When a mother of two filed a complaint against Vancouver psychologist Allan Posthuma more than eight years ago, she had no illusions about the potential outcome.
Posthuma had written a psychological assessment in her custody dispute with her ex-husband, coming to negative conclusions about her parenting and recommending her kids spend more time with their dad, whom she alleges is abusive.
She strongly disagreed with Posthuma's report and complained to the College of Psychologists of B.C. She knew it wouldn't affect the outcome of her custody dispute, but she believed it was important anyway.
"I did it because it's the principle. I thought, I'm going to do it to help other people," she said in a recent interview. CBC is not naming her or the other parents quoted in this story to protect the privacy of their children.
Her complaint prompted the college to open an investigation into Posthuma's work. That investigation ended in 2012 when he signed what's known as a resolution agreement, promising to make improvements to his work in family disputes and consult with an experienced colleague about "a number of issues arising in his professional practice."
That agreement was never made public.
Professional colleges in B.C. often use resolution agreements like this as an alternative to formal disciplinary proceedings. They take less time and fewer investigative resources, and usually have a more certain outcome.
But under the Health Professions Act, resolution agreements can only be publicized if they relate to "serious matters."
The mother was floored to hear that Posthuma continued to practise without any warning to other families.
That only came to light when a CBC News article revealed that at least five other families filed complaints against Posthuma after he signed the 2012 agreement to improve his work.
College investigations into those complaints found numerous ways that Posthuma's work allegedly "fell below minimum expected standards."
As CBC has reported, those investigations all ended when Posthuma retired at the end of 2018. There was no official finding of wrongdoing, and a planned disciplinary hearing was cancelled.
"I thought, you've got to be kidding me," the mother said. "That really blew me apart."
Agreements shouldn't be 'secret,' expert says
The college's handling of these repeated complaints against Posthuma highlights a number of problems with B.C.'s system for regulating health professionals, according to an expert.
Professional regulation adviser Harry Cayton, who was hired by the province last year to write a review of the B.C. system, said he couldn't comment directly on the Posthuma case.
But he told CBC this week that professionals should never be allowed to retire rather than face discipline.
Cayton said any sort of agreement that includes remedial actions for a health-care worker should be made public, because patients' right to know is paramount.
"If a health professional has some conditions on their practice but it's secret, then as a patient … I can't give informed consent to be treated," he said.
College registrar Andrea Kowaz said she was unable to comment on the 2012 agreement because it did not lead to a public notification.
Neither Posthuma nor his lawyer responded to requests for comment.
'They've failed me'
The terms of the 2012 agreement between Posthuma and the college are set out in a complaint investigation report completed by the college's inquiry committee.
There are no official findings of misconduct, but the report says the committee "was of the view that Dr. Posthuma's practice would benefit from certain enhancements" around issues like obtaining informed consent and using research to back up his opinions.
The report outlined a number of steps Posthuma would take to improve his work, but it does not include any details about how the college planned to monitor his progress or how long the process was expected to take.
Parents who've filed complaints against Posthuma since 2012 say they never would have agreed to let him work with their families if they'd known about the previous resolution agreement between Posthuma and the college.
"I'm infuriated," one mother said.
Another mother asked: "Why wasn't there a notice to the public? The college's mandate is to protect the public."
A father said the college has "failed the public and they've failed me…. They've failed, most of all, my children."
Cayton said there needs to be a better way for colleges to handle multiple complaints against individual health-care workers.
He points out that research suggests a small number of practitioners are usually responsible for the majority of patient complaints in a given field.
"Those complaints initially may be quite trivial, but they build up to a pattern of poor practice and may ultimately result in serious failures," Cayton said. "Regulatory colleges must be aware of this and must take it into account."
He also says that in most other countries, professionals aren't allowed to retire while they're under investigation.
"If I'm accused by the police of shoplifting and I'm prosecuted, I can't avoid that prosecution by just saying, 'Oh I'm not going to go into a shop anymore,'" he said.
In B.C., colleges do have the power to continue disciplinary proceedings and make conclusive findings about a professional even after they've given up their registration, but that's not what happened in Posthuma's case
More complaints under investigation
In an explosive report released earlier this year, Cayton called for a complete overhaul of B.C.'s regulatory system. The province is currently reviewing Cayton's recommendations to see what changes are possible.
The College of Psychologists is still investigating at least two other complaints against Posthuma, but registrar Kowaz says there are limited options for discipline when someone has already given up their registration.
Meanwhile, the mother whose complaint led to the 2012 resolution agreement has some lingering questions for the college.
"What was the point of all of that process, all that due diligence in the end? What was the point? Can you explain that to me?" she asked.