discipline summaries
was no documentation of any physical examinations he
conducted. There were no records in the patients’ charts
of supplementary questions being asked or responses,
and there was no sign of any additional documented
evidence. There was no record, in any of the 15 charts,
including those where diabetes, renal failure or anaemia
were confirmed, of the name of the patient’s family
physician. Therefore, the Committee found that with
respect to the 15 charts reviewed, Dr. Wong failed to
maintain the standard of practice with respect to his
record-keeping.
The standard of practice with respect to his
OHIP Billing
Based on Dr. Wong’s evidence and its review of the
15 patient charts, the Committee concluded that Dr.
Wong did not obtain sufficient information to attest to
the various medical conditions which he confirmed on
the SDA forms for these 15 patients. Consequently, the
Committee found that he did not meet the requirement
of taking a reasonable history of the reported condition
prior to billing OHIP for a partial assessment in the 15
patient charts reviewed.
The standard of practice does not require a physician
to conduct a physical examination in every case prior
to billing OHIP for a partial assessment. It is a reasonable expectation, however, that Dr. Wong should have
taken the blood pressure for those patients for whom he
confirmed a diagnosis of high blood pressure, but there
is no indication on the patient records that he did so for
the two patients for whom he confirmed a diagnosis of
high blood pressure on the SDA forms.
Dr. Wong’s income between 2007 and 2009 derived
from billing for completing SDA forms and conducting
partial assessments ranged from $418,925 to $718,026
annually.
Conclusion regarding Standard of Practice
The Committee found that even though he was practising within the highly restricted environment provided by a single-purpose clinic, in which there was no
expectation of providing ongoing care and treatment to
patients such as one would expect in a family practice,
Dr. Wong failed to maintain the standard of practice of
the profession in his completion of the SDA forms, his
record-keeping and his OHIP billing in the case of the
15 cases referred to the Committee.
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Dialogue Issue 4, 2014
Allegation of Disgraceful, Dishonourable
and Unprofessional Conduct
Completing the SDA forms and confirming the presence of specific diagnoses or medical conditions is
clearly relevant to the practice of medicine.
The Committee concluded that Dr. Wong’s failure
to take steps to satisfy himself that the patients had
the conditions specified was a consistent aspect of his
behaviour. The Committee based its conclusion on Dr.
Wong’s own evidence, its review of the 15 patient charts
and on the evidence regarding the SDA forms reviewed
by the Ministry (with 99% having a similar diagnosis),
and the number of patients seen in a relatively short
time. The Committee was particularly troubled by
the repetitive confirmation of four diagnoses of allergy together with chronic constipation. The inference
drawn by the Committee from this information is that
there was widespread knowledge among Dr. Wong’s
patient population that this was a way in which the
SDA allowance could be maximized. Dr. Wong, naively
or deliberately, ignored the fact that the occurrence of
such a collection of conditions represented an extremely
unlikely reality. This is not akin to providing a patient
with the benefit of the doubt.
The Committee concluded that Dr. Wong knew or
certainly ought to have known that these patients did
not have all of the medical conditions they reported.
The Committee does not believe Dr. Wong’s assertion
that he believed this to be a coincidence. Dr. Wong’s
practice of ignoring the repetitive and extremely
unlikely combination of conditions appears to have
been motivated by a desire to financially benefit the
patients. In doing so, he exhibited poor judgment and
sac