discipline summaries
witnesses who had worked as Dr . Kamermans ’ colleagues in the past , and a physician who had acted as Dr . Kamermans ’ supervisor in 2012-2013 . In addition , Dr . Kamermans testified at the penalty hearing . His evidence demonstrated that he has little insight into his deficiencies and that he did not take the 2013 findings and Order seriously . A failure of insight or refusal to take responsibility is not an aggravating factor in a penalty analysis , but it must be taken into account when considering whether or not rehabilitation is likely . When considering the potential for remediation , the first consideration is the physician ’ s amenability to the process . If the physician does not engage with his or her own remediation , it is for naught . Where there is a finding of incompetence and where lack of knowledge , skill and judgment are found , the Committee must consider the implication of these findings on Dr . Kamermans ’ practice of medicine in its entirety . Failure to do so would not achieve protection of the public , and could knowingly expose the public to harm . In 2013 , Dr . Kamermans was found to have failed to maintain the standard of practice in his family practice . As a consequence , a number of terms were imposed to allow remediation , supervision and assessment . The evidence from the College-appointed assessor regarding her 2015 practice assessment is that Dr . Kamermans ’ clinical care and documentation have not improved over the years . The Committee understands that the purpose of this penalty hearing is not to punish Dr . Kamermans for substandard care in his family practice . The Committee notes , however , that remediation efforts have been ineffective in achieving the desired results . To accept that Dr . Kamermans is incompetent to see a patient in the emergency room and yet may safely see that same patient in his family practice is logically inconsistent given the overlap in knowledge , skill and judgment in those practice areas . Dr . Kamermans ’ family practice sees walk-in as well as a number of chronically ill patients . In the circumstances of this case , whether the practice setting is a rural hospital emergency room or a family practice office is irrelevant . The patients seen by Dr . Kamermans in the emergency room , with one exception , presented with complaints one would expect to encounter in family practice . It is the quality of practice that exposes patients to harm and presents an unacceptable risk to the public . In the circumstances of this case , the Committee is of the unanimous opinion that revocation of Dr . Kamermans certificate of registration is the only appropriate penalty Members must realize the importance of maintaining their clinical knowledge , acumen and documentation standards . They should take criticism seriously and strive to overcome any deficiencies , especially when their conduct or care has been subject to prior discipline proceedings . The reputation and integrity of the profession cannot be maintained when a member denies he has problems and fails to make changes that are required to deal with deficiencies . The profession must recognize that chances for change are not infinite , and that a member who has repeatedly failed to maintain the standard of practice and is also found to be incompetent cannot continue with unsuccessful education and remediation forever . The potential for patient risk cannot be allowed to continue until a tragic outcome results . The Committee thoroughly examined rehabilitation and remediation as options but concluded they are not applicable in this case . Awarding costs , if any , and their quantum is at the Committee ’ s discretion in an appropriate case . The College has asked for $ 40,140 in costs , representing nine days at the tariff rate of $ 4,460 per day . Dr . Kamermans made no submissions in respect of costs . The Committee considered this to be an appropriate case in which to award costs . The findings made by the Committee are serious and impact both the care of patients and the effective functioning of the health-care system . The Committee is also mindful that the costs ought not to be punitive . The Committee is of the view that tariff amount for each of the nine days of hearing requested by the College would inflict significant hardship on Dr . Kamermans . The revocation of his certificate of registration will remove medical practice from his source of income . He also has had to support a practice monitor / supervisor in his family practice and has paid for previously-ordered reassessments .
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Dialogue Issue 1 , 2017