Rise of the ‘nuisance complaint’

There’s never been an easier time for people to complain about their physician. Filing a complaint is as easy as accessing a website. ChatGPT can help with language, and online forums can let people know about the process. While easing the ability to complain is designed to protect patient safety, it has also opened the door to complaints that are frivolous, vexatious, made in bad faith or otherwise an abuse of process. Altogether, these are often called “nuisance complaints.”Nuisance complaints clog up the complaints process, take up medical regulators’ time and money and delay investigations or dismissals of other cases, leaving patients and physicians in a stressful limbo for longer. At worst, the delay can mean a threat to patient safety.Doctors are not the only regulated professionals in Canada. Lawyers, chartered professional accountants and other medical professionals like nurses and pharmacists are all regulated with channels open to the public to voice concerns about breaches of safety or inappropriate behaviour. A number of these regulators are finding that nuisance complaints are on the rise. Canada’s court systems are also witnessing an increase in vexatious or nuisance suits or actions, jamming up the judicial process. Human rights tribunals, privacy commissioners, freedom to information requests all report greater nuisance submissions.How do Canadian medical regulators deal with nuisance complaints and has the number increased?First, a quick overview of the complaints process. Every complaint to a medical regular in Canada is assessed on a case-by-case basis. The process is set out in provincial or territorial law. Complaints are assessed by an inquiry committee, and a section in the legislation gives the committee the authority to take no action on complaints that it decides are “frivolous, vexatious, made in bad faith or otherwise an abuse of process,” to quote the Ontario legislation. The inquiry committee decides to take no action on a complaint, “based on the facts and circumstances of each complaint,” the College of Physicians and Surgeons of Ontario (CPSO) explained in an email. Some complaints to medical regulators may include more than one issue, and the inquiry committee may identify some parts as frivolous or vexatious, while other components merit further review.For complaints deemed vexatious or frivolous requiring “no action,” that may not be the end of the road. In Ontario, legislation dictates that the CPSO must send a letter to the complainant and the physician and they have 30 days to respond should they wish to do so. The inquiry committee considers the written response, and if it still maintains it is a nuisance complaint, it can take no action.What are these complaints?There are a few types of nuisance complaints. In broad terms, a frivolous complaint is not serious and lacks evidence. It may concern matters that are hypothetical or speculative. A vexatious complaint is generally made to annoy, harm, disrupt, harass or embarrass. A complaint made in bad faith is one that may have an ulterior motive or presents false information.Are nuisance complaints common?Unfortunately, most medical regulators don’t report the number of complaints that are considered vexatious, frivolous or made in bad faith, so it is difficult to assess if they are common in the Canadian medical regulation sphere. It may be difficult to measure in part because the regulator cannot guess the motivation of the complainant. Vexatious complaints are meant to cause harm, not something that’s always easy for a regulator to identify.The College of Physicians and Surgeons of Nova Scotia “received few complaints that meet the legal definition of frivolous or vexatious,” Dr. Gus Grant, registrar of the CPSNS wrote in an email. He added that the college does not track the number of frivolous or vexatious cases.In Ontario, the CPSO provides figures for complaints requiring “no further action,” which includes nuisance complaints, among others. In 2025, 47.6% of complaints required no further action, but the CPSO does not publish data specific for nuisance complaints. Other medical regulators across Canada also don’t have data on nuisance complaints.In Australia, a 2017 report commissioned by the national medical regulator found that about 1% of complaints were vexatious. Two in five of the vexatious notifications were made by another healthcare practitioner (which included non-physicians).Despite a lack of data, there is case law suggesting there are vexatious or frivolous complainants. In one recent Ontario case, the complainant appealed the Ontario inquiry committee’s dismissal of their complaint. The case then went to the Health Professions Appeal and Review Board, which found that the committee acted appropriately. The physician involved had to share all health records and spend time and energy on the case. Certain details in the complaint embarrassed the physician in their workplace. The judge wrote in his decision that the physician “believes this allegation to be vexatious and specifically intended to damage his reputation. The applicant initially sent a complaint (with this allegation) to the clinic manager and copied an email address that goes to every employee of the entire company (that employs him). This caused him tremendous embarrassment with his colleagues.”In another case, a person involved in litigation unrelated to medical care with a physician made a complaint to the CPSO. The inquiry committee deemed it frivolous and the Health Professions Appeal and review board supported that decision, as did a judicial review in the Superior Court of Justice Divisional Court.There are cases where it’s a physician making vexatious or frivolous complaints, like when a psychiatrist, Dr. William Komer, made a complaint against the CPSO’s registrar and all members of CPSO’s governing council. He took issue with some of the CPSO’s policies aimed to reduce the spread of COVID-19. The inquiry committee deemed the complaint frivolous and a judicial review by the Ontario Superior Court of Justice divisional court upheld the decision.Sometimes, the complainant isn’t well. A case