discipline summaries
and oral progesterone such as Prometrium do
have many of the benefits that Dr. Wojcicka is
attributing to the compounded medications.
d) Dr. Wojcicka does not appear to be letting
patients know that so-called BHRT is available
in the form of Estrogel and Prometrium. These
are often covered by Drug Plans, whereas com-
pounded therapy often is not.
e) Dr. Wojcika does a lot of redundant testing in
her practice. She does salivary levels which cost
the patients money and then she does blood lev-
els. Dr. Y was not sure why she is doing blood
levels if she is doing salivary levels. She also does
abdominal ultrasound as well as a pelvic ultra-
sound and in many cases, this is not necessary.
f ) Dr. Y saw no clear delineation of who is respon-
sible for various conditions in patients. Dr. Y
believes that investigations such as cholesterol
testing, for example, should be left to the pa-
tient’s family doctor.
g) Dr. Y also agreed with Dr. Z’s statement that the
first thing to be done is not an ultrasound, but
physical examination. Dr. Y also agreed with Dr.
Z’s statement that studies using Estrogel and oral
progesterone are readily available. Studies using
transdermal progesterone are few and far be-
tween and this is not equivalent to choosing oral
progesterone.
Despite his concerns, Dr. Y concluded that he did
not believe that Dr. Wojcicka’s patients had under-
gone any harm.
Section 37 Interim Order
On February 2, 2015, after referring allegations of
professional misconduct to the Discipline Commit-
tee, the Inquiries Complaints and Reports Commit-
tee directed the Registrar to impose terms, condi-
tions and limitations on Dr. Wojcicka’s certificate of
registration pursuant to s. 37 of the Health Profes-
sions Procedural Code. The Order required that Dr.
Wojcicka cease to provide care with regards to BHRT
to patients.
Reasons for Penalty
In considering the jointly proposed penalty, the Com-
mittee must consider the specific facts supporting the
70
Dialogue Issue 2, 2017
finding, any aggravating or mitigating factors, and
the principles that underlie a suitable penalty. Penalty
principles include: protection of the public from the
member who committed the misconduct; specific and
general deterrence; the maintenance of the public’s
confidence in the medical profession and its ability to
self-regulate in the public interest; and the extent to
which rehabilitation of the member is possible.
Aggravating factors
Dr. Wojcicka committed an act of professional
misconduct by failing to maintain the standard of
practice of the profession. The misconduct included,
but was not limited to:
1. Failing to do physical examinations;
2. Failing to document diagnoses;
3. Ordering tests without reasonable cause;
4. Ordering redundant testing;
5. Using forms of testing generally considered to be
inaccurate;
6. Failing to document discussion of consent or
actual consent;
7. Failing to offer alternative forms of treatment
covered by drug plans;
8. Prescribing BHRT to patients with contraindica-
tions such as smoking and vaginal bleeding not
yet diagnosed; and
9. Failing to follow the College’s policy on Com-
plementary/Alternative Medicine.
Mitigating factors
1. D
r. Wojcicka acknowledged the concerns ex-
pressed by the College and her own expert;
2. Dr. Wojcicka admitted to failing to maintain
the standard of her practice in her BHRT and
accepted responsibility for her actions, thus obvi-
ating the need for a lengthy and costly hearing
with expert witnesses.
3. The proposed penalty falls within the range of
penalties in similar cases.
The Committee is satisfied that the proposed pen-
alty satisfies the requisite penalty principles in the
following manner:
Dr. Wojcicka’s prohibition from practising comple-
mentary and alternative medicine and from consulting
and/or treating patients with respect to BHRT as well