Obstetricians win suit against MUHC over birthing centre delivery quotas

Obstetricians win suit against MUHC over birthing centre delivery quotas
Obstetricians win suit against MUHC over birthing centre delivery quotas

File photo ofthe entrance to the Royal Victoria Hospital at the MUHC Glen site. Allen McInnis / Montreal Gazette

The baby delivery quota imposed on a few obstetricians at the specialty birthing centre of the English-language mega-hospital is discriminatory and invalid, Quebec Superior Court has ruled.

The four obstetricians who sued the McGill University Health Centre won their case in a judgment made public last week and were awarded $5,000 each in damages.

The ruling sets an important precedent in Quebec on how hospitals operate, said lawyer Christine Kark, who filed suit in October 2016 on behalf of her clients, Alice Benjamin, Robert Koby, Dawn Johansson and Andrew Mok. The ruling “obliges hospitals to act fairly when they draw up rules,” she said.

The four obstetricians sought an injunction against the quota system imposed in June 2016 because of budget restrictions that called for shrinking the number of deliveries at the Royal Victoria Hospital of the MUHC from about 3,800 to 3,000 per year. 

The doctors argued they were being penalized for looking after their patients because the quota rules applied unevenly to two types of medical practice in obstetrics.

One group of 14 obstetricians works on call or in-house; they have rotating shifts and share each others’ patients, making about 2,400 deliveries each year. They share the quota as a group. 

But not so for the other four doctors who follow their patients individually for about 700 deliveries a year. This group had their quota applied to each individual doctor — at about 14 births a month, or 175 births a year. Three of them got hospital letters threatening to revoke their privileges from the birthing centre for exceeding their individual limit. 

In the lawsuit, the doctors said they were concerned for their patients, “many with high-risk pregnancies, who are forced to experience undue stress when they announce last- minute changes at a critical time to them …” 

The MUHC is reviewing the ruling and conducting an internal analysis to evaluate the next step, officials said in a statement. The MUHC maintained in court documents that an equal number of deliveries was allocated to all physicians.

But in his 13-page ruling, Justice David R. Collier called the quota system discriminatory. The four individual doctors were forced to transfer their patients to another hospital to avoid sanctions, he wrote. “There is no doubt the MUHC’s obstetricians are treated differently and unequally under the rules. The rules granted preferences to the on-call group that are not available to the (other group),” he wrote. “Moreover, by virtue of the shared quota, some of the on-call physicians have been able to perform more than 175 deliveries a year … with impunity.”

Collier ordered the MUHC to pay Kirk’s clients $5,000 each in moral damages as well as expunge their records of sanctions. However, Collier denied the doctors’ request for compensation for lost income as a result of fewer deliveries.

Kirk said her clients were satisfied with the ruling. 

“You can’t have sanctions apply to some doctors and not others,” Kirk said. “They have to make sure they are treating physicians the same, not favouring some to the detriment of others. That’s an important part of the judgment.”

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