Premier says he can’t do anything about Labrador gynecologist under investigation

Newfoundland and Labrador’s premier says his hands are tied amid outrage from women in Labrador over an obstetrician-gynecologist’s return to practice while under active investigation following complaints from at least 20 women.

On Sept. 10 The Independent reported that Dr. Adolf Hamann had returned to practice at the Labrador Health Centre in Happy Valley-Goose Bay despite ongoing investigations in the wake of complaints from current and former patients.

“Certainly the government doesn’t make decisions or have authority over physicians,” the premier said in response to a question from The Independent during a Sept. 16 visit to Labrador. Instead, Hogan added, “I would encourage you to speak to the college about any, I guess I would call it, HR issues.”

The premier’s remarks follow several unsuccessful requests by The Independent to speak with provincial Health Minister Krista Lynn Howell, who has still not publicly commented on the situation, which has left some women in Labrador fearful of the care they might receive from Hamann and others without immediate gynecological and obstetrical care.

Both Newfoundland and Labrador Health Services (NLHS) and the College of Physicians and Surgeons of NL (CPSNL) have told The Independent they can’t speak to ongoing investigations. 

Earlier this month Hamann’s lawyer, Robin Cook, told The Independent his client returned to work on Aug. 26 following the conclusion of an investigation by NLHS that was “favourable to Dr. Hamann.” Cook also said there are “no restrictions on his medical license or hospital privileges.”

The doctor’s return surprised women in Labrador, including Sheila Blake, one of Hamann’s former patients who filed complaints with the health authority and CPSNL. Blake’s daughter, Jodie Ashini, told The Independent her mother did not receive any updates on NLHS’s investigation into Hamann before the doctor returned to work. On Wednesday, Blake told The Independent she still has not heard from the health authority.

Patient walks away from appointment

Other women have commented on social media, saying they’ve cancelled, or will be cancelling, appointments with Hamann.

Tracy Martin, an Inuk woman living in Happy Valley-Goose Bay, told The Independent she was recently scheduled to see a gynecologist at the Labrador Health Centre. She sought the appointment after her nurse practitioner told her “a female gynecologist was visiting from out of town,” Martin recalls in a written statement to The Independent, and that “she would do her best to arrange for me to see her as soon as possible.

“A few days later, I received a call from Labrador-Grenfell Health’s booking department confirming a gynecology appointment. Based on my earlier conversation, I assumed that I would be seeing the visiting female specialist,” Martin says. 

On the day of her appointment, she overheard other women in the waiting room talking about Hamann’s return to work. “Concerned, I asked the receptionist if he was the doctor I was scheduled to see, and she confirmed he was,” Martin says. “At that point, I told her I would be refusing the appointment and she directed me to the booking office.”

Martin explains that when she told the booking clerk she didn’t want to see Hamann, the clerk “did not ask for an explanation, nor did she seem surprised!” Martin then contacted a Non-Insured Health Benefits (NIHB) office to ask about their policies in such cases. “They told me that because gynecology services are offered in Goose Bay, I would not be covered to travel to see another OB/GYN,” she said. “From what I remember, the booking clerk told me there won’t be another gynecologist available for the rest of the year. So, I then asked NIHB if this can be appealed based on my time sensitivity for other programs that would need referrals from an OB/GYN and she quoted from their policies that it cannot be appealed.”

Just one OBGYN in Central Labrador

The Independent confirmed with NL Health Services that there is just one obstetrician-gynecologist at the Labrador Health Centre, and that the nearest OBGYNs are in Labrador City and St. Anthony, both of which are hundreds of kilometres away from Happy Valley-Goose Bay, and even farther from patients on Labrador’s north coast who travel to Goose Bay for care.

Jeanette O’Keefe, director of communications for NL Health Services, told The Independent that “if a patient refuses to see an OBGYN at the site closest to them, patients can request that their referring physician submit a referral to a different OBGYN, or be placed back on the waitlist.”

O’Keefe said patients who do not have a primary care provider like a family doctor or nurse practitioner, “or who expect to be without one in the next three months, should register on Patient Connect NL,” a provincial registry that “aims to connect individuals to a family care team or a primary care provider as soon as one becomes available in their area.”

