The College

Summary

The Oath: Episode - "The College"

Introduction

In the fifth episode of The Oath, titled "The College," TVO delves into the intricate and often opaque processes of the College of Physicians and Surgeons of Ontario (CPSO). This episode scrutinizes how the CPSO handles complaints, particularly those involving serious allegations like sexual abuse and conversion therapy, through the lens of Dr. Melvin Iscove's case.

Background on Dr. Melvin Iscove

Dr. Melvin Iscove, a psychiatrist whose medical license was revoked in 2018, stands at the center of this investigation. Accused of sexually abusing two patients, Iscove's case initially appeared straightforward. However, as journalist Krysia Collyer and co-producer Brennan Lefler began their inquiry, deeper and more troubling layers emerged.

Investigations and CPSO's Handling of Complaints

The episode highlights significant concerns regarding the CPSO's transparency and efficacy in handling serious misconduct allegations. Christian Collier, the host, narrates how Iscove was questioned about his adherence to outdated and discredited methods of conversion therapy during his hearing:

"If someone doing conversion therapy in 2002, they would not have been able to find good evidence-based publications on its efficacy." (01:02)

Despite the CPSO's commitment to evidence-based care, the regulator deemed Iscove's practices not a violation of current standards, raising questions about their assessment criteria.

Insights from Former CPSO Investigator Paul Lobsinger

Brennan Lefler interviews Paul Lobsinger, a retired police officer and former CPSO investigator, who provides an insider's perspective on the investigation process:

"Izcov was an adherent of a psychoanalyst from, like, the 50s named Burglar. Do you remember anything about that?" (03:06)

Lobsinger expresses skepticism about the CPSO's handling of cases involving outdated and harmful practices, emphasizing the need for rigorous accountability.

Challenges in Obtaining Information

A significant portion of the episode focuses on the difficulties Collyer and Lefler face in accessing detailed information from the CPSO. Multiple attempts to request comprehensive data and interviews are met with vague responses and references to confidentiality:

"They have different data retention schedules for different kinds of documents. What are those different data retention schedules? The answer? You guessed it. That's confidential." (12:24)

This lack of transparency hinders the ability to fully understand and assess the CPSO's actions regarding misconduct allegations.

Contextualizing with the Dr. Brian Thicke Case

To illustrate ongoing issues within the CPSO, the episode recounts the high-profile case of Dr. Brian Thicke. Initially dismissed by the CPSO, multiple complaints eventually led to Thicke pleading no contest to misconduct charges. This case underscores the CPSO's struggles with timely and effective responses to serious allegations.

"The review board released its findings to the public. And that's how it came out that the CPSO was aware of at least one other complaint against Thicke stemming from an incident in 1994." (14:05)

Patient X's Experience

Patient X, one of Iscove's accusers, shares his harrowing experience of coming forward:

"Uncomfortable. Wasn't something I really wanted to do. I was very adamant about not speaking about it for a long time. I was embarrassed and ashamed..." (06:39)

He praises the CPSO for being professional and supportive despite his initial reluctance, highlighting a more positive aspect of the regulatory body's response.

Ongoing Issues and Calls for Accountability

The episode concludes by emphasizing the persistent lack of transparency within the CPSO and the broader need for systemic reforms. Dr. Gayle Robinson criticizes the CPSO for not outright condemning conversion therapy, reflecting on the missed opportunity to take a strong stand against harmful practices:

"I think that that was really a voice avoiding an important issue and not being willing to just come right out and say no." (18:58)

Furthermore, the episode teases the continued investigation into Iscove's case, including undisclosed complaints and the mysterious withdrawal of a hearing notice.

Conclusion

"The College" paints a comprehensive and critical picture of the CPSO's handling of serious misconduct allegations, using Dr. Melvin Iscove's case as a focal point. Through interviews, documented evidence, and personal testimonies, TVO highlights significant gaps in transparency and accountability within Ontario's medical regulatory framework. As the investigation unfolds, the episode underscores the urgent need for reforms to ensure patient safety and trust in medical professionals.

