discipline summaries
follow. A clear management plan was often not
apparent. Documentation of the procedures which
Dr. Sim was performing in his office was very poor.
There was often no documentation that he had
discussed the risks of these procedures with his
patients. In several instances there was no notation
whatsoever in the patient charts to correspond to
OHIP billings for the services rendered.
• Dr. Sim’s practice of communicating with his
patients by email demonstrated poor judgment.
Miscommunication arising from this practice led,
in the case of Patient A, to confusion and acrimony which prompted the patient to complain to
the College. This could have been avoided with
face-to-face communication. More concerning
was Dr. Sim’s habit of emailing the results of tests
and investigations to his patients. This impersonal
method of communication was inadequate under
the circumstances, as Dr. Sim’s patients would
usually not be in a position to understand or
interpret the significance of information communicated in this way.
•D
r. Sim exposed his patients to unacceptable levels
of risk by performing quasi-surgical abortions in
his office, without emergency measures available
in case of complications. Dr. Sim’s practice was
restricted to medical, and not surgical, abortions,
yet the way in which he performed these “medical” procedures, they were in effect surgical procedures. Dr. Sim’s office had neither resuscitation
equipment nor staff to assist with resuscitation,
which would be required in the case of catastrophic
complications such as uterine perforation or major
hemorrhage. The type of anesthesia Dr. Sim used
was inadequate for a surgical abortion. Monitoring
equipment for patients under sedation was similarly inadequate. Dr. Sim’s judgment in persisting
with these procedures was seriously flawed: he
should have recognized the risks to which he was
exposing his patients, and referred them to a hospital or clinic setting where proper anesthesia and
resuscitation capacity was available.
• Following procedures in his office, Dr. Sim occasionally sent