Dialogue Volume 15, Issue 3 2019 - Page 63

DISCIPLINE SUMMARIES DR. BALDEEP TAKHAR PRACTICE LOCATION: Cambridge, Kitchener AREA OF PRACTICE: Family Medicine HEARING INFORMATION: Admission; Agreed Statement of Facts; Joint Submission on Penalty On May 24, 2019, the Discipline Committee found that Dr. Takhar committed an act of professional misconduct, in that she failed to maintain the stan- dard of practice of the profession. In November 2013, Dr. Takhar, along with three other doctors, created the Franklin Family Health Organization (FHO). Dr. Takhar assumed the role of “Lead FHO Physician.” Dr. Takhar practised at two locations of the Frank- lin FHO in Kitchener, and at one location in Cam- bridge. A further location opened in Guelph in 2014, which was run by two other member physicians. Dr. Takhar’s practice grew between December 2013 and December 2015 from 4,453 patients to 7,282 patients. Dr. Takhar rostered too many patients at the FHO and to herself personally, without ensuring that continuity of care could be provided. The FHO used an electronic medical records system, but the system in place did not reliably show whether a test result in the system had been reviewed by a physician, wheth- er a patient had taken a test that had been ordered, or whether a test result was lost. It was difficult to de- termine who was the most responsible physician and there was no clear policy about who should follow up. This resulted in inconsistent follow-up and in necessary follow-up sometimes being missed. Issues were identified with Dr. Takhar’s charting practices in a number of charts, including incomplete or vague progress notes, failing to document clinical indica- tion for tests ordered or for medications prescribed, missing information in patient profiles, and lack of appropriate documentation regarding two diabetic patients. Dr. Takhar’s clinical care of patients also did not meet the standard of practice in a variety of ways, such as delayed or missed follow-up on test results, inconsistent follow-up on preventive health care, and lack of clinical details in referral letters. Patients enrolled with the Franklin FHO were rostered to an individual physician. However, the Franklin FHO used a “shared care model”, in which each patient could book an appointment to see any of the physicians on staff or walk in on the weekend to do so. The rapid growth of the Franklin FHO and the problems that arose in implementing the “shared care model” contributed to Dr. Takhar’s failure to maintain the standard of practice of the profession. Dr. Takhar has advised that she has made a vari- ety of practice changes since the time period dur- ing which her practice was investigated, including reducing her practice to a single site and completing a record-keeping course. ORDER The Discipline Committee ordered: a reprimand, and the imposition of terms conditions and limitations on Dr. Takhar’s certificate of registration requiring attendance at a family medicine program/conference, successful completion of educational training in “Ef- fective Team Interactions”; an ethics and boundaries course; and an assessment of Dr. Takhar’s practice within one year. The College also ordered hearing costs in the amount of $6,000. 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. Takhar waived her right to an appeal and the Committee administered the public reprimand. ISSUE 3, 2019 DIALOGUE 63