If, as a member of the public, you feel your MRT has not treated you in a professional manner, you can do something about it. You can speak with the MRT. You can ask to speak with the MRT's supervisor or with the medical professional who ordered your treatment. Or, you can call the CMRTO to discuss the circumstances surrounding your complaint.
If you feel your complaint should be investigated by the CMRTO, then you must notify the Registrar about the incident in writing as soon as possible, providing details of the incident or incidents. This sets in motion a procedure designed to ensure a fair and thorough investigation of your complaint, and to provide safeguards for you and the MRT. The process includes an investigation by the CMRTO's Inquiries, Complaints & Reports (ICR) Committee and possible referral to the Discipline Committee.
If you have difficulty writing your complaint, we would take a statement, and provide you with an opportunity to view the statement and make corrections.
In your written complaint, please be sure to:
- State that you are making a complaint against the actions of a medical radiation technologist
- Provide the name(s) of the medical radiation technologist(s) involved. (If not known, the CMRTO can assist you in identifying the medical radiation technologist(s)
- State your specific concern and provide:
- the date the incident occurred
- the time the incident occurred
- the exact location where the incident occurred (e.g., name of facility, hospital, room number)
- the patient's name if you are not the patient
- as many details as possible about the incident
- your name, address and telephone number so that an investigator can contact you
If your complaint is not about the actions of a medical radiation technologist, but rather the administrative processes or policies of a facility or a hospital, then your complaint is outside the jurisdiction of the CMRTO.
If your complaint is about administrative processes or policies of a clinic (Independent Health Facility) in Ontario, you can register your concern from the Ministry of Health and Long-Term Care's Independent Health Facilities Program page at http://www.health.gov.on.ca/en/public/programs/ihf/fact_sheets.aspx.
If your complaint is about the collection, use or disclosure of your personal information, you may wish to contact the Privacy Commissioner of Ontario at www.ipc.on.ca.
Investigation of a complaint
The CMRTO's ICR Committee, which is made up of both members of the public and members of the profession, conducts an investigation into all written complaints received by the CMRTO.
The ICR Committee determines what will happen to a complaint. Actions which the ICR Committee may take include:
- Referring a complaint to the Discipline Committee for a hearing
- Referring a complaint to the inquiry panel to investigate suspected incapacity
- Requiring the member to appear before the ICR Committee to be cautioned
- Dismissing the complaint
Common types of complaints
Every year, the CMRTO receives complaints from the public about the behaviour of some MRTs in examination and treatment settings. Sometimes these complaints can be serious enough to warrant action by the CMRTO's Discipline Committee. MRTs must be aware that some of their actions can concern or confuse patients. Yet many of these problems can be avoided by simply explaining to patients what is happening and why. The section below looks at some of the more common complaints received by the CMRTO about MRTs.
Patients become concerned if questions about diagnostic or therapeutic procedures are ignored or answers aren't given clearly or are given in an off-handed, dismissive manner. In fact, patients should be encouraged to ask questions about the procedure they are undergoing. Our profession's Standards of Practice require MRTs to provide clear and understandable information to patients. More information is available about the guidance CMRTO provide MRTS surrounding effective communication between MRTs, patients and their families is outlined in the CMRTO publication, What you must know about ... communicating with patients.
Explaining procedures fully is very important to easing a patient's fears before and during a procedure. Some patients may be afraid to ask questions during the procedure, so they may telephone before or after the procedure. These calls must still be handled with care and sensitivity so that the patient does not feel anxious or angry.
MRTs must also be clear when explaining departmental policy in regard to certain procedures. For example, if the policy in the imaging department is that lead shielding is not applied to the gonadal area for a routine chest x-ray on female patients over the age of 55, it is important that you are able to articulate the basis of the policy to the patient.
