Threats, discipline, fear: The muzzling of B.C. health-care workers

Many British Columbia medical staffers are frustrated and even angry about what they describe as a culture of fear and silence when it comes to raising questions about the quality of care in the province, as well as other issues.

For months, CTV News has been speaking to health-care staffers on background, meaning they have agreed to provide information on the condition that their names and any identifying details are withheld from publication for fear of reprisal from their employers: hospitals, health authorities and government agencies.

In all of these conversations, the health-care workers who spoke to CTV News have been meticulous about avoiding any breaches of patient confidentiality.

They describe having a duty of care to report issues around patient safety or adequate care, but being labeled as troublemakers or even facing disciplinary action for coming forward to administrators. The idea of speaking publicly was out of the question for most, as they claimed to have been warned and even threatened against doing so by higher-ups. 

Professional associations, which typically speak on behalf of their members, are unsurprised that a growing number of workers are risking their jobs by speaking out. Many have begun posting on social media because they see no other way of raising the alarm about patient care concerns, problems with facility or interpersonal operations, and even toxic workplaces. 

“We feel like there isn't a place where we can speak out that gets heard or listened to, so we feel, at times, the last resort is to speak truth either on social media or otherwise,” said Doctors of BC president Dr. Josh Greggain, pointing out the current strain in the system is a tipping point for many.

“In medicine, one of our roles is advocate for our patients.”

TWO DOCTORS SPEAK OUT

A pediatric heart surgeon who just stepped down from his role at BC Children’s Hospital after 30 years of life-saving procedures is providing rare insight into how health-care workers are silenced from going public.

“There's no question people are afraid to speak up. They're worried about their jobs, they're worried about providing for their family, and I understand that,” said Dr. Sanjiv Gandhi, who says there’s always been a tight rein on staff, which has only worsened in the last couple of years.

“The health authority model is such that anybody whose paycheque comes from a health authority feels threatened when they speak out.” 

Emails and memos from B.C. health authorities to staff typically end with a reminder that all media requests should be forwarded to the communications team. Staff members rarely get approval to speak to reporters.

That’s been a frustration for Gandhi, who continued to speak about what he considers insufficient public safety measures during a respiratory season that’s seen first the children’s hospital, then 19 other acute care centres operate under a state of emergency. 

“This whole story that 'everything's fine, there's nothing to see here, we have it all under control' isn't helping anybody. It's not serving the public,” he said. “Oftentimes, the desire to preserve a positive narrative was not consistent with telling the truth … it’s politics and optics, really, over medicine, and I think the optics are driven by politics.” 

Dr. Paul Winston, a physical and rehabilitative medicine physician on Vancouver Island, is also speaking up out of frustration that policies and systems – from annual flu shots to COVID-19 protections – were overtaken by the provincial government, which did little or no consultation with frontline staff.

“We did (health care) really well our whole careers, and suddenly the power's been taken away from us to provide good care, so we have to speak up,” he said. “In my specialty, we're always taught to speak up to get a better solution. So none of us should be attacking anyone and I don't think anyone in the government is a bad person or not trying, but when you don't consult, you don't get the results.” 

DISCIPLINARY ACTIONS TAKEN

The BC Nurses Union has launched a campaign featuring emotional and graphic testimonials from nurses whose identities have been carefully concealed in order to avoid repercussions for speaking out about critical staffing shortages impacting patient care and staff wellbeing, mass casualty events like the heat dome, even suicidal ideation. 

“Our members have been disciplined for posting on social media, for speaking out even in private groups,” said Aman Grewal, president of the BC Nurses’ Union.

“We advocate for our patients to make sure they get the best care possible, and if that is – gagged is basically what it is – then what avenue is there for nurses?” 

The health minister has been asked about gag orders by legislators and journalists on numerous occasions and has denied there’s any such policy, despite the chorus of voices to the contrary. CTV News has reached out to Adrian Dix to discuss the issue, which we hope to include in the second story diving deeper into this issue on Thursday.