Physician Self-Regulation Is a Canada-Wide Problem, Not a British Columbia Problem
It's tempting to read the cases already documented on this site — Zigurts Strauts, John Gannage, Akbar Khan, William Makis — as evidence that one province's medical college is uniquely slow or lenient. A side-by-side look at Alberta, Ontario, and British Columbia's physician colleges over roughly the past decade doesn't support that. The same failure patterns show up in all three, which points to a structural problem with self-regulation as a model, not a problem with any single province.
A note on method, up front
This is not a systematic study. It's a comparison built from the cases this site had already documented, plus targeted searches for equivalent controversies at Alberta's CPSA and Ontario's CPSO. It's entirely possible a more rigorous count would find real differences between provinces. What follows should be read as "these three colleges show comparable patterns in the cases that became public," not as a ranked scorecard.
The base rate that puts any single case in context
Alberta's CPSA received 867 complaints in the 2023 fiscal year against fewer than 14,000 regulated members, with fewer than 2% of complaints ever reaching a formal disciplinary hearing. That ratio is a useful reminder before treating any one province's high-profile cases as representative: the overwhelming majority of complaints against physicians, in any province, never become public controversies at all. The cases below are the exceptions that did.
Pattern one: slow or dropped action on COVID-era misinformation
| College | Case | Pattern |
|---|---|---|
| CPSO (Ontario) | Dr. Mark Trozzi | Investigation opened 2021; found incompetent and licence revoked October 2023 — a roughly two-year gap |
| CPSO (Ontario) | Dr. Caroline Turek | Disciplined for COVID-related social media conduct, December 2023 |
| CPSBC (B.C.) | Dr. Charles Hoffe | Cited for misconduct February 2022; citation quietly dropped February 2025 with minimal public explanation, despite complaints from more than a dozen physicians |
| CPSBC (B.C.) | Dr. Stephen Malthouse | Reprimanded for COVID misinformation; sued his own college alleging a free-speech violation |
| CPSA (Alberta) | Dr. William Makis | Licence inactive since February 2019; permanent injunction not obtained until March 2026 — a seven-year gap between loss of standing and enforcement |
In each province, physicians and members of the public went on record saying their own regulator wasn't acting quickly enough. This wasn't a one-college problem during the pandemic; it was the pattern everywhere.
Pattern two: long-tolerated misconduct before a final reckoning
The gap between conduct and consequence, in all three provinces
In B.C., Dr. Gustavo Carvalho had "decades" of fraud and misconduct discipline on file before his licence was permanently cancelled in 2022. In Alberta, orthopedic surgeon Dr. Wynand Wessels admitted at a 2020 disciplinary hearing to an incident from 2016 — tying a noose to an operating-room door — a four-year gap between the conduct and any public hearing. In Ontario, Dr. Akbar Khan's case took roughly two years to move from tribunal finding to a confirmed Superior Court appeal outcome in 2023. None of these are unusually fast, and none are unique to one college.
Pattern three: the structural criticism, and who's actually acting on it
The underlying complaint about physician self-regulation predates any of these individual cases: a college run by elected and appointed members of the profession itself has an inherent tension between protecting the public and protecting its own members, who elect its governors and fund its operations. British Columbia is currently the most visible example of a government acting on that criticism — a 2026 overhaul shifts physician discipline decisions to a provincially appointed director rather than leaving them inside the college, over Doctors of BC's objection that self-regulation "has been effective." That B.C. is first to reform doesn't mean B.C. was worst; it may just mean B.C. moved first on a problem that applies equally in Alberta and Ontario, which have not yet undergone comparable reform.
Why this belongs on QuackeryWatch
Several individual physicians documented elsewhere on this site — Zigurts Strauts, John Gannage, Akbar Khan, and William Makis — happen to be regulated by different provincial colleges. Reading their stories together could create a false impression that one college is the outlier. The fairer conclusion, based on what a comparable search turns up in Alberta and Ontario, is that self-regulation itself — not any single province's implementation of it — produces this same shape of failure: slow action, quietly dropped cases, and years-long gaps between misconduct and consequence.