1. College of Dietitians of British Columbia What every Dietitian should know about the Complaint Process Mélanie Journoud, CDBC Practice Advisor and Investigator October 23, 2009

2. CDBC mandate Complaint process Investigation Resolution options Discipline Health Professions Review Board Referrals and publication FOIPPA Topics

3. CDBC Mandate … it is the duty of the College at all times to: serve and protect the public, and exercise its powers and discharge its responsibilities… in the public interest. Mandated objectives include… (d) to establish, monitor and enforce standards of practice to enhance the quality of practice and reduce incompetent, impaired or unethical practice amongst registrants.

4. Receiving Complaints Who? Public Dietitians Other professionals Media Lawyer

5. Receiving Complaints In writing & signed Complainant name and contact Dietitian name and work info Complaint details Determines jurisdiction & legal sufficiency

6. Complaint Process

7. Types of Complaints for Weight Loss RD Hazelnut Wright

8. Complaint Process Dear Mrs. Watt: I phoned the College of Dietitians of BC yesterday to complain about the conduct of Nancy Dietitian, Nutrition Consultant, who is a registrant of the College. I was told that I need to send my complaint to you, Head of the Inquiry Committee, in writing. I weigh just over 300 pounds and have tried many diets. It has been a life- long frustration for me that none of the diets worked. I started seeing Nancy in August 2008 for help losing weight. She had just opened a dietetic office called HealthWorks near where I live and as well as advertising herself as a weight control specialist. There are before and after photos in her office window of people who have lost amazing amounts of weight following her program. I made an appointment to see her and Nancy analyzed my diet. She told me that I needed to lose at least 100 pounds and then gave me a generic diet plan that was low in calories, carbohydrates and fat, and also included 6 cans a day of Lose-A-Lot, a lemon flavoured diet drink that she sells.

9. Nancy told me that if I followed her plan, I would lose 40 pounds over the next four months and another 60 pounds in the following six months. She also said that if I followed her maintenance diet after that, which includes 3 cans of Lose- A-Lot a day, I wouldnt gain any weight back. I was to see her once every two weeks for a fee of $75 per visit. Lose-A-Lot costs $20 for a dozen cans. The initial consultation visit fee was $250. I met with Nancy every two weeks and she reviewed my diet records. I followed the diet strictly for 3 months and lost about 20 pounds, gained 5 pounds back over Christmas, started again in January and lost another 10 pounds by the end of February. I have been doing what she said and have spent a lot of money on the cans and visits but just cant lose any more weight. I complained to Nancy several times that her diet wasnt working and she said that I must not be following it. It is now April 2009. I have spent over $3500 dollars over the last seven months and have lost 25 pounds. I do not think Lose-A-Lot works and question Nancys abilities as a Nutrition Consultant. I think she took advantage of my strong desire to lose weight and lied to me about how much weight I could lose. I would like to see her license taken away so that she cant take advantage of any other overweight people. I would also like to have my money refunded. Yours truly, Sarah Farewell

10. Decision Registrar communicates with: Complainant RD Investigators

11. Investigation Investigators work plan – Analysis 1.Receipt of letter of complaint What are the allegations? 1.Misleading marketing 2.Use of specialist and misleading title 3.Services not based on evidence-based practice

12. Investigation Investigators work plan – Analysis Which Act, Regulation or Bylaw may have been violated? 1.CDBC Bylaw, s.75 (2)(c), 3(a) and (b) Marketing 2.Bylaw Sch. A - Code of Ethics, Prin. 1-4 3.Bylaw Sch. B - Standards of Practice, 3:1 and 3:3

13. Investigation Investigators work plan – Planning Draft investigation plan and send to IC for approval Who: Sarah Farewell, Nancy Dietitian What: CDBC Bylaw 75, Code of Ethics, Stds of Practice Where: Nancy Dietitians office When: April 2007 to April 2009 Why/how: Need to find evidence of allegations via testimonies, observation of RD office, Lose-a-lot, records

14. Investigation Investigators work plan – Planning Draft investigation plan and send to IC for approval Do we need experts? Lose-a-lot analysis What type of interview? Phone, in-person Prepare interview outline Taking notes versus recording interviews? Handling of records for copying, timely return to owner Follow-up with all parties

15. Investigation Lose-a-lot

16. Investigation Heresay Stds of Practice Integrity Code of Ethics Notes Facts & Objectivity Good rapport

17. Resolution Options

18. No action and dismissal Mediation Consent order Discipline

19. Discipline Complaint is serious No consent agreement negotiated Similar to court proceedings Managed by lawyers: CDBC and complainant Open to public

20. Reports Notification to complainant and RD Reports to: CDBC Board Registrants Public If serious, matter and RD name must be published on College website

21. Health Professions Review Board Since 2008, BC Government May review College decisions inability of IC to resolve complaints or complete investigation within 120 days Review case dismissal/ consent order decision at complainants request www.hprb.gov.bc.ca

22. Referrals & Publication Referrals: Criminal/ civil complaints referred to police Other regulatory organizations Publication: Complaint information only published after final IC decision Complainant timeline to appeal to HPRB passed

23. FOIPPA Decision retention Record safety Investigation records Resignation/ reinstatement following inquiry or discipline process

24. Thank You! Questions? www.collegeofdietitiansbc.org Phone: 604.736.2016 Toll free in BC: 1.877.736.2016