discipline summaries
Dr. ANNA MARIA WOJCICKA
Practice Location: Mount Albert
Area of Practice: : Internal Medicine; Radiation
Oncology (Hormone Replacement Therapy)
Hearing Information: Admission, Agreed
Statement of Facts, Joint Submission on Penalty
On February 17, 2016, the Discipline Committee
found that Dr. Anna Maria Wojcicka committed an
act of professional misconduct, in that she has failed
to maintain the standard of practice of the profession.
Dr. Wojcicka is a radiation oncology and internal
medicine specialist who currently provides radiation
oncology consultation services and practices general
medicine in an office at 6165 Vivian Road in Mount
Albert, Ontario. She also provides complex medi-
cal rehabilitation care at Southlake Regional Health
Centre in Newmarket, Ontario.
The College initiated an investigation into Dr.
Wojcicka’s Bioidentical Hormone Replacement
Therapy (BHRT) practice in 2012 after the College
received information about membership fees and ser-
vices relating to the Vivian Medical Spa, also located
at 6165 Vivian Road, Mount Albert, Ontario.
The College retained an expert, Dr. Z, to provide
an opinion on the care of 22 patients who were
receiving BHRT from Dr. Wojcicka. On the basis of
her chart reviews and an interview, Dr. Z concluded
that Dr. Wojcicka’s care did not meet the standard
of practice of the profession in all 22 cases in that
she failed to meet some component of the College’s
policy on Complementary/Alternative Medicine for
each patient.
In 14 of the 22 cases, Dr. Z also found that Dr.
Wojcicka’s care demonstrated a lack of knowledge,
skill and judgment and that her practice posed a risk
of harm to patients. Dr. Z’s concerns with respect to
Dr. Wojcicka’s BHRT practice included:
a) 17 cases of prescription BHRT administered
without performing a pelvic exam;
b) three cases where BHRT was prescribed and no
physical exam was documented in the chart;
c) four cases of pelvic ultrasound being performed
without reasonable cause;
d) 1 5 charts where a conventional diagnosis is not
listed;
e) 17 charts where salivary or blood hormone lev-
els are used to guide treatment;
f ) one chart in which there is no documented dis-
cussion or consent surrounding administration
of BHRT;
g) one chart in which a woman who has had a total
hysterectomy received a Pap test;
h) three charts in which BHRT is prescribed to a
smoker over 40; one in a patient with history of
migraine; one with undiagnosed vaginal bleed-
ing;
i) one chart in which a patient’s method of contra-
ception is discontinued without proper counsel-
ling; and
j) one chart in which a patient’s diastolic blood
pressure is read as over 100 and they are not
directed to urgent care.
In response to Dr. Z’s report, Dr. Wojcicka pro-
vided her own rebuttal defending her care of the
patients reviewed. Dr. Wojcicka also retained Dr.
Y to provide an opinion with respect to her BHRT
practice. Dr. Y reviewed the same 2 2 patient charts
that were reviewed by Dr. Z and provided a report,
dated July 8, 2015. The concerns noted in Dr. Y’s
report included:
a) Dr. Wojcicka seemed reluctant in some cases to
do pelvic examinations and Pap smears. She also
does not undertake endometrial biopsies and so
this would necessitate referring to a gynecologist;
b) she relies heavily on saliva levels and it is not
generally agreed that this is accurate testing. Dr.
Y expressed concern in this regard, particularly
looking at progesterone levels in saliva when
they do not appear to be the same in blood or
tissue levels;
c) the literature suggesting that compounded
therapy using such things as BiEst and progester-
one cream is not strong. The European literature
shows that transdermal estrogen such as Estrogel
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Issue 2, 2017 Dialogue
69