Illegal practice of medicine
Definition of the Practice of Medicine
Under the terms of the Medical Act, the practice of medicine is defined as follows:
"31. Every act having as its object to diagnose or treat any deficiency in the health of a human being constitutes the practice of medicine.
In the context of the practice of medicine, the activities restricted to the physician are as follows:
1. diagnosing illness;
2. ordering diagnostic examinations;
3. using diagnostic techniques that are invasive or present a risk of harm;
4. determine medical treatment;
5. prescribe medication and other substances;
6. prescribe treatments;
7. use techniques or apply treatments that are invasive or present a risk of harm, esthetic procedures included;
8. monitor clinically the condition of patients whose state of health presents risks;
9. provide follow-up care in pregnancy and attend at confinements;
10. decide on the use of restraint measures. "The medical profession being an exclusive one, only those who hold a permit from the Collège des médecins du Québec may apply such measures. Any treatment, if administered with a view to caring for or healing a patient, is a form of medical practice.
What is the illegal practice of medicine?
There are two ways to infringe upon the Medical Act in matters of the illegal practice of medicine:
- to engage in medical activities without holding a permit from the Collège des médecins du Québec;
- to use the title of "physician", which is a reserved title, or claim to be capable of practising medicine, an exclusive profession.
The Professional Code stipulates that:
"No person shall claim in any manner to be an advocate, notary, physician, dentist, pharmacist, optometrist, veterinary surgeon, agrologist, architect, engineer, land-surveyor, forest engineer, chemist, chartered accountant, radiology technologist, denturologist, dispensing optician, chiropractor, hearing-aid acoustician, podiatrist, nurse, acupuncturist, bailiff, midwife or geologist, or use one of the above titles or any other title or abbreviation which may lead to the belief that he is one, or engage in a professional activity reserved to the members of a professional order, claim to have the right to do so or act in such a way as to lead to the belief that he is authorized to do so, unless he holds a valid, appropriate permit and is entered on the roll of the order empowered to issue the permit, unless it is allowed by law."
One need not go as far as using a title in one form or another to break the law; it is enough to act in a manner that leads to the belief that he or she is authorized to practise medicine. Thus, a person who publishes, claims or attests to having healed a condition of any kind could be breaking the law.
Inquiries into offences linked to the illegal practice of medicine
While the Collège des médecins du Québec is responsible for the application of laws and regulations relative to medicine (regulatory framework), it is up to the tribunals to determine whether an offence was committed and to then impose penalties. To do so, the Collège must present proof of an offence, which it gathers by means of an inquiry. The Inquiries Division does this work, in addition to its mandate to protect the public against the conduct of any person who engages in medical acts by usurping the title of physician or claiming to be competent to practise the medical profession. The entire case is submitted to the Executive Committee of the Collège for approval.
The Inquiries Division also acts preventatively, notably by dissuading persons attempting to practise medicine illegally and by preventing the publication of advertising that would mislead the public.
Information to Agencies and the Media
The Inquiries Division also provides information on "alternative therapies" to all establishments or agencies that request it, including the media.
Sensitizing Potential Clients
In fulfilling its mandate, the Inquiries Division counterbalances the values disseminated by certain groups and the media. Not only does it dissuade the violators, but it also cautions, through sensitization, information and consciousness–raising, potential clients who may be tempted to entrust the care of their health to non-physicians.
The members of the Division also strive to inform the public so that it will avoid situations where its health could be adversely affected. The Division attempts to sensitize the public in two ways:
by ensuring that the information disseminated in the large daily newspapers, in specialty magazines or on the radio is correct and complete;
by creating a reference and documentation centre in response to requests made by public agencies and the media.
When the Inquiries Division receives a complaint, it opens an inquiry and, if need be, starts penal proceedings against the healer or any other violator of the Medical Act or Professional Code.
Whereas in the past, the fines for those who engaged in the illegal practice of medicine were specifically stipulated for a first or second offence and subsequent violations, in the Professional Code, the legislator has left it up to the tribunal to determine the gravity of the offence committed and to fix a scale of penalties
in which the judge may exercise discretion. Thus, the fines provided for in the Professional Code for those who break the law range from $1500 to $20,000 per count.