DISCIPLINE SUMMARIES
In the summer of 2014 , Dr . Di Paola was invited to attend a meeting regarding Patient A ’ s care at a hospital by virtue of Dr . Di Paola ’ s close personal relationship with Patient A . This meeting was attended by Patient A ’ s treating physician and by a Children ’ s Aid Society social worker who had been involved with Patient A ’ s family . At that meeting , Dr . Di Paola took a position with respect to Patient A ’ s access to Patient A ’ s child that was adverse to the position taken on this issue by Patient A ’ s treating physician .
CAMH Policies and Privacy Education On December 10 , 2012 , Dr . Di Paola signed a letter of offer of appointment to the medical staff at CAMH . On April 17 , 2013 , Dr . Di Paola signed a letter of re-appointment to the medical staff at CAMH . Each letter provided that , by signing the letter , Dr . Di Paola confirmed that she was familiar with the Personal Health Information and Privacy Protection Act and was aware of , and agreed to honour , her obligations set out therein . Each letter also provided that acceptance of the appointment entailed Dr . Di Paola ’ s agreement to govern herself in accordance with all CAMH Policies , which included a Privacy Policy . Dr . Di Paola completed CAMH ’ s e-learning program on Privacy Fundamentals on April 26 , 2012 and again on August 31 , 2014 . Dr . Di Paola was aware each time that she accessed the medical records of Patient A and Patient B that she was doing so without authority or consent .
CAMH Disciplinary Action The Medical Advisory Committee at CAMH , where Dr . Di Paola holds privileges and where the breaches of privacy occurred , took disciplinary action against Dr . Di Paola . The disciplinary action consisted of a two-week unpaid leave of absence ; the completion of two courses addressing issues relating to professional boundaries and privacy and confidentiality ; and the drafting of three letters of apology , one to Patient A , one to Patient B , and one to CAMH as an organization .
REASONS FOR PENALTY The Committee took into account a number of principles in assessing the proposed penalty . Paramount is the protection of the public . Also important is a desire to express the abhorrence of the profession for the member ’ s behaviour , and to maintain public confidence in the profession and the College ’ s ability to regulate the profession in the public interest . Deterrence both of the member and other physicians is also an important feature in a penalty . When possible , the penalty should also provide for rehabilitation of the member . The penalty should also be proportionate to the misconduct .
Dr . Di Paola accessed the confidential medical records of two people with whom she had a close personal connection . Dr . Di Paola improperly accessed the medical records of these two patients willfully for her own purposes , rather than for the wellbeing of the patients . Confidentiality is one of the fundamental pillars within medical education . Patients must feel that their personal medical information is handled in a confidential manner . Medical records contain information about their background , their experiences , their illnesses and their treatments , and may only be disclosed with the patients ’ informed consent . Dr . Di Paola signed annual re-appointment forms at the hospital from July 2013 acknowledging her understanding of confidentiality and handling of clinical records . In spite of this , she acted deliberately and repeatedly to violate the confidentiality of the medical records of the two patients . The conduct of Dr . Di Paola was not a transient , impulsive act ; rather , she gained unauthorized access to the patients ’ medical records on 19 occasions , and accessed multiple records on some occasions , over a two year period . Dr . Di Paola ’ s activity only stopped when the hospital changed its method of accessing health records . Accessing health records inappropriately is not a harmless activity . This was demonstrated in the victim impact statement provided by one of the patients . She felt “ extremely devastated ,” humiliated , and helpless . Because she lacked the power to prevent these acts , this patient felt re-traumatized by the breach of confidentiality . She had always guarded her privacy , for example , by discussing confidential material with only one psychiatrist over an 18-year period . It is likely that this breach will affect her trust in the medical profession in the future and could affect her ability to receive optimal care .
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DIALOGUE ISSUE 4 , 2017