DISCIPLINE SUMMARIES
• Demonstrated a lack of knowledge when he in-
creased Patient C’s dose of thyroxine and added
Cytomel without evidence of thyroid deficiency;
• Demonstrated a lack of knowledge when he pre-
scribed Flagyl to Patient C without indication;
• Demonstrated a lack of knowledge in failing
to identify the significance of Patient C’s rising
erythrocyte sedimentation rate (ESR) (which with
other symptoms was suggestive of an autoimmune
disorder); and
• Demonstrated poor judgment in failing to comply
with College guidelines for record keeping, pre-
scribing drugs and the use of alternative therapies.
The College retained a second family physician
with some knowledge of and interest in complemen-
tary and alternative medicine to provide an opinion
regarding Dr. Barnard’s care of Patients B and C,
having regard to the College’s complementary/alter-
native medicine policy.
With regard to Patient B, the family physician
opined that Dr. Barnard’s use of testosterone and
vitamin injections was unconventional and not sup-
ported by any scientific evidence of which he was
aware. Dr. Barnard had failed to clearly indicate the
diagnosis although he treated chronic pain syndrome
with an associated neuropathy. Dr. Barnard did not
document valid informed consent for his unconven-
tional therapeutic interventions.
With respect to Patient C:
• Dr. Barnard’s care of Patient C’s inflammatory
disorders falls within the realm of complementary
medicine;
• Dr. Barnard failed to provide an appropriate clini-
cal assessment with regard to Patient C. He record-
ed no clear working diagnosis or treatment plan;
• Dr. Barnard failed to document a conventional
diagnosis;
• He did not record any evidence of informed con-
sent having been obtained for the unconventional
therapeutic interventions;
• He failed to address the patient’s elevated ESR; and
• Despite the poor assessment and review of Patient
C, his care did not demonstrate a lack of knowl-
edge or skills. However, Dr. Barnard showed poor
judgment by failing to document more appropriate
patient counselling regarding the unconventional
therapies being utilized.
It was found that Dr. Barnard failed to maintain the
standard of practice of the profession in his care of
Patients B and C.
Investigations Regarding Patients D, E and F
Patients D, E and F were a mother and her two chil-
dren. They became Dr. Barnard’s patients in the fall/
winter of 2010/2011, and continued as his patients
until November 2013.
The College retained a family physician to review the
standard of care provided by Dr. Barnard to Patients
D, E and F. He concluded that Dr. Barnard did not
meet the standard of practice of the profession in rela-
tion to Patients D, E and F and that he demonstrated
a lack of knowledge and skill. Examples include:
• a lack of knowledge of appropriate testing and
investigations for specific symptoms. Among other
things, Dr. Barnard repeatedly ordered a broad
spectrum of tests on Patients D, E and F without
indication, including broad annual testing for
Patient D, and ordered specific tests that were not
inappropriate based on the patient’s age or lack of
suitability as a screening tool;
• a lack of knowledge in treating asthma in children
with respect to Patients E and F: those patients
received oral medications without any clear indica-
tion for their use and without corresponding use of
inhaled medications;
• a lack of knowledge in the use of antibiotics, in-
cluding prescribing incorrect doses and prescribing
in cases where antibiotics are not indicated;
• a lack of knowledge in prescribing with respect to
dosage of Topamax;
• a lack of knowledge of the treatment of anxiety for
Patient D, and giving inappropriate treatment for
the same; and
• a lack of skill in the documentation of visits, in-
cluding incomplete or absent charting of history,
Full decisions are available online at www.cpso.on.ca.
Select Find a Doctor and enter the doctor’s name.
ISSUE 2, 2018 DIALOGUE
59