ONTARIO, CANADA — Due to Canadian law, Guelph, Ontario audiologist Brenda Berge, who obtained her doctorate in audiology from Ball State University in Indiana, is barred from using the prefix “Dr.” before her name. Berge was recently slapped with a three-month suspension and almost $100,000 in costs for using the title by the College of Audiologists and Speech Language Pathologists.
Last year the College found Berge guilty of misconduct for using the doctor title. In addition, she was suspended for three months, ordered to take a course in professional ethics, and also undergo two unannounced inspections.
A Biased System?
According to an article in the May 5 edition of the National Post, each Canadian province parses out rights to use the coveted title of doctor. In Ontario, physicians, dentists, chiropractors, optometrists and psychologists are among those allowed to call themselves doctors. However, in 2006, a provincial advisory committee commented in a report that the rules seemed to lack any underlying principle – they seemed to favor male-dominated professions and appeared to maintain certain groups’ status than to protect patients.
The committee recommended letting any health professional with a clinical doctorate recognized by his or her college to use the title, which could include some pharmacists, nurses and speech-language pathologists, as well as audiologists. The province of Ontario never implemented the advice, although recently they extended the privilege individually to licensed naturopaths and Chinese traditional practitioners.
A Violation of Rights?
Berge, who in addition to her Doctor of Audiology (AuD) degree, completed a post-doctoral fellowship in neuro-anatomy at an American institution, is fighting the disciplinary action and believes her freedom of expression is being violated. In the National Post report, Berge was quoted as saying:
“It’s completely irrational. How is a four-year degree on the ears any different than four years on the eyes as a doctor of optometry, or four years on the mouth and teeth as a dentist, or four years on the back as a chiropractor?
You want to be able to convey to patients that you are a doctor, and if you do so, that’s a form of expression. It becomes a very important constitutional issue.”
Her arguments under the charter’s freedom of expression section will be heard by the Ontario Divisional Court in June, part of an appeal of her discipline conviction.
Post-Publication Addendum: January 2017
Unfortunately for Berge, her case was dismissed by the Ontario Divisional Court. According to a summary published on January 17, 2017:
(1) the speech being regulated by s 33 [of the Charter] is commercial speech that does not inhibit informed consumer choice; and (2) there is a power imbalance between health practitioners and patients. The Court was satisfied that s 33 has a pressing and substantial objective, namely to protect the public by minimising confusion that arises through the use of the title “Doctor” when providing or offering to provide health care services to individuals. Restricting audiologists from using the title “Doctor” when delivering health care services is rationally connected to the goal of preventing confusion as to whether an audiologist is medically trained. Since the RHPA does not prevent an audiologist with a doctorate from communicating that fact (by using “Au.D.”), it satisfies the minimal impairment requirement. Finally, while s 33 seeks to protect a vulnerable group – those seeking health care – from being confused, with minimal effect on the audiologist, the overall effects are not disproportionate to the legislative objective.[…]
The Court disposed of several other grounds of appeal raised (by Berge), which were all subject to review on the reasonableness standard… Finally, the Court found no issue with the process of the College’s Inquiries, Complaints and Reports Committee to refer a matter in principle to the Discipline Committee, instruct College counsel to draft specific allegations of professional misconduct, and then decide whether to refer the draft allegations or a variation of them to the Discipline Committee for a hearing.
*images courtesy the National Post