DISCIPLINE SUMMARIES
For complete details of the Order , please see the full decision at www . cpso . on . ca . Select Find a Doctor and enter the doctor ’ s name .
At the conclusion of the hearing , Dr . Ghumman waived his right to an appeal and the Committee administered the public reprimand .
DR . JEFFREY RICE HOLMES MATHESON
PRACTICE LOCATION : Ajax
AREA OF PRACTICE : General Practice ( Chronic Pain Management )
HEARING INFORMATION : Admission , Agreed Statement of Facts ; Contested Penalty
On May 1 , 2017 , the Discipline Committee found that Dr . Matheson committed an act of professional misconduct in that he failed to maintain the standard of practice of the profession , and he engaged in an act or omission relevant to the practice of medicine that , having regard to all the circumstances , would reasonably be regarded by members as disgraceful , dishonourable , or unprofessional . Dr . Matheson is a family physician practising in Ajax . Beginning in 2002 , Dr . Matheson developed a specialty in chronic pain management .
PRESCRIBING PRACTICES During the period from July 2013 to October 2014 , the College received four telephone calls from four pharmacists raising concerns about Dr . Matheson ’ s prescribing practices . The College retained an expert to review Dr . Matheson ’ s opioid prescribing . The expert concluded that Dr . Matheson did not meet the expected standard of practice as outlined in the Canadian Guidelines for Opioids for Chronic Non-Cancer Pain either at the level of primary care physicians , or at a reasonably higher standard of physicians , like Dr . Matheson , holding themselves out as a specialist in the field . The expert ’ s concerns included that :
• Dr . Matheson consistently demonstrated a lack of understanding of the expectations outlined in the Canadian Guidelines with respect to instituting opioid therapy , following up , changing from one opioid to another and the medical implications of high-dose opioids .
• Dr . Matheson consistently demonstrated an almost cavalier approach to switching opioids , most often increasing the total daily morphine equivalent , by as much as 30 % rather than allowing for incomplete tolerance and decreasing by 30 – 50 %, all the time with no documentation of discussion around the driving or fall risk .
• Dr . Matheson ’ s greatest failure of judgment is perhaps his complete lack of adherence to and recognition of the fundamental importance of the Canadian Guidelines to an opioid practice . This shows a significant lack of judgment to the point of negligence causing harm .
• Dr . Matheson ’ s prescribing of opioids and failure to follow any standards of care beyond opioid agreements is nothing short of reckless . There is a risk to both his patients ’ health and that of the public at large .
As a result of concerns raised by the College and its expert during the investigation , Dr . Matheson voluntarily ceased prescribing narcotics and controlled substances on March 16 , 2015 . On May 28 , 2015 , Dr . Matheson signed a formal interim undertaking to cease prescribing narcotics and controlled substances .
OUT-OF-HOSPITAL PREMISES Dr . Matheson was a medical director of premises that were subject to the inspection / assessment regime at the College . Pursuant to the regulation , no person may perform procedures as defined in the regulation , in premises , unless the College “ passes ” the premises or passes it with conditions that allow procedures to be performed . On September 9 , 2014 , the College ’ s Out-of- Hospital Premises Inspection Program received notice that Dr . Matheson ’ s premises was intending
Full decisions are available online at www . cpso . on . ca . Select Find a Doctor and enter the doctor ’ s name .
ISSUE 2 , 2018 DIALOGUE 71