Protecting the Public and the Professional: Can One Association do Both?

A decade long tenure as a Medical Radiation Technologist in Ontario dictates that I am familiar with the legislation and standards regarding my profession in that province. However, as I prepare for a similar position in New Brunswick, the parallels within my new province are relatively foreign to me. The most glaring contrast is that the regulatory College that ensures the compliance of Technologists in Ontario seems to be merged with the professional association in New Brunswick. I decided to dig a little deeper to understand this concept and determine if this dual role may represent an unethical conflict of interest, or if there are factors that may mitigate the apparent­ issue.

The CAMRT is a national body that governs the entry to practice exam and supplies PLI for MRT’s across Canada, while the provincial associations branch into Ontario’s OAMRS and New Brunswick’s NBAMRT. In Ontario, the provincial association largely serves the interests of the Medical Radiation Technologist (MRT) members by offering professional development opportunities, member discount agreements with various companies and publicly promoting the Medical Radiation Sciences (CMRTO, 2019). The NBAMRT mirrors these functions for New Brunswick –while conversely serving as a public regulatory body for the profession (NBAMRT, 2018). This involves enforcing a Code of Ethics (NBAMRT, n.d.), setting standards of practice (NBAMRT, 2018), defending the public interest by handling claims of professional misconduct, administering member disciplinary rulings, dictating required education, including annual professional development and regular audits to ensure continued competency (CAMRT New Brunswick Division, 2004). In contrast, the CMRTO is the independent regulator shouldering these responsibilities in Ontario (CMRTO, 2019).

This brings us to the main question: can one association legitimately have the best interest of the public at heart, while at the same time claiming support for its professional members? To answer this, one must first understand the legal requirements or safeguards that must be instituted before a collection of professionals may establish a College to self-regulate. The New Brunswick government has a document in place to outline such rules. Included are: “licensing (entry to practice); standards of practice; disciplinary mechanisms; and continuing education requirements”, (New Brunswick Department of Health, n.d.). With these mandates in place, a professional group may establish authority over regulating their own profession. Differences between how Ontario and NB have decided to approach regulation can be attributed to their relative sizes; Ontario supports 6600 MRT’s (CMRTO, 2019), while New Brunswick totals a modest 600 (NBAMRT, 2017). This is demonstrated by the statement: “where practitioner numbers are smaller, the association [may assume] a dual role of oversight and representation with regard to practicing members” (New Brunswick Department of Health, n.d.).

So what are the benefits of self-regulation? Parker (2002, p.vii) discusses a scandal that tainted the Mitsubishi Motors Corporation almost twenty years ago after years of corporate cover ups related to product defects were discovered. The public backlash damaged the company’s reputation and hurt their bottom line. The result is that all employees were negatively affected in some way. The same can be said of misconduct in any company or profession. Professional misconduct by any MRT will have an impact on how society views myself, as an MRT, and the profession as a whole. Self-regulation can be more effective than independent regulation because those on the inside have a better understanding of -and more intimate vantage point for- incidents that may not comply with regulatory standards than would a government run watchdog (Parker, 2002, pp.vii-ix).

Back to our original question: is a College that is singularly focused on protecting the public and holding a professional body accountable inherently more effective than one also tasked with supporting those same professionals? This is better answered with another question: when conflict arises, which side takes priority? According to the Medical Radiation Technologists Act, for the NBAMRT, the answer is clearly on the side of the public interest (CAMRT New Brunswick Division, 2004). In fact, the association benefits to members -conferences, leadership development, professional development opportunities- are all specifically in place to ultimately help facilitate our optimal provision of care to the public. Logically, the same efforts that make us better equipped healthcare workers and more informed leaders also keep us more closely aligned with our standards of practice and thus, our regulatory mandate. To say the New Brunswick system is superior to that of the CMRTO in any way would be untrue. However, I do believe that the public can and should place equal faith in the integrity of my new governing body.

References

CAMRT New Brunswick Division. (2004). An Act to Incorporate the New Brunswick Association of Medical Radiation Technologists. Retrieved from https://nbamrt.ca/uploads/file/pdfs/nbamrt_act_2004.pdf

CMRTO. (2019). Differing roles of the CMRTO and the OAMRS and CAMRT. Retrieved May 21, 2019, from https://www.cmrto.org/employers/differing-roles-of-the-cmrto-and-the-oamrs-and-camrt/

NBAMRT. (n.d.). Code of Ethics for Members of the New Brunswick Association of Medical Radiation Technologists. Retrieved from https://nbamrt.ca/uploads/NBMRT-CODE-OF-ETHICS-ENG.pdf

NBAMRT. (2017). NBAMRT Executive Director Job Posting. Retrieved from https://www.camrt.ca/wp-content/uploads/2017/09/2017-NBAMRT-Job-Ad-ENG-REV.pdf

NBAMRT. (2018). Standards of Practice. Retrieved from https://nbamrt.ca/uploads/NBAMRT_SOP_Stakeholder_Consult.pdf

New Brunswick Department of Health. (n.d.). A Guide to Private Legislation For Self-regulated Health Professions. Retrieved from http://www.gnb.ca/legis/publications/rules-reglement.pdf

Parker, C. (2002). The Open Corporation: Effective Self-regulation and Democracy - Christine Parker - Google Books. Retrieved from https://books.google.ca/books?hl=en&lr=&id=jspFnQ8oqNcC&oi=fnd&pg=PR6&dq=ethics+of+self+regulation&ots=F6xL47GwoA&sig=U67HpTxxsSBiQWbxwzpFRaHm72Q#v=onepage&q=ethics of self regulation&f=false