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Notable Quotes with Timestamps:

• Dr. Gayle Robinson: "You're either sick or sinful. Those were the messages absorbed by generations of people." (00:27)

• Paul Lobsinger: "Izcov was an adherent of a psychoanalyst from, like, the 50s named Burglar." (03:06)

• Patient X: "I didn't actually make that decision to come forward right away. I was still quite hesitant..." (05:37)

• Paul Hart (Malpractice Lawyer): "The reality is no one's gone to court to really flesh out what that legislation permits." (10:16)

• Dr. Gayle Robinson: "Any kind of therapy which says that it's trying to change your sexual orientation as opposed to make you comfortable with your sexual orientation, is a form of conversion therapy." (17:51)

• Paul Lobsinger: "You've got this public hearing announcement and then you can't figure out whatever happened." (21:53)

Timestamps Reference:

• 00:27
• 00:43
• 01:02
• 03:06
• 05:37
• 10:16
• 12:24
• 14:05
• 17:51
• 18:58
• 21:53

Note: Click on the timestamps to reference specific moments in the episode.

Transcript

[Christian Collier]

You are listening. You're listening.

[Brennan Lefler]

You are listening.

[Christian Collier]

You're listening to a TVO Today with TVO Today. TVO Today podcast, A listener note. The following podcast contains sexual language, descriptions of violence and sensitive themes which may not be suitable for younger audiences. Listener discretion is advised. Previously on the Oath.

[Dr. Gayle Robinson]

You're either sick or sinful. Those were the messages absorbed by generations of people. And that's what led to these clinical forms of conversion therapy and then these religious or spiritual forms of conversion therapy that you could be fixed.

[Paul Lobsinger]

So any messages or pressures to suppress, deny and change your identity, whether it's sexual or gender or both or expression, is considered a conversion practice.

[Christian Collier]

I guess the question is how long should practitioners have known this is not a credible theory.

[Dr. Gayle Robinson]

If somebody doing conversion therapy in 2002, they would not have been able to find good evidence based publications on its efficacy.

[Christian Collier]

So in relation to conversion therapy, just because it became banned in 2015 doesn't absolve you from using it prior to that? No. If you have ever watched Law and Order, you know, when they get to the court scene, the prosecutor strategically unveils their case. That's sort of like what happened at Dr. Melvin Izcove's hearing. The lawyer representing the College of Physicians and Surgeons of Ontario, the CPSO, peppered him with questions about Dr. Edmund Burglar and homosexuality. At one point, Dr. Izcove was asked if he told one of the complainants that homosexuality could be cured. Izcov answered, yes. I would have told him that there was a chance for changing this condition if he wanted to try. But even if members of the discipline committee thought that was wrong, they couldn't have done anything about it. You see, the college is the one that decides what the allegations should be. And it had already determined the case wasn't about a standard of practice violation, meaning it wasn't saying the doctor failed to comply with current guidelines. That's the part that puzzles us, because by its own standards, the medical regulator makes a commitment to ensuring that physicians adhere to evidence based care. And it seems like the college was aware of isco's clinical practices during its investigation. We believe that because producer Brennan Lefler tracked down a former CPSO investigator named Paul Lobsinger.

[Paul Lobsinger]

You were involved with the Melvin Newscoast. You were investigator on that case?

[Brennan Lefler]

I was involved with Dr. Iscove, yes.

[Christian Collier]

Lobsinger is a retired cop. He says he worked for the college for about five and a half years. It's been a really long time since he looked into the complaints against Iscov. Turns out what he learned still sticks out in his mind.

[Paul Lobsinger]

Izcov was an adherent of a psychoanalyst from, like, the 50s named burglar. Do you remember anything about that?

