discipline summaries
prescribed narcotics to Patient A; in dealing with her
underlying substance abuse problem and mood disorder; and, in the overall care of Patient A, including
in the absences of history taking and physical exam,
as well as failing to ensure that proper screening
protocols were undertaken, such as a PAP test, colon
cancer screening and diabetes screening.
In July 2012, the College commenced a broader investigation into Dr. Nicol’s practice and retained Dr.
Y, an independent assessor, to opine on Dr. Nicol’s
care and treatment of 25 patients. Dr. Y reported
that Dr. Nicol’s record-keeping failed to maintain the
standard of practice of medicine in each case. He also
concluded that Dr. Nicol’s overall care of multiple
patients failed to maintain the standard of practice
including:
• He failed to acknowledge test results or follow up
on some results;
• He appeared hesitant in making the diagnosis of
diabetes when the diagnostic criteria were met and
seemed hesitant to manage these patients in an effective manner;
• With respect to pain management, he started
patients on high doses of narcotics and, in some
cases, mixed varieties, without employing a slower,
more cautious approach to the initiation of therapy.
Initial screening steps and a clearer recording of
functional abilities was lacking. He did not consider drug interactions in his prescribing of medications;
• He was not diligent in minimizing the use of benzodiazepines;
• He was inconsistent in his lipid assessment and
management;
• He needlessly treated what seemed to be viral respiratory infections with antibiotics;
• He displayed some lack of knowledge in the area of
vaccines; and
• He displayed a lack of knowledge with respect to
screening recommendations for mammography,
PAP smears, colorectal screening and did not keep
up-to-date with current concepts in osteoporosis.
In January 2014, Dr. Nicol entered into an undertaking with the College pending the disposition of the
discipline hearing. In accordance with the undertak-
72
ing, Dr. Nicol has practised under supervision. The
College has received regular reports from Dr. Nicol