DISCIPLINE SUMMARIES about this issue and until now has not known how to make things right .” Dr . Mansour also told the College that he billed OHIP when he was out of the country and his PA was seeing patients , should not have done so , and was conducting a self-audit of these amounts in order to repay OHIP . On May 23 , 2014 , the College wrote to Dr . Mansour ’ s counsel requesting clarification about where Dr . Mansour was between July 9 and August 8 , 2013 . On June 3 , 2014 , Dr . Mansour ’ s counsel told the College that Dr . Mansour was in Ontario between July 9 and August 8 , 2013 , and was in Toronto on any day on which he was scheduled to work during that time period . The College then asked Dr . Mansour to attend at the College with his passport and any other supporting documents to verify he was in Ontario between July 9 and August 8 , 2013 . The College sent a further letter dated July 24 , 2014 , requesting confirmation of a date upon which Dr . Mansour could attend the College , and a further request on August 7 , 2014 . Dr . Mansour ’ s counsel wrote to the College on August 7 , 2014 , saying that Dr . Mansour was in Libya and his return to Canada had been delayed . Counsel advised Dr . Mansour would not be in a position to provide the requested documents until his return , which was expected on August 10 , 2014 . Counsel further advised dates upon which Dr . Mansour was available to attend at the CPSO for an interview by the Medical Inspector . Dr . Mansour ’ s counsel told the College in an August 14 , 2014 letter that Dr . Mansour had had to surrender his Libyan passport ( which he used for his trip in July / August 2013 ) when he changed to a Canadian passport . Counsel also provided the billing and medication records requested by the College . Dr . Mansour ’ s counsel told the College in a September 22 , 2014 letter that the information previously provided to the College by Dr . Mansour was incorrect in the following ways : i ) Dr . Mansour had not surrendered his Libyan passport ; and ii ) Dr . Mansour was in Libya and Turkey continuously between July 5 and August 15 , 2013 , returning to Canada on August 16 , 2013 . He was not in Ontario between July 9 and August 8 , 2013 as previously advised . Enclosed with the letter was a copy of Dr . Mansour ’ s Libyan passport used in 2013 .
Dr . Mansour apologized through his counsel for having provided inaccurate information in the past and indicated that , having now shared the information about his whereabouts , he was eager to fully cooperate with the College ’ s investigation . The College interviewed the PA , who confirmed she saw patients at the clinic without Dr . Mansour being present , at his request . The PA advised she initially worked under verbal orders from Dr . Mansour , and that she created Medical Directives later , and sent them to the clinic for its use . Dr . Mansour confirms this is true . The PA had graduated from a PA program at McMaster University in 2012 , and started working with Dr . Mansour , in about May , 2013 . Dr . Mansour spent a couple of weeks seeing patients with her , assessing her skills , and discussing cases and patient management with her in breaks between seeing patients . The PA told the College that Dr . Mansour personally asked her to see patients when he was not there . When Dr . Mansour was away in July and August 2013 , he directed the PA to contact him if she needed him . The PA told the College that at no time did Dr . Mansour discourage the PA from contacting him to discuss patient care and that she was usually able to reach him . After a self-audit , Dr . Mansour repaid $ 16,734.32 to the Ministry of Health and Long-Term Care in respect of billings made in relation to patient visits in the months of July and August 2013 , where the patients were seen by the PA but not by Dr . Mansour .
Standard of Practice A College-retained expert opined that Dr . Mansour failed to meet the standards of practice in the following respects :
• His use of a PA fell below the standard of care in respect of 19 patients , primarily with respect to supervision and delegation . The criteria for delegation were met in only one chart . These deficiencies could expose his patients to harm .
• His medical documentation fell below the standard of care in respect of 15 to 17 patients . In some cases , there were notes which appeared to be
Full decisions are available online at www . cpso . on . ca . Select Doctor Search and enter the doctor ’ s name .
ISSUE 4 , 2017 DIALOGUE 83