On January 31, 2024, the IPC/Ontario ordered the Ontario Medical Association’s Physician Health Program to provide a complainant with access to a draft assessment report, though it permitted the OMA to withhold behavioral information collected in preparing the report.
Many institutions have processes that support behavioral threat assessment – a process by which multi-disciplinary teams (often including medical clinicians) conduct a threat inquiry to gather behavioral information (usually indirectly), assess behaviors and determine whether someone poses a threat to themselves and/or others. The assessment can lead to interventions, medical and otherwise, that are of benefit to the person being assessed.
The OMA’s Physician Health Program appears to be a threat assessment program, though its mandate is vague, and involves “education; support and referral; assessment; and monitoring and advocacy.” And in responding to an IPC complaint about its access request denial, the OMA argued it was a health information custodian engaged primarily in the provision of health care. The IPC re-articulated the position as follows:
[16] The OMA PHP describes its monitoring function as “first and foremost a clinical service provided to an individual physician or learner to assist in the maintenance of their health in the context of recovery from a mental health or substance use disorder.” This may involve collecting clinical information, providing clinical opinions, and reviewing urine, hair, blood, or other toxicological tests.
[17] Overall, the OMA PHP states that its employees provide services “to maintain an individual’s mental condition, … to promote health, and in the case of clients already diagnosed, to prevent disease in the form of recurrence, all of which it states fall under the definition of “health care.”
This position drove the outcome given PHIPA has a very broad right of access to personal health information. The OMA was left with no valid basis to shield its draft report, even though the IPC has held that assessment is different than providing health care. The IPC did find that the (critical and sensitive) behavioral reports made to the OMA could be withheld on the basis of section 52(3), which applies to records “not… dedicated primarily to personal health information about the individual requesting access” and permits reasonable severance.
Threat assessment can and should be framed as beneficial to the person being assessed, which is important because it aligns threat assessment with the duty not to discriminate against individuals with disabilities. In other words, threat assessment is an aspect of accommodating disability and meeting institutional health and safety duties. Threat assessment is both a lawful and critical process.
This framing does not make threat assessment health care, nor should it ever be treated as health care in my view. The interventions that threat assessment invites are meant to help in the long and medium term, but in the short term they are about the restriction privileges (e.g., of practicing, working, attending school) based on the assessed risk. There is therefore a conflict in striving to be both a heath care provider and a threat assessor, and individuals under assessment must know the true nature of the process with which they are engaged. Are you my doctor? Or are you working for the institution? If threat assessment is framed as assessment, even if it is conducted by medical clinicians, PHIPA will not apply.
Ontario Medical Association Physician Health Program (Re), 2025 CanLII 9695 (ON IPC), <https://canlii.ca/t/k9ftg>, retrieved on 2025-07-17.