons – Disciplinary proceedings – Jurisdiction – Fairness – Suspensions – Judicial review application – Breach of procedural fairness – Standard of review – Reasonableness

Loiselle v. College of Physicians and Surgeons of New Brunswick, [2003] N.B.J. No. 111, New Brunswick Court of Queen’s Bench, March 12, 2003, Garnett J.

Loiselle was a physician who was licensed to practice in the State of Maine. He had what is known as a “Border Area License” issued by the College of Physicians and Surgeons of New Brunswick. The Registrar of the College of the Manitoba Pharmaceutical Association received a letter of complaint stating that Dr. Loiselle had been prescribing to patients not attended by him. On the same day, the Executive Committee of the College met by conference call and the Registrar provided the members with a copy of the complaint. The Committee decided that the potential risks to the public of misdirected or inappropriate prescribing was so great as to require immediate action. The Committee suspended Loiselle’s Border Area License and referred the matter to the Complaints and Registration Committee. On the same day, the College wrote to Dr. Loiselle to advise him of his suspension. Two weeks later, a lawyer in Winnipeg wrote to the College informing them that Loiselle was asking for an extension of 10 days within which to respond to the allegations. One week later, the matter was considered by the Complaints and Registration Committee. The Committee decided to await a response before taking any further action. Three weeks later, the matter returned to the Complaints Committee. No formal response had been received and the Committee decided to take no further action. In the meantime, Dr. Loiselle had filed an application for judicial review. Loiselle submitted that the decision of the College to suspend him should be quashed on the grounds that (1) the information, documents or evidence acted on by the College were obtained outside of the procedures under the Medical Act and did not constitute a valid complaint, (2) that the College lacked the jurisdiction to effect an immediate suspension of his licence, (3) that the College erred in law and thereby acted without jurisdiction in concluding that the circumstances constituted “an urgent matter requiring immediate action”, and (4) that the College failed to observe the principles of natural justice and procedural fairness by not providing him with prior notice and an opportunity to be heard before suspending his licence.

In deciding to dismiss the Application, the New Brunswick Court of Queens Bench held that the complaint was sufficiently clear so that the person complained about would know what conduct was objected to. Loiselle was accused of writing prescriptions for patients whom he had not seen. Loiselle knew precisely what the conduct was that was complained of and therefore the letter was a “complaint” within the meaning of the Medical Act. In response to the second ground of appeal, the court held that section 56.1 of the Medical Act, S.N.B. 1981 C-87 confers the Executive Committee of the College the power to suspend a member’s licence under certain circumstances. Section 56.1(1) states:

Council or the Executive Committee may direct the Registrar to suspend or impose conditions or limitations on a member’s licence if it is of the opinion that a complaint involving the member requires immediate action.

The court held that the Executive reasonably concluded that these were circumstances which required immediate action. In responding to the third issue, the court noted that the applicable standard of review was that of reasonableness. The decision of the Executive should not be interfered with by the court unless it is patently unreasonable. The court held that the Executive’s decision was based on information received from another professional body and that it was reasonable to rely upon this information. The court held that the power to immediately suspend” a member’s licence is granted to the Executive by the Act and that in suspending the members licence the Executive had complied with the procedural requirements set out in the Act. Loiselles’s application failed on each ground and was dismissed.

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