discipline summaries
investigation . Dr . X found that Dr . Esmond failed to meet the standard of practice in the care provided to 16 of the 36 patients whose charts were reviewed and one of seven patient encounters observed in Dr . Esmond ’ s office . Further , Dr . Esmond ’ s care exposed patients to risk of harm by “ placing [ them ] in a situation of reliance on major analgesics for an undefined and indeterminate length of time .” On May 20 , 2014 , after receiving Dr . X ’ s report , Dr . Esmond voluntarily entered into an undertaking relinquishing his privileges to prescribe narcotics , benzodiazepines and all other monitored drugs and controlled substances . Dr . Esmond also undertook to refer all patients on opioid therapy to other physicians for assessment and care . On February 12 , 2015 , following the referral of this matter to the Discipline Committee , Dr . Esmond signed an interim undertaking imposing substantially similar restrictions on his certificate of registration pending the hearing . In addition , Dr . Esmond treated a family member between 2007 and 2014 , acting as the family member ’ s primary care provider between 2007 and 2011 , and following the family member for a number of serious medical conditions . In the course of treating his family member , Dr . Esmond made diagnoses , ordered investigations , made referrals to specialists , wrote prescriptions , including prescriptions for psychotropic medication , billed the Ontario Health Insurance Program ( OHIP ), and completed insurance forms . Some of Dr . Esmond ’ s treatment of his family member was not documented in his records or billed to OHIP . By treating his family member in this manner over the course of many years , Dr . Esmond acted in direct contravention of the College ’ s policy on Treating Self and Family Members . A second investigation into Dr . Esmond ’ s practice was commenced after the College received a third-party complaint alleging that Dr . Esmond had entered into a relationship with a physician whom he was supervising , Dr . A , between February 2009 and March 2011 . Dr . Esmond and Dr . A subsequently developed a personal and intimate relationship . While acting as her supervisor , Dr . Esmond sought and received medical treatment from Dr . A on approximately 40 occasions for various conditions , including a burn to his hand and chronic back pain . In addition , Dr . A referred Dr . Esmond to a chiropractor , urologist , psychiatrist , nephrologist and a Physical Medicine specialist as well as prescribed various medications to him , completed a disability form for him , ordered a CT scan of his lumbar spine and ordered an MRI scan of his thoracic spine . Dr . Esmond continued to seek intermittent treatment from Dr . A following the conclusion of the period of supervision . In addition , after the conclusion of the period of supervision , Dr . A completed an insurance assessment for Dr . Esmond which was submitted to his insurance company in support of his application for disability benefits . Dr . Esmond also treated Dr . A during the period of supervision . Dr . Esmond continued to provide incidental treatment to Dr . A on occasion following the conclusion of the period of supervision , including ordering an ultrasound for Dr . A and referring Dr . A to a gynecologist .
Penalty and Reasons for Penalty Counsel for the College and counsel for the member made a joint submission as to an appropriate penalty and costs order whose terms included : a four-month suspension ; terms , conditions and limitations on Dr . Esmond ’ s certificate of registration , including a requirement that Dr . Esmond complete courses in professional boundaries and ethics as well as medical record keeping ; a public reprimand and costs to the College for a single hearing day at the tariff rate of $ 4,460 . The Committee found that the joint penalty submission adequately addresses the penalty principles of public protection , specific and general deterrence , the expression of the condemnation of the profession for the admitted behaviour , maintenance of public confidence in professional self-regulation and appropriate rehabilitation of the member .
The practice deficiencies found in the course of the inspection of Dr . Esmond ’ s practice , relating to narcotic prescribing and record keeping , cry out for public protection and the imposition of a practice limitation prohibiting the prescription of narcotic drugs , narcotic preparations , controlled drugs , benzodiazepines and other targeted substances and all other controlled drugs is fully justified . The Committee noted that Dr . Esmond voluntarily relinquished
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Dialogue Issue 4 , 2016