[Brennan Lefler]

I remember he was a guy who followed a guy named Burglar's methods or beliefs when it came to the way he treated certain patients as just a normal person. I thought Burglar was a nut. I thought he was crazy. I thought it was total craziness.

[Paul Lobsinger]

Did it strike you as strange that that was coming up in the mid-2010s when you're investigating this?

[Brennan Lefler]

The fact there's still people who believe that it's not strange. It's crazy. It really is.

[Christian Collier]

So in today's episode, we're going to focus on the cpso, its record of transparency, and how it deals with complaints, because the college never really drew a clear line in the sand on how Iscov used Burglar's methods in his practice, especially when it came to certain sexual orientations. And it isn't saying why. For TVO today, this is the Oath. I'm Christian Collier. This is episode five, the College. For months, we have been going over all the Iscov documents again, looking for anything we may have missed. One exhibit that stood out to us was an application for funding that's meant to cover therapy for patients who allege they have been sexually abused by a doctor. It's part of the CPSO process. What got our attention was. Was a date. It says the person reported the sexual abuse to someone at the college in 2014. That's about a year and a half before the CPSO's notice of hearing, where all the allegations were spelled out. Most of the information on the document is redacted, but there is some handwriting, so I asked patient X if it looked familiar for accuracy. I wanted to see if this was you. It's basically all redacted, but. But does that look like you're writing, oh, yeah. Okay.

[Patient X]

That must be around the time that I reported it to the college.

[Christian Collier]

It's been a while since we heard from patient X, so let me reintroduce you. He was a patient of Izco's for about two decades. He is one of the men who came forward with accusations of sexual abuse.

[Patient X]

I didn't actually make that decision to come forward right away. I was still quite hesitant because I didn't want to go on the record. I didn't want to uncover and unbury all of the skeletons.

[Christian Collier]

For years after patient X stopped therapy with IZCOV he says he kept the alleged abuse to himself. Then, according to the discipline committee's decision, he told a new psychiatrist he was seeing this. Psychiatrist, by law, had to report it to the cpso, which caused patient X a lot of distress.

[Patient X]

I would only be willing to talk to the college if there were other complaints. And in fact, there was another complainant. And I said, yeah, now that I know there's a second person, I would feel badly if this were an ongoing thing with other patients.

[Christian Collier]

What was the process like for you?

[Patient X]

Uncomfortable. Wasn't something I really wanted to do. I was very adamant about not speaking about it for a long time. I was embarrassed and ashamed, and I was fearful that certain people would find out and judge me or I think I was an idiot for not seeing through it or protecting myself or whatever. Reporting him earlier, I went into the college and had an interview with the investigator, and they documented everything.

[Christian Collier]

I'm basically telling you the investigator he spoke to was Lobsinger. It's confirmed on the form I'm holding. Brennan met him at a busy coffee shop about an hour and a half south of Toronto. That's the lunchtime rush. You can hear in the background, so the next bit of tape is going to be a little bit noisy.

[Paul Lobsinger]

So how many complaints did you investigate?

[Brennan Lefler]

I couldn't tell you.

[Paul Lobsinger]

You're talking about hundreds, thousands.

[Brennan Lefler]

In the hundreds.

[Paul Lobsinger]

Okay.

[Christian Collier]

Lobsinger has a friendly, easygoing manner. He worked for the Toronto Police service for almost 31 years. He was part of different specialty units, including the sexual assault school. After retiring in 2011, Lobsinger says he was immediately snapped up by the CPSO.

[Paul Lobsinger]

So when you get a complaint and you start investigating, can you take me through how that works?

[Brennan Lefler]

In many cases, the process was different than policing in that you would notify the physician that you had a complaint, that it involves this patient, that it involves records. You get a response back, either from the physician or from the physician. Through counsel, through a lawyer.

