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An English Psychiatrist in Ontario

  • J. L. Crammer (a1)
Extract

After 30 years of psychiatry in England I've just had a cold plunge through Canadian psychiatry as a staffman in an Ontario general hospital. Because science is international and a good many British psychiatrists work in Canada I expected clinical practice to be the same: but psychiatry is different on the two sides of the Atlantic. Before my raw, insistent perceptions of these differences fade, as they do so quickly when one adapts to a new life, I will write some of them down. However faulty they form a rough mirror in which we can all examine our own professional faces.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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1 Note that the work of the 10 Ontario mental hospitals is outside this form of health service and governed directly by the Ministry of Health. A licence to practise in the mental hospital service is a licence only for that and does not allow participation in OHIP or in full private practice: the wider and fuller licence is now very difficult for non-Canadians to obtain. On the other hand things differ somewhat in the other Canadian provinces: one needs to find out precisely.

2 Form 14 is a legal document which must be signed by every patient, and countersigned by a witness other than the doctor, authorising disclosure or transmittal to or examination by the named doctor of the clinical record previously compiled. Without this authorisation it is illegal for the hospital doctor to tell the GP what drugs a patient is having on discharge from hospital (or indeed to make any communication to the GP at all), or for a consultant to write back any opinion on an outpatient referred to the GP who has asked for one. Nor will any medical records officer release any hospital case notes to the doctor now endeavouring to treat the patient. The paranoid, the deluded, the demented, manipulators and those who make a good thing out of repeated hospital admissions are only too likely to refuse to sign.

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BJPsych Bulletin
  • ISSN: 0140-0789
  • EISSN: 2514-9954
  • URL: /core/journals/bjpsych-bulletin
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An English Psychiatrist in Ontario

  • J. L. Crammer (a1)
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