discipline summaries
patient requested that the monitor not be present.
Submissions for Penalty
Counsel for the College and counsel for Dr. Lau did
not agree on an appropriate penalty and did not make
a joint submission on penalty. They did express agreement with the general principles to be applied in
considering penalty, those being the need for public
protection, general and specific deterrence, public confidence in the profession and its self-regulation, remediation and rehabilitation of the member. The parties each
made submissions on what the appropriate penalty and
costs order should be in the circumstances of this case.
Counsel for the College proposed that the penalty and
costs order should be:
• a reprimand
s
• uspension of the member’s certificate of registration
for three months
c
• ontinuation of the terms, conditions and limitations
as described in the Order of the Discipline Committee
on August 21, 2007
t
• he posting of a sign in each clinic room where Dr.
Lau sees patients stating, “Dr. Lau sees all patients in
the presence of a practice monitor”; and
payment by Dr. Lau of costs in the amount of $4,460.
•
Counsel for Dr. Lau proposed that the penalty and costs
order should be:
• a reprimand
• payment by Dr. Lau of costs in the amount of $4,460.
Reasons for Penalty
No evidence was presented that Dr. Lau’s breach of the
conditions posed a risk of harm to his patients or the
public. The requirement for a monitor to be present
during patient interactions was to ensure congruence
between examinations performed by the doctor and the
chart, not because of any egregious or abusive behaviour. The Committee noted that these conditions were
stringent, comprehensive and of significant duration,
and that other than the specific breach in question, had
been complied with.
The Committee noted that none of Dr. Lau’s monitors had ever communicated a negative report to the
College concerning his practice. Furthermore, in the
few cases where patients requested the absence of the
monitor, the monitor triaged and assessed each patient,
brought them to Dr. Lau, and only stepped out for
the requested private discussion and examination. The
potential for false recording of examinations that did
not occur (as was the case in Dr. Lau’s original hearing)
seemed to the Committee to be very limited in these
episodic, limited and rare circumstances, and certainly
did not arouse the concerns of a series of mentors over
five years.
Although any breach of conditions in a Committee’s
Order is serious, the Committee was not persuaded that
the specific nature of the breach of conditions by Dr.
Lau in the circumstances identified on the record would
require a suspension of his certificate of registration as a
penalty.
The Committee accepted that Dr. Lau has shown remorse, has cooperated with the College from the outset
and has apologized for his breach of the conditions.
This cooperation made a contested hearing unnecessary.
The Committee concluded in the circumstances that a
reprimand and costs were sufficient as a specific deterrent for Dr. Lau and as general deterrence to the profession. The Committee was not persuaded that a suspension would assist in remediation, and in fact could harm
an otherwise successful medical practice in providing
care to the community.
The Committee recognizes that the public must have
confidence in the medical profession and in the authority and effectiveness of its self-regulation. This requires
that the College visibly and coherently protects the
interests of the public, and that terms, limitations and
conditions applied to members’ certificates of registration be honoured and observed.
The Committee noted that the discipline panel in
August 2007 imposed a very significant sanction, a net
suspension of eight months, and placed conditions on
Dr. Lau’s certificate of registration that were stringent,
extensive and of long duration.
The Committee concluded that over the period in
question Dr. Lau had complied with those extensive
conditions, other than in rare circumstances at the behest of and in the interest of his patients rather than to
suit his own convenience. In this breach of the conditions, his monitors were aware and saw no reason to
make negative reports to the College.
The required monitoring was not needed or designed
to prevent egregious inter-personal or abusive behaviour, but was intended to ensure the appropriateness of
Issue 1, 2015 Dialogue
Issue1_15.indd 53
53
2015-03-19 11:18 AM