DISCIPLINE SUMMARIES about this issue and until now has not known how to make things right.” Dr. Mansour also told the College that he billed OHIP when he was out of the country and his PA was seeing patients, should not have done so, and was conducting a self-audit of these amounts in order to repay OHIP. On May 23, 2014, the College wrote to Dr. Mansour’ s counsel requesting clarification about where Dr. Mansour was between July 9 and August 8, 2013. On June 3, 2014, Dr. Mansour’ s counsel told the College that Dr. Mansour was in Ontario between July 9 and August 8, 2013, and was in Toronto on any day on which he was scheduled to work during that time period. The College then asked Dr. Mansour to attend at the College with his passport and any other supporting documents to verify he was in Ontario between July 9 and August 8, 2013. The College sent a further letter dated July 24, 2014, requesting confirmation of a date upon which Dr. Mansour could attend the College, and a further request on August 7, 2014. Dr. Mansour’ s counsel wrote to the College on August 7, 2014, saying that Dr. Mansour was in Libya and his return to Canada had been delayed. Counsel advised Dr. Mansour would not be in a position to provide the requested documents until his return, which was expected on August 10, 2014. Counsel further advised dates upon which Dr. Mansour was available to attend at the CPSO for an interview by the Medical Inspector. Dr. Mansour’ s counsel told the College in an August 14, 2014 letter that Dr. Mansour had had to surrender his Libyan passport( which he used for his trip in July / August 2013) when he changed to a Canadian passport. Counsel also provided the billing and medication records requested by the College. Dr. Mansour’ s counsel told the College in a September 22, 2014 letter that the information previously provided to the College by Dr. Mansour was incorrect in the following ways: i) Dr. Mansour had not surrendered his Libyan passport; and ii) Dr. Mansour was in Libya and Turkey continuously between July 5 and August 15, 2013, returning to Canada on August 16, 2013. He was not in Ontario between July 9 and August 8, 2013 as previously advised. Enclosed with the letter was a copy of Dr. Mansour’ s Libyan passport used in 2013.
Dr. Mansour apologized through his counsel for having provided inaccurate information in the past and indicated that, having now shared the information about his whereabouts, he was eager to fully cooperate with the College’ s investigation. The College interviewed the PA, who confirmed she saw patients at the clinic without Dr. Mansour being present, at his request. The PA advised she initially worked under verbal orders from Dr. Mansour, and that she created Medical Directives later, and sent them to the clinic for its use. Dr. Mansour confirms this is true. The PA had graduated from a PA program at McMaster University in 2012, and started working with Dr. Mansour, in about May, 2013. Dr. Mansour spent a couple of weeks seeing patients with her, assessing her skills, and discussing cases and patient management with her in breaks between seeing patients. The PA told the College that Dr. Mansour personally asked her to see patients when he was not there. When Dr. Mansour was away in July and August 2013, he directed the PA to contact him if she needed him. The PA told the College that at no time did Dr. Mansour discourage the PA from contacting him to discuss patient care and that she was usually able to reach him. After a self-audit, Dr. Mansour repaid $ 16,734.32 to the Ministry of Health and Long-Term Care in respect of billings made in relation to patient visits in the months of July and August 2013, where the patients were seen by the PA but not by Dr. Mansour.
Standard of Practice A College-retained expert opined that Dr. Mansour failed to meet the standards of practice in the following respects:
• His use of a PA fell below the standard of care in respect of 19 patients, primarily with respect to supervision and delegation. The criteria for delegation were met in only one chart. These deficiencies could expose his patients to harm.
• His medical documentation fell below the standard of care in respect of 15 to 17 patients. In some cases, there were notes which appeared to be
Full decisions are available online at www. cpso. on. ca. Select Doctor Search and enter the doctor’ s name.
ISSUE 4, 2017 DIALOGUE 83