College of Dietitians of British ColumbiaCollege of Dietitians of British Columbia

What every Dietitian should know What every Dietitian should know about the Complaint Processabout the Complaint Process

Mélanie Journoud, CDBC Practice Advisor and InvestigatorMélanie Journoud, CDBC Practice Advisor and Investigator

October 23, 2009October 23, 2009

CDBC mandate Complaint process Investigation Resolution options Discipline Health Professions Review Board Referrals and publication FOIPPA

TopicsTopics

CDBC MandateCDBC Mandate

… it is the duty of the College at all times to:serve and protect the public, andexercise its powers and discharge its responsibilities… in the public interest.

Mandated objectives include…(d) to establish, monitor and enforce standards of

practice to enhance the quality of practice and reduce incompetent, impaired or unethical practice amongst registrants.

Receiving ComplaintsReceiving Complaints

Who? Public Dietitians Other professionals Media Lawyer

Receiving ComplaintsReceiving Complaints

In writing & signed

Complainant name and contact

Dietitian name and work info

Complaint details

Determines jurisdiction & legal sufficiency

Complaint ProcessComplaint Process

Types of ComplaintsTypes of Complaints

for Weight for Weight LossLoss

RD

Hazelnut Wright

Complaint ProcessComplaint ProcessDear Mrs. Watt:

I phoned the College of Dietitians of BC yesterday to complain about the conduct of Nancy Dietitian, Nutrition Consultant, who is a registrant of the College. I was told that I need to send my complaint to you, Head of the Inquiry Committee, in writing.

I weigh just over 300 pounds and have tried many diets. It has been a life-long frustration for me that none of the diets worked. I started seeing Nancy in August 2008 for help losing weight. She had just opened a dietetic office called HealthWorks near where I live and as well as advertising herself as a weight control specialist. There are before and after photos in her office window of people who have lost amazing amounts of weight following her program.

I made an appointment to see her and Nancy analyzed my diet. She told me that I needed to lose at least 100 pounds and then gave me a generic diet plan that was low in calories, carbohydrates and fat, and also included 6 cans a day of Lose-A-Lot, a lemon flavoured diet drink that she sells.

Nancy told me that if I followed her plan, I would lose 40 pounds over the next four months and another 60 pounds in the following six months. She also said that if I followed her maintenance diet after that, which includes 3 cans of Lose-A-Lot a day, I wouldn’t gain any weight back. I was to see her once every two weeks for a fee of $75 per visit. Lose-A-Lot costs $20 for a dozen cans. The initial consultation visit fee was $250.

I met with Nancy every two weeks and she reviewed my diet records. I followed the diet strictly for 3 months and lost about 20 pounds, gained 5 pounds back over Christmas, started again in January and lost another 10 pounds by the end of February. I have been doing what she said and have spent a lot of money on the cans and visits but just can’t lose any more weight. I complained to Nancy several times that her diet wasn’t working and she said that I must not be following it.

It is now April 2009. I have spent over $3500 dollars over the last seven months and have lost 25 pounds. I do not think Lose-A-Lot works and question Nancy’s abilities as a Nutrition Consultant. I think she took advantage of my strong desire to lose weight and lied to me about how much weight I could lose.I would like to see her license taken away so that she can’t take advantage of any other overweight people. I would also like to have my money refunded.

Yours truly,Sarah Farewell

DecisionDecision

Registrar communicates with: Complainant RD Investigators

InvestigationInvestigation

Investigators’ work plan – Analysis

1. Receipt of letter of complaint What are the allegations?

1. Misleading marketing

2. Use of specialist and misleading title

3. Services not based on evidence-based practice

InvestigationInvestigation

Investigators’ work plan – Analysis

Which Act, Regulation or Bylaw may have been violated?

1.CDBC Bylaw, s.75 (2)(c), 3(a) and (b) Marketing

2.Bylaw Sch. A - Code of Ethics, Prin. 1-4

3.Bylaw Sch. B - Standards of Practice, 3:1 and 3:3

InvestigationInvestigation

Investigators’ work plan – Planning

Draft investigation plan and send to IC for approval

• Who: Sarah Farewell, Nancy Dietitian

• What: CDBC Bylaw 75, Code of Ethics, Stds of Practice

• Where: Nancy Dietitian’s office

• When: April 2007 to April 2009

• Why/how: Need to find evidence of allegations via testimonies, observation of RD office, Lose-a-lot, records

InvestigationInvestigation

Investigators’ work plan – Planning Draft investigation plan and send to IC for

approval• Do we need experts? Lose-a-lot analysis• What type of interview? Phone, in-person• Prepare interview outline• Taking notes versus recording interviews?• Handling of records for copying, timely return to

owner• Follow-up with all parties

InvestigationInvestigation

Lose-a-lot

InvestigationInvestigation

HeresayStds of Practice

Integrity

Code of Ethics

Notes Facts & Objectivity

Good rapport

Resolution OptionsResolution Options

Resolution OptionsResolution Options

No action and dismissalMediationConsent orderDiscipline

DisciplineDiscipline

Complaint is serious No consent agreement negotiated Similar to court proceedings Managed by lawyers: CDBC and

complainant Open to public

ReportsReports

Notification to complainant and RDReports to:

CDBC BoardRegistrantsPublic

If serious, matter and RD name must be published on College website

Health Professions Review BoardHealth Professions Review Board

Since 2008, BC Government May review College decisions

• inability of IC to resolve complaints or complete investigation within 120 days

• Review case dismissal/ consent order decision at complainant’s request

www.hprb.gov.bc.ca

Referrals & PublicationReferrals & Publication

Referrals: Criminal/ civil complaints referred to police Other regulatory organizations

Publication: Complaint information only published after

final IC decision Complainant timeline to appeal to HPRB

passed

FOIPPAFOIPPA

Decision retentionRecord safety Investigation recordsResignation/ reinstatement following

inquiry or discipline process

Thank You!Thank You!

Questions?

www.collegeofdietitiansbc.org

Phone: 604.736.2016

Toll free in BC: 1.877.736.2016