DISCIPLINE SUMMARIES
copied and pasted in patient charts .
• The care provided demonstrated concerns about his knowledge and judgment in almost all charts reviewed . In various files , this related to one or more of timely or appropriate follow-up of abnormal test results , lack of knowledge of current guidelines , and over-extensive investigations without apparent clinical reasoning documented or explained . Dr . Mansour responded to the expert ’ s report and said that he had not used a PA in his practice since these issues arose in August 2013 . Dr . Mansour told the College that he has since completed the University of Toronto medical record-keeping course and had become more comfortable with the clinic ’ s EMR system . He told the College that , in response to the expert ’ s concerns about his knowledge of various guidelines , Dr . Mansour reviewed five CPSO policies , as well as a number of clinical guidelines . Dr . Mansour also told the College he had registered to take a course on diabetes management and a review course in internal medicine , and had performed a self-audit and repaid to OHIP the amounts he billed during the times he was not present at the clinic . Dr . Mansour completed the medical record-keeping course at the University of Toronto in November 2014 .
REASONS FOR PENALTY The Committee was appalled at Dr . Mansour ’ s disrespect to the both the College and to the profession at large when he wilfully obstructed the College ’ s investigation into his misconduct for over a year . Dr . Mansour ’ s lies to and disrespect of the College as his governing body impeded and delayed the College ’ s investigation . Dr . Mansour should have familiarized himself with all of the components of the College ’ s Delegation of Controlled Acts policy . Dr . Mansour should have strictly adhered to all components of that policy prior to engaging a PA who is an unregulated person . By ignoring his obligations regarding delegation , Dr . Mansour put his patients at risk of potential harm . He also required his PA to perform outside her scope of practice . The Committee was disturbed that Dr . Mansour ignored certain components of the policy while simultaneously deliberately capitalizing on improper delegation by billing of the Ministry of Health and Long-Term Care in relation to patient visits in July and August of 2013 , when the patients were not seen by Dr . Mansour . All Ontarians suffer when a physician improperly bills OHIP because it leaves fewer dollars available for legitimate care . The Committee had grave concerns about Dr . Mansour ’ s practice standards , especially as a physician in independent practice . These concerns included not only Dr . Mansour ’ s delegation and record-keeping , but also the quality of his care as detailed by the College-appointed medical inspector . The medical inspection opined that Dr . Mansour :
• fell short in terms of timely or appropriate followup of abnormal test results ;
• lacked knowledge of current guidelines ; and
• conducted over-extensive investigations without apparent clinical reasoning or documentation . Counsel for the College and counsel for the member made a joint submission as to an appropriate penalty and costs order . The proposed penalty was a nine-month suspension followed by the imposition of certain terms , conditions , and limitations on Dr . Mansour ’ s certificate of registration , as well as a reprimand . The Committee accepted the jointly-proposed penalty and costs as being both just and in the public interest . The Committee considered the following mitigating factors in coming to its determination :
• Dr . Mansour had no previous discipline findings ;
• Dr . Mansour admitted the allegations ;
• Dr . Mansour complied with his February 12 , 2016 Undertaking with the College ;
• Dr . Mansour has not delegated any acts since the College investigation commenced in August 2013 ;
• Dr . Mansour assessed what he owed to OHIP through a self-audit and repaid it ; and
• Dr . Mansour has begun education and rehabilitation to improve his practice standards . The principles relevant to the imposition of penalty in disciplinary proceedings are well-established . The protection of the public is the paramount consideration . Others include maintenance of public confidence in the reputation and integrity of the profession and in the principle of effective self-governance ;
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DIALOGUE ISSUE 4 , 2017