DISCIPLINE SUMMARIES
In the summer of 2012, a pharmacist expressed
concern about Dr. Garcia’s narcotic prescribing prac-
tices to both Dr. Garcia and the physician who had
supervised him at Wellington Medical Centre.
In the late summer and fall of 2012, the supervis-
ing physician reviewed the charts for most of the ap-
proximately dozen patients to whom Dr. Garcia was
prescribing narcotics or opioids at the Wellington
Medical Centre, met with several of these patients,
along with Dr. Garcia, and conducted an assessment
of each patient’s pain and the appropriateness of the
narcotics prescriptions given by Dr. Garcia. Follow-
ing this process, several patients seen together by the
supervising physician and Dr. Garcia were referred to
a pain clinic, specialist or detoxification program.
In May 2013, the supervising physician contacted
the College to report his concerns about the medical
care provided by Dr. Garcia.
Following receipt of this information, the College
began an investigation into Dr. Garcia’s practice. The
College obtained medical records with respect to 36
patients. A review by a medical inspector retained
by the College concluded that Dr. Garcia provided
quality medical care to some patients and failed to
maintain the standard of practice of the profession in
his care of other patients.
During the College investigation, Dr. Garcia
stated that his practice had changed since 2012 and
early 2013, and that he had tried to slow down how
quickly he saw patients and communicate more ef-
fectively with them. Dr. Garcia also said that he was
“duped” by a couple of patients who were engaged in
drug-seeking behaviour and that he was too trust-
ing of patients who were seeking narcotics for pain
medication.
Dr. Garcia failed to maintain the standard of prac-
tice of the profession with respect to 11 patients. The
deficiencies noted included:
• not obtaining an adequate history or doing a
proper physical examination of a patient who com-
plained of “chronic pain”;
• in the case of several patients, not recording any
physical examination and not recording details
about the source or type of pain they experienced;
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DIALOGUE ISSUE 3, 2018
• p
rescribing narcotics to pain patients without tak-
ing a proper and full history and without doing any
physical examination;
• e arly renewal of narcotic prescriptions without a
notation in the chart to explain why the medication
was renewed early;
• r egarding one patient who was given a typhoid
immunization, Dr. Garcia made no notes of this
appointment in the chart and no record was kept of
the drug identification number or lot number for
the vaccine given; and
• i n the case of one patient, Dr. Garcia’s charting was
moderately below standard. Dr. Garcia’s typed note
for a visit incorrectly indicated he gave the patient
a typhoid shot, although his handwritten note cor-
rectly indicated that he gave the patient an allergy
shot on that date.
The medical inspector expressed concern that Dr. Gar-
cia’s general patient population was put at risk because of
his willingness to prescribe narcotics and repeated inabil-
ity to detect the misuse of opioid medication.
DISGRACEFUL, DISHONOURABLE OR
UNPROFESSIONAL CONDUCT (A CONTESTED
HEARING)
The Committee found that Dr. Garcia prescribed
medications and provided a medical service to Ms. A,
a woman who was not a patient and with whom he
had a personal and romantic relationship. Dr. Garcia
prescribed medications to Ms. A on three occasions.
On one of those occasions, he prescribed an IUD
and referred Ms. A to a gynecologist to perform the
IUD insertion. There was no record of an assessment,
including a history and physical examination, prior
to providing any of the prescriptions. The Treat-
ing Self and Family Members policy clearly states
that physicians should not treat either themselves
or family members, except for a minor condition or
in an emergency situation and when another quali-
fied health-care professional is not readily available.
These conditions were not present on the occasions
when Dr. Garcia chose to prescribe medications, an
IUD and provide a medical service to Ms. A. As Ms.