Dialogue Volume 11 Issue 4 2015 | Page 60

discipline summaries •D  r. Armstrong concentrated on giving vitamins, minerals and amino acids, which are not the standard of care. Her focus regarding this patient was on chemical sensitivities and metal toxicities. Reasons for Penalty Counsel for the College and counsel for the member made a joint submission as to an appropriate penalty and costs order. The Committee accepted the submission as appropriate. The Committee was concerned that while Dr. Armstrong has a specific interest in a particular area of medicine, she failed as a general practitioner to consider the patient’s needs as a whole. General practitioners, if unable to provide care in a certain area, must refer for assistance. The Committee is confident that an order specifying that Dr. Armstrong only see patients who are also under the care of a family physician or appropriate specialist will ensure the protection of the patients in Dr. Armstrong’s care in the future, and maintain the public’s trust in the medical profession’s ability to self-regulate. Counsel for the College provided the Committee with the College’s, “Complementary/Alternative Medicine” policy, for review. The Committee was advised that Dr. Armstrong intends to only provide complementary medicine and does not intend to carry on a general practice. Dr. Armstrong has undertaken to practise under supervision for one year and will undergo reassessment of her practice six to nine months after the completion of the supervision. The proposed terms, conditions and limitations on Dr. Armstrong’s certificate of registration, by way of an undertaking with the College, will ensure that another physician is involved in the care of Dr. Armstrong’s patients in the future. Dr. Armstrong failed to maintain the standard of the profession by, among other things, failing to refer Patient A to another physician, and should be reprimanded. A reprimand allows the Committee to denounce her conduct and send a message to the membership at large that there is an expected standard to which all physicians must practise, and that failure to meet such standards is unacceptable. The Committee acknowledged the mitigating factors, namely Dr. Armstrong’s admission and cooperation with the College by way of the Agreed State- 60 ment of Facts and Joint Submission on Penalty, and the fact that this case is her first appearance before the Discipline Committee. The Committee has the jurisdiction to award costs where appropriate. In this case, the Committee found that the order of costs of $4,460 to the College, representing a partial recovery on the costs of conducting the hearing, is appropriate. In the Committee’s view, the cost of the hearing should be at least in part the responsibility of the member and not borne solely by the membership as a whole. Order The Discipline Committee ordered and directed that: 1. Dr. Armstrong appear before the panel to be reprimanded. 2. The Registrar impose the following terms, conditions and limitations on Dr. Armstrong’s certificate of registration: (a) Dr. Armstrong shall engage in clinical supervision and a reassessment of her practice in accordance with the terms of her undertaking, attached to the Order; (b) Effective immediately, Dr. Armstrong will require that all of her current patients have a family physician or certified specialist who will provide concurrent care and to whom she will send information about all treatment she initiates or she has initiated and any changes to that treatment that she provides to the patient. Dr. Armstrong will provide each of her current patients (i.e., patients of hers as of the date of the undertaking) with a period of 45 days to obtain care from a primary care physician or appropriate specialist, and will not take on any new patient who does not have a primary care physician or appropriate specialist. Dr. Armstrong will cease treating any of her current patients who have not arranged concurrent care as set out above by January 31, 2015; and (c) Dr. Armstrong shall post a sign in her waiting room and each of her examination rooms, in each of her practice locations, in a clearly visible location, that states: “I require that all of my current patients have a family physician or certified specialist who will provide concurrent care and to whom I will send information about all treatment I initiate or have initiated and any changes to that Dialogue Issue 4, 2015 Issue4_15.indd 60 2015-12-16 9:36 AM