[Christian Collier]

The college gets a lot of complaints. From 2020 through 2024, it received an average of 3,866 new ones a year. Many are relatively minor, but some can be much more serious, like what the CPSO calls sexual impropriety or boundary violations. This is where experienced investigators like Lopsinger are really important.

[Paul Lobsinger]

When you finish your investigation, what happens then?

[Brennan Lefler]

Our report does not make any recommendation. Our report is simply, this is what we found. This is who we talk to. This is what we gathered, and they make that decision.

[Christian Collier]

They refers to the cpso. See, the college has A committee called the Inquiries, Complaints, and Reports Committee that decides what allegations to make. Brennan asked Lobsinger about the Izkov case, and he wasn't willing to talk specifically about the evidence he gathered. But when asked if he spoke with Izkov and his accusers, Lobsinger confirmed he did. I have to tell you, there's a big difference between the candid conversation we had with Lobsinger and what we got from the cpso. It's like night and day. When I started looking into Izco's history, I contacted the college. I asked if there had been any other complaints against him. The media department responded, quote, due to confidentiality restrictions outlined in section 36 of the Regulated Health Professions Act 1991, we cannot disclose any further information. So I simplified my request and asked for just numbers. The response was essentially the same.

[Paul Hart]

I believe the wording of that regulation is vague, and I do believe that they could release information, for example, about the number of complaints a doctor has had.

[Christian Collier]

Malpractice lawyer Paul Hart says from his perspective, the CPSO has a tendency to leave questions unanswered. He says the medical regulator often claims it can't release certain information, but he believes it does have some discretion.

[Paul Hart]

The reality is no one's gone to court to really flesh out what that legislation permits. And a college acting in the public interest, in my view, would be going to court and attempting to release more information, not less.

[Christian Collier]

We decided to try again. This time, Brennan emailed the college. One of the things he asked for was annual statistics of sexual abuse complaints going back to 1980. Right now, the CPSO publishes complaint data in its annual report. The last 10 years are on its website. So we both thought there wouldn't be an issue. We were wrong. Hello.

[Paul Lobsinger]

Hey.

[Christian Collier]

Did they cite confidentiality?

[Paul Lobsinger]

No. So I'll just read it to you.

[Christian Collier]

Yeah.

[Paul Lobsinger]

So she says, hello, Brennan. Thank you for your patience. CPSO's archive of annual reports is limited to what is available on our website in accordance with our data retention policy, which is 10 years.

[Christian Collier]

That sounds like they are wiping things after 10. Well, everything after 10 years. Because if you're saying data, that's a pretty broad term.

[Paul Lobsinger]

Surely they didn't create a data retention policy to destroy every single piece of paper in their archives prior to 10 years ago?

[Christian Collier]

Yeah, I think we just need to know more, because at face value, it's too broad and it's all encompassing, and it may or may not be their true intention of what they're saying. We hoped it was a misunderstanding, so we asked for clarification, the answer, There are different data retention schedules for different kinds of documents. What are those different data retention schedules? The answer? You guessed it. That's confidential.

[Paul Hart]

You have questions that do not have answers and that are never going to be answered. In our current system, there needs to be an overhaul. This is not a tweakable situation.

[Christian Collier]

Over the years, the college has been criticized about how it has handled sexual abuse complaints. There have been three task forces about that issue. The first, in 1991, was commissioned by the CPSO to review its own practices. The other two were initiated by government. They focused on sexual abuse in all health professions. The CPSO was mentioned in those, too. Dr. Gayle Robinson, remember her from episode one? Well, she has been heavily involved in efforts to reform the system for what feels like forever. She was even a key advisor on the first task force, which traveled around speaking to patients.

[Dr. Gayle Robinson]

The patients were either unwilling to come forward, thinking that nobody would listen to them, or if they did come forward. Generally, the college would ask the doctor if he or she had abused the patient. The doctor would say no, and so they dismiss the complaint.

