A lot more Nova Scotians are complaining about their doctors these days. And according to patient advocates, that’s a good thing.

Want to take an incompetent doctor to task? Ditch the lawsuit and call up the doctors’ regulators instead, say experts.

A growing number of Nova Scotians are doing just that. The College of Physicians and Surgeons of Nova Scotia (CPSNS), the agency that disciplines doctors, fielded almost 45 per cent more complaints last year than they did in 2008. While it’s difficult to verify how much actual medical incidents may be increasing, “what this tells us is that more patients and families are finding their voice,” says Jennifer Rodgers, a patient safety improvement lead at the Canadian Patient Safety Institute. “And in the patient safety world, that’s part of the solution.”

Based on data sent by the College of Physicians and Surgeons of Nova Scotia’s Pattie Lacroix 

A solution, patient advocates hope, that will prevent fatal medical blunders like the biopsy botched by Truro surgeon Martin Dzierzanowski. In 2012, Dzierzanowski removed a patient’s pancreas instead of his gall bladder. The patient later died in a Halifax hospital. Last week, the College wrapped up a two-year investigation of Dzierzanowski and formally reprimanded him for “deficiencies in his practice”. In 2012, he had been banned from performing major surgeries for a year. Now, he is able to practice with certain restrictions, but his surgeries will be audited for the next six months.

Whether or not that’s the punishment the patient’s family would have chosen, the College is still the only body with the power to formally discipline doctors, which is why even some medical malpractice lawyers will tell clients to file a complaint with the College.

Why complain?

Raymond Wagner, a personal injury lawyer in Halifax, says complaints help the College to flag doctors who have chronic problems, something lawsuits can’t do. “We’ve had multiple suits against the same physician and you get to wonder, from our end, how that doctor continues to practice, given the amount of carnage they have caused in terms of unnecessary deaths,” he says.

Listen to Raymond Wagner on why complaints to the College matter 

Pattie LaCroix, communications director at the CPSNS, said in an emailed response that the College “can review material that is in the public domain as one source of information”, meaning that prior lawsuits against a doctor can be taken into account during an investigation.

But usually, the College will only investigate a physician after a patient complaint, says John McKiggan, who also practices personal injury law in Halifax. So even if a doctor has been sued multiple times before, “when finally someone down the road decides to file a complaint, to the college it looks like a first offence.”

Lawyers like McKiggan had heard about Dzierzanowski long before the gall bladder incident. In 2010, Dzieranowski performed surgery on a 91-year-old patient in Pictou named Walter Langille, after a pathologist incorrectly diagnosed Langille with colon cancer. During the surgery, even though Dzierzanowski couldn’t find the cancerous cells, he still removed a large part of Langille’s colon. Langille spent the rest of his life wearing a colostomy bag. On the urging of his family, Langille sued the pathologist and Dzierzanowski. They settled out of court for a modest claim, and Dzierzanowski continued to practice surgery.

Down by law

There are other reasons a lawsuit might not be the best first choice when dealing with medical malpractice. For starters, they’re very hard to win in Canada. According to data from the Canadian Medical Protective Association, the organization that defends doctors in legal cases, in 2013 its member physicians won two and a half times as many court cases as the plaintiffs did.

And, of course, they’re expensive: Wagner says a medical malpractice suit could cost up to $500,000, and these days many lawyers won’t bother with a medical malpractice suit if they don’t expect it to net at least $300,000 in damages.

That may be why there are about half as many lawsuits against Canadian doctors as there were twenty years ago, according to CMPA data. At the same time, physicians across Canada are contacting the CMPA to help with College cases they’re implicated in nearly twice as often as they did a decade ago:

Graph: Canadian Medical Protection Association Annual Report, 2013

Wagner thinks Canadians are becoming less willing to say  “this is God’s will, we just need to suck it up and carry on with our lives,” and more likely to want to hold doctors accountable for their actions. “There’s an element of public protection that goes into it. People do legitimately state on a regular basis, I don’t want this to happen to someone else.”