involving an anonymous complainant against the College of Physicians and Surgeons of British Columbia (CPSBC) notes the complainant has schizophrenia. The inquiry committee took no further action and the review board supported the decision.The cost of a safe systemThe complaint system is needed for a safe healthcare system. Medical regulators must ensure that the holes in the sieve are the right size, so serious complaints made in good faith continue to get proper consideration. It is perhaps for this reason that Canadian medical regulators must consider every single case, and in some jurisdictions inform both parties if no action is taken, so the complainant can appeal. Still, it may be judicious for medical regulators to prepare for a rise in these types of complaints, as AI assists the disenchanted, and online discussions fire up imagined grievances.The Australian Health Practitioner Regulation Agency, recently developed a framework for vexatious complaints. It includes a list of indicators that the complaint (“notification”) is vexatious, including use of excessive emphasis, overly dramatic language, a convoluted structure, providing unnecessary documents and demanding unrealistic outcomes. These indicators may not be obvious in the future as AI helps complainants smooth out their language and demands. Repeated complaints from the same person is another clue. The framework considers the possibility of flagging complainants who submit repeated vexatious complaints.The U.K.’s General Medical Council has a vexatious complaints framework, but it is only for complaints about the council’s work and services, not about physicians’ fitness to practice.Malpractice suits and vexatious reviewsCanada’s court systems have been working for years to deter vexatious litigants, with processes in some provinces that will allow an order to declare a person as a vexatious litigant. This often involves malpractice suits.Six physicians from Kingston, Ont., successfully obtained an order declaring a former patient to be a vexatious litigant and prohibit him from starting any further court proceedings within Ontario without first obtaining a leave from a judge of the Superior Court of Justice.The mental health tollAustralia’s medical regulator notes in their new framework that vexatious complaints can have a significant impact on medical practitioners, including added stress and anxiety, reputational damage and feeling unsafe.As with any complaint, physicians should try to protect their own well-being, advised Dr. Adam Thompson, president of Doctors of BC. That could include talking to a colleague and accessing counselling and peer support through a provincial medical association.“It’s also really important to maintain the regular routines outside of work and try not to fixate on the complaint,” Dr. Thompson said.The toll on mental health increases as the process drags on. The cases cited above (against the Kingston physicians and from the schizophrenic patient) took three years or more between the initial nuisance complaint and a reported decision.“One of the biggest concerns is trying to get the complaints process done as speedily as possible. The more the outcome is unknown the more the physician is under pressure. We acknowledge and appreciate that patients are under pressure too, and also want an answer,” Dr. Thompson said.Canadian medical regulators are working on resolving complaints more quickly, and 2025 annual reports show gains in that area. “Whenever it is permitted by the language of the Medical Act, and when it is in the public interest to do so, the college will seek early or informal resolution of complaints,” Dr. Grant wrote.Whether those gains will continue if there is a rise in nuisance complaints remains to be seen.People may also turn to an instant, alternative and informal complaints process, namely sites such as RateMDs, or Google reviews, some of which “almost reach the level of being slanderous, to be honest,” Dr. Thompson said. The posts on these sites could be harmful to physician well-being, in that they’re either glowing or insulting. Choosing not to look is considered a good idea. Choosing not to react is a requirement by Canadian medical regulators.How to protectDoes “firing” an offensive patient help protect from nuisance complaints or does it encourage them? Sadly, there’s no straight answer. Retired FP Dr. John Crosby of Cambridge, Ont., provides advice on how to fire a patient in a manner that could prevent complaints. Dr. Crosby suggests keeping it positive, providing a list of other physicians taking on new patients and providing them with their medical records for free. While these actions may help lower the risk of a nuisance complaint, it doesn’t guarantee that the patient won’t go to the medical regulator.“Most of us will get a complaint at some point in our careers. It’s very difficult to do the volume of work that we do and not find somebody choosing to make a complaint at some point,” Dr. Thompson said.Just as the advice on maintaining health is a bit boring (exercise, eat well, get enough sleep), so too is the advice on maintaining sanity when dealing with a complaint. The guidance goes like this: Take a deep breath and contact the Canadian Medical Protective Association (CMPA) for guidance for how to respond. To protect against a poor (or prolonged) outcome of a complaint: Document, document, document and listen. More direction is available from the CMPA and medical regulators.The complaint process in the Canadian medical regulatory system is designed with the concept that people will use it in good faith and it will protect patient safety. It’s necessary and should be accessible as possible. At the same time, medical regulators should learn from other regulators’ experience and plan for a rise in people using the system in bad faith or who are not acting in a rational manner. Discouraging and dismissing nuisance complaints, which harm both the system and physician well-being, while ensuring continued patient safety is a tricky but important balancing act the medical regulators must make.

Rise of the ‘nuisance complaint’

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