discipline summaries
which numerous tests were ordered without
indication and/or contradictory information was
gathered;
• a patient who had 7 appointments for bronchitis,
at which treatment initially ordered in March was
continued at each;
• a postpartum appointment at which a glucometer
was done without indication;
• an annual physical examination at which no plan
or comment was made as to how to address the
patient’s health complaints;
• a patient who was seen numerous unnecessary
times for changing of a dressing;
• an 18-month-well baby visit, which is a detailed
developmental examination which should be conducted by a physician;
• advising a child patient’s mother of test results;
• an appointment at which a patient obtained
medication and a special diet form (billed as an
‘intermediate assessment’).
Dr. Patel inappropriately billed OHIP during the
time period that he was on vacation in April 2011.
Physicians must be physically present in the office to
bill OHIP for all but a limited number of simple office
procedures (which must be rendered in accordance with
the standard of practice).
In addition, as described in Dr. X’s report, Dr. Patel engaged in other inappropriate billing practices:
(a) billing for a ‘minor assessment’ when faxing
prescription renewals to or receiving them from
pharmacies;
(b) billing for a ‘minor assessment’ when a patient’s
family member dropped off or picked up a
document, prescription, or testing kit;
(c) billing inappropriately with respect to administration of the Rotateq vaccination.
After allegations against him were referred to the
College’s Discipline Committee, Dr. Patel entered
into an undertaking dated May 1, 2014. Among other things, Dr. Patel undertook that, effective immediately, he would not “delegate to any other person any
controlled act, as that term is defined in the Regulated Health Professions Act, 1991.” He also undertook
to engage a clinical supervisor who would review his
practice and meet with him every two weeks to observe his encounters with no fewer than 10 patients;
review no fewer than 10 patient records randomly,
discuss any issues or concerns arising therefrom, and
make recommendations to Dr. Patel. The clinical
supervisor would report to the College. Dr. Patel undertook “to cooperate fully with the supervision of ”
his practice, and to abide by the recommendations
made by his clinical supervisor, including but not
limited to any recommended practice improvements
and ongoing professional development.
Dr. Patel engaged Dr. Y as his clinical supervisor.
Dr. Y reviewed patient charts from Dr. Patel’s practice and observed patient encounters in his office as
required by the undertaking. In the course of her duties, Dr. Y found that Dr. Patel continued to delegate
controlled acts in breach of his undertaking, namely:
(a) Staff put an instrument beyond the labia majora
by continuing to perform Pap tests delegated by
Dr. Patel.
(b) Staff administered substances by injection and
inhalation by carrying out immunizations and
B12 injections, and by administering treatment by
inhalation for respiratory issues.
Dr. Patel continued to delegate controlled acts in
breach of his undertaking until July 8, 2014.
Dr. Patel failed to abide by practice recommendations made by Dr. Y, in breach of his undertaking,
namely:
(a) Dr. Patel did not follow Dr. Y’s recommendation
to cease having staff enter billing codes for visits
that were in progress and to begin entering billing
codes only upon completion of a patient encounter.
(b) Dr. Patel did not follow Dr. Y’s recommendation to cease billing for visits at which the
patient was not present, including missed
appointments and where the patient or family
Full decisions are available online at www.cpso.on.ca.
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Issue 2, 2016 Dialogue
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2016-06-16 12:27 PM