DISCIPLINE SUMMARIES
primarily of immigrants from Iran, many of whom
spent time regularly in Iran while also seeing phy-
sicians there, and that it was difficult to provide
comprehensive coordinated care to those patients. He
indicated that Dr. Pardis provided care with cultural
sensitivity and demonstrated knowledge of the cir-
cumstances of their lives. However, the expert found
a number of concerns with Dr. Pardis’ practice and
that he failed to meet the standard of practice of the
profession. Among other things:
(a) Dr. Pardis’ record-keeping fell below the standard
with respect to eighty percent of the charts he
reviewed;
(b) Dr. Pardis failed to provide preventive care that
met the standard of practice of the profession to
his patients in the majority of cases;
(c) Dr. Pardis lacked a coordinated approach to
chronic disease management;
(d) Dr. Pardis did not document having weighed the
risks appropriately when prescribing non-ste-
roidal anti-inflammatory drugs to patients with
cardiovascular risk factors and/or gastrointestinal
inflammation, and lacked knowledge regarding
these risks;
(e) Dr. Pardis did not take steps to provide renal and
vascular protection to patients with diabetes;
(f ) Dr. Pardis engaged in over-testing and over-
screening, including by ordering unnecessary
echocardiograms and routine blood and urine
testing without justification;
(g) Dr. Pardis overprescribed antibiotics for viral ill-
nesses; and
(h) Dr. Pardis coordinated care poorly with consul-
tants regarding medication management.
The medical expert found a more immediate risk
of harm in four cases, and found that, on balance,
Dr. Pardis’ care was “substandard” and represented a
potential risk of harm.
Methadone Practice
As a result of clinical concerns on the part of the
College’s Methadone Committee regarding Dr.
Pardis’ methadone practice and his ongoing devia-
tions from the Methadone Maintenance Treatment
Guidelines, Dr. Pardis entered into an undertaking
on November 9, 2010, by which he agreed that his
methadone practice would be subject to clinical
supervision and would be reassessed by a College-
appointed assessor.
The assessor found that Dr. Pardis failed to meet
the standard of practice of the profession regarding
three patients, and in his medical record-keeping,
which was so deficient that it was not possible to
determine in other cases whether his care met the
standard of practice of the profession. The assessor
also noted concerns regarding Dr. Pardis’ prescribing
of testosterone replacement to methadone patients,
specifically appropriate dosage and regular monitor-
ing of the same in eight cases.
In response to the assessor’s concerns, Dr. Pardis
indicated that he had made changes to his prac-
tice, including only prescribing medications in his
methadone practice that are related to methadone
treatment and its side effects, sought to improve his
counselling of patients about side effects and risks
of medications and documenting those discussions,
and documented patient counselling. He also advised
that he had upgraded his electronic medical record-
keeping system to include a methadone module.
College History
In February 2013, the ICRC of the College con-
sidered a report of an investigation into Dr. Pardis’
family practice, which noted deficiencies of care,
including in primary prevention. The ICRC ordered
Dr. Pardis to undergo a SCERP, which resulted in
the preceptorship described above. The ICRC also
issued Dr. Pardis a written caution with respect
to his record-keeping, which it described as “very
deficient,” and provided him with advice about his
practice management.
Also in February 2013, the ICRC issued a writ-
ten caution to Dr. Pardis in a public complaint.
The ICRC’s written caution to Dr. Pardis was with
respect to compliance with the College policy on
Ending the Physician-Patient Relationship and
also with respect to practice deficiencies that result in
poor patient care, including that:
• He should not treat methadone patients for chronic
pain;
Full decisions are available online at www.cpso.on.ca.
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ISSUE 2, 2018 DIALOGUE
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