[Christian Collier]

Since then, there have been some improvements. For example, in 1993, the province updated the rules. One big change was a zero tolerance approach to sexual abuse. Any doctor caught doing it would automatically lose their license. It was a major victory.

[Dr. Gayle Robinson]

It was brilliant. And they were really sticking to that idea that if you erred, you lost your license and you had to really prove why you should get it back.

[Christian Collier]

But high profile cases have continued to pop up. Just look at the story of Dr. Brian Thicke. Global News covered the case in 2019. Longtime Brampton doctor Brian Thicke leads a disciplinary hearing after pleading no contest to misconduct charges. It started with one patient. She filed a complaint in 2015 accusing Dr. Thicke of groping her during an unnecessary breast exam. The CPSO originally decided it didn't merit a hearing. The college didn't release its reasons to the public because it says the law doesn't allow it to. But after the complaint was dismissed, the woman who made it turned to Ontario's Health Professions Appeal and Review Board. The review board found the CPSO's investigation was adequate. But it said based on the evidence, the decision to take no action was unreasonable and ordered the college to reconsider. The review board released its findings to the public. And that's how it came out that the CPSO was aware of at least one other complaint against Thicke stemming from an incident in 1994. It was also dismissed. Eventually, Thicke was accused by 15 women of things like conducting breast exams without warning or consent. The complainant who started it all spoke to Global. I came forward and so many other people came forward and the college didn't hear us. Ultimately, the CPSO did order a hearing. In October of 2019, Thicke pleaded no contest to two of the four allegations against him. By that point, the 90 year old doctor's medical license had already expired. He agreed not to apply to get it back. We reached out to the CPSO about Dr. Thicke. In an email, a spokesperson said the CPSO takes its responsibility to protect patients and allegations of professional misconduct, including sexual abuse, extremely seriously. The college said it is committed to continuous improvement and it has implemented a series of reforms over the years to how it responds to complaints.

[Paul Lobsinger]

Who is ensuring that the CPSO is accountable to the public and transparent?

[Christian Collier]

That's a good question.

[Brennan Lefler]

I'm not a politician, I'm not a lawyer. I'm a retired policeman and an investigator. You should be able to get an answer to those questions. If it exists, that should all be available. Someone has that information.

[Christian Collier]

And that's what brings us back to the start of this episode, the Izcov case. We wanted to ask the CPSO why it didn't include an allegation related to isco's clinical practices on certain sexual orientations, but it declined our request for an interview. A media rep did get back to us indicating that physicians are expected to comply with professional guidelines, including CPSO's Human Rights in the provision of health services policy. It calls for doctors to create a safe environment where. Where the rights, autonomy, dignity and diversity of all people are respected. The statement added, physicians are supposed to follow legal requirements under the human Rights Code as well as provincial and federal laws. If they don't, the doctor may be subject to disciplinary action. Under the Professional Misconduct regulation of the medicine act of 1991. The college suggested it would file conversion therapy under, quote, failing to maintain the standard of practice of the profession. Whatever you call it, Izcov wasn't accused of it. And once again, the CPSO didn't explain why, citing confidentiality.

[Dr. Gayle Robinson]

Any kind of therapy which says that it's trying to change your sexual orientation as opposed to make you comfortable with your sexual orientation, is a form of conversion therapy. Anybody who was up to date on what was going on in psychiatry should definitely know that.

[Christian Collier]

And the college definitely knew the rules had changed. At the time of the provincial ban, the CPSO released an article saying the organization was committed to ensuring that patients receive evidence based care. It went on to point out that, quote, any service that treats particular sexual orientations or gender identities as pathologies to be cured is outside the bounds of acceptable professional practice. But for some reason, it didn't appear to think Izkov crossed that boundary.

[Dr. Gayle Robinson]

The province was noting that this was not seen as a curable disorder, but somehow the college didn't want to say that.

[Paul Lobsinger]

I mean, come on, seems like that was a missed opportunity to stomp on that practice.

