DISCIPLINE SUMMARIES
DR. IAN KENT SHIOZAKI
PRACTICE LOCATION: Newboro
AREA OF PRACTICE: General Practice
HEARING INFORMATION: Admission; Agreed Statement of
Facts; Joint Submission on Penalty
On March 21, 2018, the Discipline Committee
found that Dr. Shiozaki committed an act of profes-
sional misconduct in that he failed to maintain the
standard of practice of the profession, and engaged in
disgraceful, dishonourable or unprofessional con-
duct. It also found that he was incompetent in his
prescribing and injecting of controlled substances,
including narcotics.
On October 22, 2015, the College received in-
formation from a physician about the dosages of a
stimulant prescribed by Dr. Shiozaki to a mutual pa-
tient. On the basis of this and other information, the
College began an investigation to obtain a broader
view of Dr. Shiozaki’s general medicine practice,
including his prescribing.
In February 2016, the College received information
from the Ministry of Health and Long-Term Care’s
Narcotics Monitoring System (NMS) regarding Dr.
Shiozaki’s prescribing of controlled drugs, including
narcotics.
The College retained a specialist in family medi-
cine to provide an opinion on Dr. Shiozaki’s general
medicine practice, including his prescribing.
The expert physician identified significant concerns
in Dr. Shiozaki’s care and treatment of his patients’
chronic non-cancer pain, particularly in the areas of
(a) prescribing of controlled drugs, including narcot-
ics, and (b) injecting of opioids, and associated stor-
age and disposal of injectable opioids.
The expert physician opined that Dr. Shiozaki failed
to meet the standard of practice of the profession and
that he demonstrated a lack of knowledge, skill and/
or judgment in his prescribing of controlled drugs, in-
cluding narcotics, and, in some cases, his injecting of
opioids and associated storage and disposal of inject-
able opioids, in all 25 patient charts reviewed.
In addition to the concerns identified about Dr.
Shiozaki’s treatment of pain, the expert physician
76
DIALOGUE ISSUE 4, 2018
identified other concerns about Dr. Shiozaki’s general
medicine practice in 11 of the 25 charts reviewed,
including a failure to offer or document age-specific
preventive screening and a failure to adequately treat
and monitor certain conditions.
Dr. Shiozaki provided the College with a report
of a family medicine/emergency medicine special-
ist, who noted in his report that Dr. Shiozaki has a
challenging patient population and, as an isolated
rural family physician in a small community, he has
limited ancillary resources to assist him with the
management of his patients.
COLLEGE’S PAIN MEDICINE EXPERT
The College retained a pain medicine expert to
provide an opinion about whether certain injections
performed by Dr. Shiozaki were of a nature that they
could only be performed in a licensed out-of-hospital
premises.
The pain medicine expert reviewed five patient
charts, and attended at Dr. Shiozaki’s office where
he toured the clinic, reviewed equipment and inter-
viewed Dr. Shiozaki as to the variety of injections
that he performed. Dr. Shiozaki advised the pain
medicine expert that he had not performed nerve
block injections since the out-of-hospital premises
(OHP) program was implemented.
In his report, the pain medicine expert took issue with
one of the injection procedures conducted by Dr. Shio-
zaki and concluded that Dr. Shiozaki was performing
nerve blocks in the form of SI joint injections – a Level
1 nerve block procedure under the OHP guidelines.
Level 1 nerve block procedures may only be per-
formed in authorized out-of-hospital premises.
Dr. Shiozaki’s office was not an authorized out-
of-hospital premises. Dr. Shiozaki applied to the
College in 2010 to have his office authorized as an
out-of-hospital premises because he was performing
nerve blocks. He elected not to proceed with the ap-
plication after learning what was required to obtain
authorization to operate an out-of-hospital premises
and advised a College investigator at that time that
he was no longer performing nerve blocks.
The pain medicine expert identified concerns with Dr.
Shiozaki’s clinic’s preparedness for medical emergencies
given that Dr. Shiozaki was performing Level 1 nerve
block procedures, and opined that, in the five charts
that he reviewed, Dr. Shiozaki’s procedural notes fell be-