Our Standards of Practice outline clearly the need for MRTs to explain procedures to patients. The Standards outline four basic principles:
- Provide clear and understandable information to the patient or patient's substitute decision maker prior to, during and after the diagnostic or therapeutic procedure, using an interpreter if necessary
- Give the patient or patient's substitution decision maker an opportunity to ask questions
- Provide the patient or the patient's substitute decision maker with answers to his or her questions within the scope of MRT responsibility
- Refer questions of the patient or patient's substitute decision maker that are outside the scope of MRT responsibility to an appropriate health professional for answers
Patients are naturally anxious when undergoing an x-ray, nuclear medicine or radiation therapy procedure, especially if repeat exposures or injections are required.
MRTs are responsible to follow the ALARA principle (As Low As Reasonably Achievable) and to use only the minimum amount of radiation necessary during the course of the procedure. MRTs always use the lowest dosage possible for the particular procedure being performed. Under the professional misconduct regulation made under the Medical Radiation Technology Act, (MRT Act), carelessly, negligently or unskillfully using ionizing radiation is defined as an act of professional misconduct.
In addition, MRTs must not apply or administer ionizing radiation or radiopharmaceuticals unless the conditions under the applicable legislation (including without limitation, the Healing Arts Radiation Protection Act (RHPA) and its regulations and the Nuclear Safety and Control Act, its regulations and licences issued thereunder) have been met.
Physical or Verbal Abuse
Complaints to the CMRTO of physical abuse are sometimes made after pediatric or geriatric procedures, where restraint has been required. Many of the procedures we perform are uncomfortable for patients. While it is our responsibility as MRTs to obtain the best possible images or to provide an accurate radiation treatment, it is essential that we are also sensitive to a patient's discomfort and aware of a patient's rights. For example, not only is a patient entitled to be advised of all aspects of a procedure, but he or she can also refuse to have the examination or treatment.
Verbal abuse complaints often occur after a breakdown in communication between a patient and the MRT. It is true that because of sickness or age, our patients may not always be easy to work with; but as professionals we can't let this distract us from treating all patients with dignity and respect at all times.
Complaints of sexual abuse are reported to the CMRTO by patients or by another health professional who has reasonable grounds to believe that a member is sexually abusing a patient. The CMRTO has adopted a policy of zero tolerance in cases such as these, and all complaints are investigated thoroughly. This process is outlined in the CMRTO publication, What you must know about ... Sexual Abuse. MRTs must touch patients only in those areas needed to facilitate carrying out the procedure, and it must be explained clearly to patients when and why we need to touch them.
The CMRTO has also received complaints with regards to the performance of authorized acts. As an MRT, you are authorized to perform five of the 13 controlled acts as listed in the RHPA:
- Administering substances by injection or inhalation.
- Tracheal suctioning of a tracheostomy.
- Administering contrast media, or putting an instrument, hand or finger,
- Beyond the opening of the urethra,
- Beyond the labia majora,
- Beyond the anal verge, or
- Into an artificial opening of the body.
- Performing a procedure on tissue below the dermis.
- Applying a prescribed form of energy.
Note - performing a procedure on tissue below the dermis includes such procedures as: inserting a needle or angiocath for administering substances by injection, taking blood samples from veins and tattooing for marking treatment areas for radiation therapy.
Before performing authorized acts, it is critical that MRT's have the requisite knowledge, skill and judgment, that the proper documentation from the authorizing physician (or, in the case of the application of electromagnetism for magnetic resonance imaging procedures, the order may also be from another authorized health professional) has been prepared, and that the situational factors are adequate to perform the procedure safely and effectively.
Confidentiality and Privacy
The CMRTO's Standards of Practice requires MRTs to understand how and act to protect the confidentiality of all professionally acquired information about patients and the privacy of patients with respect to that information, while facilitating the effective delivery of health care. MRTs must keep all information confidential except when necessary to facilitate diagnosis or treatment of the patient, or when legally obliged or allowed to disclose such information.
Standards of Practice
The CMRTO's Standards of Practice set out minimum standards of professional practice and conduct for MRTs and assist MRTs in understanding the CMRTO's expectations with respect to the professional practice. The Standards of Practice are used by the CMRTO in determining whether MRTs have maintained appropriate standards of practice and conduct. MRTs are reminded that the CMRTO's Standards of Practice contain the essential information you need to provide safe, effective and ethical medical radiation technology services to your patients.