Lela Evans, the MHA for Torngat Mountains, whose constituents fly from Innu and Inuit communities on the coast to Happy Valley-Goose Bay for gynecological and obstetrical care, said earlier this month she’s worried women who refuse to see Hamann may not get the medical care they need.

The situation is “creating a lot of stress and anxiety, and to me it’s unacceptable,” she said, explaining its gravity is compounded by cultural differences since many of Hamann’s patients are Innu or Inuit. “ A lot of times it’s really hard for people to even go and get treatment, or to get diagnosed, just because of the sensitive nature of the conditions,” Evans said. “Especially in Northern Labrador, people are very sensitive about that thing, so they got to have an established trust that the doctor is going to help them, is going to look after them, is going to be respectful, is going to be caring.”

What happens when a patient files a complaint?

Last week, Health and Community Services Director of Communications Brian Scott said in an email to The Independent, “when an allegation and/or complaint of clinical and professional misconduct against a physician is made, there are formal processes under [NLHS’s] Medical Staff Bylaws.

According to the health authority’s bylaws, conduct subject to discipline can include “demeanor or conduct or any one of more act(s), omission(s) or statement(s) […] that if proven would, or would be likely to,” among other things, expose a patient “to harm or injury, including, but not limited to, physical or psychological harm,” or “be detrimental to the safety of a patient,” or “be detrimental to the delivery of quality patient care.”

NLHS’s bylaws also empower the authority’s CEO or VP Medical Services to “immediately modify or suspend” the appointment and/or privileges of a doctor when, in the senior administrators’ opinion, “the conduct, performance or competence of a [Medical Staff member […] exposes, or is likely to expose, one or more patient(s) […] to harm or injury, including but not limited to physical or psychological harm, or is, or is likely to be, detrimental to the delivery of quality patient, client or resident care provided by NL Health Services.” A doctor’s appointment and privileges can also be revoked by the CEO or VP Medical Services when, in their opinion, “immediate action by be taken to protect one or more patient(s) […] or to avoid detriment to the delivery of quality patient, client or resident care.”

In his email to The Independent Brian Scott also said that “NL Health Services works closely with the College of Physicians and Surgeons to maintain patient safety,” and that “all health care professionals and employees of NL Health Services are entitled to privacy under NL Health Services’ Privacy and Confidentiality policy.”

The College of Physicians and Surgeons NL has not publicly commented on the matter, but The Independent reviewed an email from the college to one of Hamann’s former patients—who filed a complaint against the doctor—stating that 19 patients had shared  concerns with them.

In an email to The Independent earlier this month Nikki Street, a communications officer with CPSNL, said the college must follow processes outlined in provincial legislation, and that as a regulator the college is “unable to comment publicly on any physician or complaint in question […] to ensure that any investigation and/or subsequent hearing is conducted in a fair and impartial manner.”

When complaints “move forward to a public hearing or result in a disciplinary settlement,” Street said, the college will “confirm the details on our website.” The public is able to, via the college’s website, see which doctors in the province have been through discipline hearings or have signed settlement agreements. Members of the public can also search the college’s public directory for any doctor in the province to see if they have had any restrictions placed on their license, or if any regulatory actions have been taken against them.

Limited options for patients

NL Health Services told The Independent that patients in need of financial assistance to travel elsewhere for medical care can get support from the province’s Medical Transportation Assistance Program. According to the government website, the program “is the payer of last resort,” and patients “with private health insurance benefits must have their medical travel costs assessed by the private insurance provider before submitting their post-travel” claim. 

If patients face other barriers to accessing care, the health authority said, “patients are encouraged to speak with their care team or reach out to the Patient Relations Office in their zone so we can review and respond appropriately.”

Finally, NLHS said, “in case of an emergency, individuals should go to their nearest Emergency Department or call 911 for an ambulance,” adding “those who are unsure whether they or a loved one should go to the Emergency Department can call 811 to speak with a registered nurse 24 hours, seven days a week.”