DISCIPLINE SUMMARIES
referral to a gynecologist for contraception and a CT
scan for chest and heart. Dr. Ramzy referred Ms. A
to the cardiologist who was in the office the same day
to manage her chest pain.
Three days later, Ms. A returned to Pro Care Medi-
cal Clinic, where she received care from Dr. Ramzy.
Dr. Ramzy’s entry in Ms. A’s chart indicates that she
attended that day for a CT scan for her chest, report-
ing a chronic cough. On a date in September 2013,
Ms. A attended Dr. Ramzy’s practice for a cardiac
work report and a stress echo test. Dr. Ramzy’s entry
reads: “she threatened me regarding her husband
case, he died … 3 years ago, she wants money from
me or she is going to complain to the College. She
was told that nothing wrong in her husband case. I
will not give her money if she wants to complain she
can [sic].”
Ms. A’s Complaints to the College
In October 2013, Ms. A made two complaints to
the College against Dr. Ramzy: one with respect to
the care her late husband had received and one with
respect to feeling “used” after Dr. Ramzy dated her
for two months.
The College obtained an independent opinion with
respect to Dr. Ramzy’s care of Mr. B. The assessor
found Dr. Ramzy to have met the standard of care.
As such, the Inquiries, Complaints and Reports
Committee took no further action with respect to
Ms. A’s complaint about the care her husband re-
ceived from Dr. Ramzy.
Dr. Ramzy admitted that he committed an act of
professional misconduct, in that he engaged in con-
duct that, having regard to all of the circumstances,
would reasonably be regarded by members as dis-
graceful, dishonourable or unprofessional by plan-
ning a social encounter during C’s medical appoint-
ment and by treating Ms. A too soon, given their
recent sexual relationship.
REASONS FOR PENALTY
The jointly proposed penalty consisted of a repri-
mand, a three-month suspension of Dr. Ramzy’s cer-
tificate of registration, and the term, condition and
limitation on his certificate that he shall successfully
complete a College-approved course on understand-
ing boundaries. The proposed penalty also included
the requirement that Dr. Ramzy pay the cost of a
one-day hearing to the College within 30 days of the
order.
A penalty should express the profession’s abhor-
rence of the physician’s behaviour and serve to main-
tain the public’s confidence in the profession’s ability
to self-regulate in the public interest. A penalty must
send a strong message to the member himself, and
to the membership at large, that such transgressions
will not be tolerated by the College. The penalty
must protect the public from such misconduct in the
future. Finally, in as far as it is possible, the penalty
should serve to help with the rehabilitation of the
subject doctor.
Physicians are called upon to provide professional
services to trusting patients. By virtue of this fact, an
inherent power imbalance exists in all doctor-patient
interactions and relationships. The patient is the vul-
nerable party. The physician is expected to maintain
professional boundaries at all times.
In addition to the expectation that these very basic
tenets of medical practice are known to all registered
physicians, the College publishes policies for all
Ontario physicians to be very clear on their respon-
sibilities. The Physician Treatment of Self, Family
Members or Others Close to Them policy clearly
states that “physicians must not provide treatment to
a spouse, partner, or anyone else with whom they are
sexually or romantically involved beyond the circum-
stances of a minor condition or emergency, where
no other qualified health-care professional is readily
available.”
Dr. Ramzy had a sexual relationship with Patient
A which ended in August 2012. It is understandable
that he provided emergent care to Patient A in the
face of a cardiac problem in October of that year. In
contrast to that first doctor-patient interaction which
resulted in an urgent referral to a cardiologist, Dr.
Ramzy admits, and his records show, that he went
on to provide general care to Patient A in his family
practice. He provided routine care including a flu
shot, a gynecologic referral, and an assessment of an
upper respiratory infection.
The Committee is of the view that if Dr. Ramzy
had initially maintained a clear doctor-patient
boundary with Patient A when she returned to his
office in July 2012, not for care for herself but for
ISSUE 3, 2017 DIALOGUE
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