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Investigations Changes needed to end ‘unconscious bias’ in hiring at Ontario’s Southlake Regional Health Centre, review says

The Southlake Regional Health Centre in Newmarket, Ont., seen here on Dec. 6, 2018., announced a third-party investigation of its emergency department amid a Globe and Mail investigation.

Fred Lum/The Globe and Mail

An independent review of a hospital emergency department in Newmarket, Ont., is recommending changes to prevent “unconscious bias” from affecting hiring decisions.

The review was ordered after a Globe and Mail investigation into allegations of gender discrimination by Marko Duic, chief of the emergency department at Southlake Regional Health Centre in Newmarket.

The Globe began looking into Dr. Duic last spring, after lawyer Danny Kastner sent a complaint to Southlake on behalf of eight female physicians who alleged gender discrimination in Dr. Duic’s hiring and training practices. The allegations spanned 16 years, and involved his time as chief of emergency at St. Joseph’s Health Centre in Toronto, and later at Southlake.

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The Globe spoke to 26 physicians who worked with Dr. Duic or were aware of concerns about his leadership, including discriminatory comments he allegedly made about or to women. The Globe found that Dr. Duic hired no female physicians and, at a minimum, 23 male physicians in those 16 years.

Dr. Duic has declined to comment. He stepped down as chief in January, but Southlake chief executive Arden Krystal confirmed in an interview that he still works in the department as a physician.

Ms. Krystal said the law firm Rubin Thomlinson interviewed about 30 people for its independent review, almost all of whom work in the department.

While it was announced last year as an “independent investigation,” the Rubin Thomlinson report uses the term “assessment.” Ms. Krystal said it was meant to highlight “overall themes of the kinds of workplace issues with physicians and nurses and others in the department … not just whether one person was a contributing factor.” However, she added that Rubin Thomlinson committed to informing the hospital of “particularly troublesome allegations and firsthand allegations” about any individuals in the emergency department.

The assessment did not bring to light concerns about any individual, including Dr. Duic, according to Ms. Krystal. “There were no allegations that were personal in nature. There were a lot of third-hand comments or ‘I heard’ kind of comments,” she told The Globe.

However, Ms. Krystal said the review found “concerns about the processes that were in place that the former chief [Dr. Duic] was engaged with around the selection of individuals for locum positions and selection for staff positions.”

In its recommendations, which have been published on Southlake’s website, Rubin Thomlinson noted that hiring policies overseen by the chief left open the “possibility for unconscious bias.”

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In addition, the law firm noted that many of the people who participated in the review said they didn’t feel comfortable raising their concerns about the emergency department with hospital management due to "fear of being labelled a ‘troublemaker’ or of reprisal.”

The independent assessors did not seek to verify the specific allegations The Globe reported, including that Dr. Duic chose only male trainees to supervise. When asked whether the assessment shed light on why Southlake’s data show that Dr. Duic supervised about 25 male trainees and no female trainees in a four-year period, Ms. Krystal said, “No one who was interviewed in the report brought that up.”

Rubin Thomlinson’s report made recommendations to formalize hiring and create fairer and more transparent processes. Ms. Krystal noted that Southlake has already implemented some of the recommendations.

“I can tell you that the board is very committed to making sure that we see change … moving forward, there is a significant, higher level of vigilance around making sure we have fair and equitable processes.”

Mr. Kastner expressed disappointment that what was described as an investigation was in fact an overall workplace review.

“Southlake indicated there would be an independent investigation,” Mr. Kastner wrote in an e-mail. “As far as we know, the investigator was not given the authority to investigate the actual allegations against Dr. Duic. He is being protected.”

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Steve Flindall and Jason Falk, who worked in the department, said they participated in the Rubin Thomlinson investigation and are dismayed by the result.

Dr. Flindall, Dr. Falk and three other physicians who were granted anonymity by The Globe because of fear of career reprisals said Dr. Duic gradually or abruptly cut their shifts after they disagreed with him on workplace concerns. “Many of the emergency physicians left the group after Dr. Duic took over. Myself and others felt we were forced out,” Dr. Falk said. The report noted that schedules seemed “entirely up to the discretion” of the chief.

Despite the limits of the investigation, Mr. Kastner said Rubin Thomlinson’s recommendations are a “vindication” of his clients and others who made allegations of gender discrimination because they suggest that “Dr. Duic had near total control over hiring, opportunities, and the work environment in the [department]” and “that work environment was discriminatory, toxic, and nepotistic.”

Speaking for Canadian Women in Medicine, a group that has supported the physicians who brought the complaints, Setareh Ziai said: “We are disconcerted by the hospital’s inability to hold Marco Duic accountable for his overtly discriminatory actions. Furthermore, those who enabled this environment and sat silently over the years also seem to be escaping culpability.”

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