[Dr. Gayle Robinson]

I think that that was really a voice avoiding an important issue and not being willing to just come right out and say no. That's silly.

[Christian Collier]

In our many back and forths with the cpso, it did refer us to the Ontario Physicians and Surgeons Discipline Tribunal for a number of our questions. A reminder, that's what the discipline committee is called now. Like the college, when we asked for an on the record interview, it turned down our request and sent us an email response instead. But after our first episode aired, the tribunal spokesperson quickly reached out to explain why it took almost seven months to send us the Izcov exhibits. They said the delay was primarily because confidential patient information had to be redacted. The parties involved were also given a chance to review the documents before they were sent to us. As we learned that included Izcof. They told us that the rules were changed in 2023 so that documents could be provided upon request and that files from after 2023 are now usually sent within one business day. After all that, we still didn't have a clear answer about what was being done to prevent doctors from engaging in so called conversion therapy. So we took one last shot and reached out to Ontario's Minister of Health. But the Minister declined our interview request too. And instead a PR person sent us a statement outlining the laws that apply to the CPSO and adding, ontario has comprehensive rules regarding how health regulatory colleges must handle complaints involving patient abuse, including sexual abuse. But they didn't respond to our question about conversion therapy. So just in case you aren't counting like we are, all three organizations refuse to do an interview. And that's what gets me thinking about Patient X again. Coming forward is difficult, and he only did it when he knew he wasn't alone. So we wondered if there might be others who had filed complaints against Izcov. As it happens, there was at least one other allegation, and it was serious enough for the college to post a notice of hearing. Izcov was accused of improper conduct in a men's public washroom in about two January 2014. We confirmed it with Lobsinger.

[Brennan Lefler]

Yes, I remember an incident hearing that, yes.

[Paul Lobsinger]

Do you know what happened to that hearing or that complaint?

[Brennan Lefler]

I left in September of 16? I don't know.

[Christian Collier]

You won't find it anywhere on the college's website now, but as they say, the Internet is forever. We found an archived copy of isco's CPSO profile that mentioned the incident. So far, that's all we can find. Neither the regulator nor the tribunal will tell us much about this other than the notice was withdrawn and the hearing was called off. Izcov denies any insinuation of wrongdoing here. We will get into this more in the final episode.

[Paul Lobsinger]

You've got this public hearing announcement and then you can't figure out whatever happened.

[Brennan Lefler]

And the college should be able to answer that if it's listed as a hearing, what happened to it?

[Christian Collier]

To be fair, there are lots of cases where the patient has seen some sort of justice. Patient X feels like he did. He was very complimentary of the college. He said the people he dealt with were very sympathetic.

[Patient X]

They kept me in the loop as to what was going on and they allotted a certain amount of funds for me to go for further therapy to help me deal with, you know, whatever I was experiencing as a result of coming forward. From my perspective, they were good and professional and supportive.

[Christian Collier]

I'm not surprised by this. Even some skeptics admit the regulator has made progress. But when it comes to transparency, the college is rather opaque. Most of what we want to know is under lock and key at the cpso. We couldn't get access to that information, so it was up to us to try and find another way. And there's really only one person left on our list to ask, and that's Melvin Izkov himself. That's interesting. His name is still on.

[Paul Lobsinger]

So Izkov's name is still on the directory. Directory. That is interesting.

[Christian Collier]

That's next time on the Oath. The Oath is hosted, written and co produced by me, Krisha Collier. Brennan Leffler is a co producer and writer. Sound design and editing by Damien Kearns. Editing and technical support by Matthew o' Meara. Theme music by Alison Layton Graham Special thanks to the Berry and Lori Greene Family Charitable Trust who made this podcast possible for tvo. Katie o' Connor is the managing editor of Podcasts and Digital Video. Laurie Few is the executive producer of Digital. John Ferry is vice president, Programming and content. Thank you for listening.