Dr. Richard Cunningham has fought alcoholism for much of his career, something his patients won’t learn from Alberta’s medical regulator.

A difficult Friday night in one of the province’s emergency wards last December sent him over the edge and back into the abyss, an inevitable slide that started with a glass of wine and ended with shots of single malt Scotch.

“Come Monday morning, I wasn’t fit to do anything,” he said in a recent telephone interview.

While practising across North America during the last two decades, Cunningham has been arrested and charged with numerous alcohol-related offences. He went to jail for threatening to kill his wife. And in Alabama, he lost his licence after an incident related to his alcoholism.

After a stint in rehab in 2014, the Newfoundland native started a practice in the small town of Fort Macleod, a two-hour drive south of Calgary, where he now lives.

Patients will find no trace of his checkered history on his public profile in Alberta because the province’s medical regulator has withheld his disciplinary and criminal records.

According to the Fort Macleod Medical Clinic, Cunningham has yet to return to practice since December.

He’s one of more than 159 doctors identified by the Star in an 18-month investigation into cross-border medical discipline. After doctors face sanctions in one jurisdiction, they can move to a new province or state and start again with a clean slate, the Star found.

Read part one of the Star’s Medical Disorder investigation

Nine doctors in the Star’s database have held licences in Alberta. Three were able to get licences here after disciplinary issues in other jurisdictions and four have active licences in the province today. Five were disciplined after leaving Alberta. No trace of their disciplinary histories can be found on their public profiles.

Patients rely on medical regulators to protect them and the public interest. Across North America, the public physicians profiles on medical college and board websites play a vital role in the function. But the 64 North American regulators each have different bylaws, rules and laws that govern what is made public.

Disciplinary records from other jurisdictions aren’t posted publicly by the College of Physicians and Surgeons of Alberta as they are in Ontario. Records for discipline that occurred in Alberta, no matter how severe, are scrubbed after five years, but are kept public indefinitely in Ontario and New Brunswick. Criminal convictions aren’t on Alberta profiles as they are now in Ontario.

College spokesperson Steve Buick said the Alberta regulator is reviewing whether more of a physician’s history should be revealed.

“It’s really an open question,” Buick said, “about what our priorities should be going forward to be more transparent.”

Cunningham believes the public doesn’t have a right to know about his past.

“Patients should know as much as they can about their physician. But not whether or not I have a certain illness,” he said. “I’m not a threat to my patients.”

Edmonton-based medical malpractice lawyer Carol Robinson said patients have the right to make that call themselves.

“These are people that you disrobe in front of, these are people that give you advice and make decisions and help you make decisions on your very life and death and your family’s life and death,” Robinson said.

“People are grownups and they can decide if they will dismiss the history when making a choice as to what doctor to see.”

In the summer of 2000, Cunningham had been practising family medicine in Lucedale, Miss., for almost a decade and, following a diagnosis of alcoholism, had joined the Mississippi Recovering Physicians Program.

“It would be my professional opinion that the continued, unrestricted practice of medicine by Dr. Cunningham could pose an immediate threat to the public,” Dr. Gary Carr, the program’s director told the state’s medical board.

He was charged with professional misconduct, but, barely a month later, the charges were dropped — or “placed in abeyance for an indefinite period of time” — because Cunningham allowed his licence to lapse.

Investigative reporters Diana Zlomislic and Rachel Mendleson discuss the doctors discipline investigation which took 18 months to complete.

Before giving up his Mississippi license, Cunningham obtained a licence in Alabama and was able to move there to practice.

Cunningham called his frequent moves a “geographic cure” for his alcoholism and said that as long as he hasn’t harmed his patients, he is fit to practise medicine.

Cunningham said he has disclosed his alcoholism, his professional discipline and his criminal history to medical regulators each time he moved to a new province or state, and said it’s up to the local regulator to decide whether he can practise.

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“They don’t let you go working if they think you’re a danger,” he said.

The Alberta college declined to comment on Cunningham’s case, citing privacy laws. In general, however, the college is “aware of any disciplinary history” and “takes that information into account,” wrote college spokesperson Kelly Eby.

“Every situation is different, but we need to find a balance between informing the public and keeping them safe, and treating the physician fairly,” Eby wrote in an email.

In Alabama, Cunningham practised apparently without any problems from 2000 until 2004, when he agreed to a voluntary restriction on his licence that prevented him from consuming alcohol or drugs. There’s no record of the incident that led to this restriction.

Four months later, at the Bayfest Music Festival in Mobile, Ala., Cunningham was arrested by for public intoxication.

“Dr. Cunningham had difficulty standing and communicating and was trying to get into a vehicle which was determined not to be his,” according to Alabama medical board records.

The state regulator revoked his licence after Cunningham skipped his disciplinary hearing.

Having previously obtained a licence in the Northwest Territories, Cunningham moved to Yellowknife.

While Cunningham has no disciplinary record in the N.W.T., he had repeated run-ins with the law. Between 2008 and 2011, he was criminally convicted for drunk driving, falsely declaring to have explosives at an airport and uttering a death threat.

According to media reports, Cunningham arrived at the Yellowknife airport in October 2009 intoxicated and refused to show his boarding pass while attempting to get on the aircraft. He was asked to identify his luggage and replied “I hope my bag blows up your plane.” He pleaded guilty and was fined $3,000.

In 2011, he was convicted of threatening to kill his wife and of violating a restraining order. He was sentenced to 90 days and served his time on weekends.

Cunningham told the Star that colleagues know about his alcoholism. Until last June, he said he was in a mandatory monitoring program with the Alberta medical college that required him to blow into a breathalyzer daily. That information isn’t posted on his public profile.

“I’m quite open about the fact that I’m an alcoholic, but I’m in recovery,” he said. “I had some guilt and things to be paid for, but I did that. It’s a consequence of what I’ve done when I’m drinking. I’ve accepted that. I’m monitored every day.”

Cunningham was one of 234 Alberta physicians in a health monitoring program in 2016. Nearly one in five of those doctors had a substance abuse or addictions issue.

Two months after his mandatory monitoring program ended, Cunningham said he had his first relapse since starting his practice in Alberta, something he admits he kept secret at the time.

“To be honest, I didn’t report in August because it was a short thing but I knew by December that I was getting in trouble again,” he said.

The Alberta college ordered him to take a leave and Cunningham said he is now in another five-year mandatory monitoring program, visits a psychiatrist and addictions counsellor regularly, and undergoes daily testing.

“I want to continue to be monitored for my own sake,” Cunningham said, “because if I don’t document that I’m sober, then people can say I don’t want to deal with this idiot anymore.”

With files from Diana Zlomislic, Rachel Mendleson, Robert Cribb and Marco Chown Oved

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