DISCIPLINE SUMMARIES
DR. DAVID JAMES HILL
PRACTICE LOCATION: Toronto
AREA OF PRACTICE: General Practice
HEARING INFORMATION: Allegations Denied; Contested
Eight-Day Hearing
On December 2, 2016, the Discipline Committee
found that Dr. Hill committed acts of professional
misconduct, in that he failed to maintain the stan-
dard of practice of the profession, and he engaged in
conduct or an act or omission relevant to the practice
of medicine that, having regard to all the circum-
stances, would reasonably be regarded by members
as disgraceful, dishonourable, or unprofessional. The
Committee also found that Dr. Hill’s charting and
patient care reflect a lack of knowledge, skill and
judgment to an extent that demonstrates Dr. Hill is
incompetent.
Dr. Hill, a physician with a solo office practice in
Toronto, retired from active practice in 2015.
FAILURE TO MAINTAIN THE STANDARD OF
PRACTICE
The finding that Dr. Hill failed to maintain the stan-
dard of practice relates to his care of Patient A and
24 additional patients.
Patient A
Patient A, Dr. Hill’s former patient, complained
to the College that Dr. Hill had missed a diagnosis
of colon cancer. The Committee agreed with the
evidence of the College’s expert, Dr. X, that Dr. Hill
failed to maintain the standard of practice of the
profession with respect to Patient A:
1. Although Dr. Hill saw Patient A on dozens of
occasions, visits were devoted exclusively to
treating episodic and chronic illness and mini-
mal attention was paid to prevention of disease;
2. Dr. Hill’s notes with respect to Patient A were
vague and repetitive with little documentation of
physical findings or specifics with regard to his-
tory, investigations, or treatment;
3. The cumulative patient profile (CPP) used by
Dr. Hill was out of date and incomplete, with
important data on family history missing;
4. D
r. Hill failed to document a proper family his-
tory, which may have led to a screening colonos-
copy; and
5. D
r. Hill failed to properly document or investi-
gate Patient A’s abdominal pain in 2010, which
may have led to a delay in the diagnosis of his
cancer.
Dr. X reviewed 25 additional, randomly selected
patient charts and concluded that Dr. Hill failed
to maintain the standard of practice in 24 of those
cases. Many of the concerns identified by Dr. X were
common among the care provided the patients. Dr.
Y, an expert retained by Dr. Hill, agreed with a num-
ber of the problems identified by Dr. X. The Com-
mittee found that Dr. Hill failed to maintain the
standard of practice for the 24 additional patients.
The Committee’s reasons addressed the concerns
by issue, with examples provided from the charts
reviewed.
Record Keeping
The Committee found that Dr. Hill failed to main-
tain the standard of practice of the profession in his
record keeping. Based on the evidence of both Dr. X
and Dr. Y, it was clear that Dr. Hill’s record keeping
fell far below what is expected of a family physician.
Dr. X found that Dr. Hill often failed to document
a proper family history and did not record immu-
nizations, laboratory reports, consultant reports or
preventive care investigations on the CPP. Narra-
tive notes lacked detail and contained diagnoses and
inclusions unrelated to the reasons for assessment.
There was a chronological discrepancy between narra-
tive notes, laboratory reports and consultation notes.
Dr. Y agreed that Dr. Hill’s charting fell below the
standard of practice of the profession and described
Dr. Hill’s documentation of patient records as “unac-
ceptably brief.” Dr. Y agreed that “some of these
deficiencies generate risk to the patient and potential
for medical error.”
The Committee also found that Dr. Hill failed to
maintain the standard of practice of the profession
Full decisions are available online at www.cpso.on.ca.
Select Find a Doctor and enter the doctor’s name.
ISSUE 1, 2018 DIALOGUE
53