DISCIPLINE SUMMARIES medical expert concluded that Dr. Leung fell below the standard of care expected by the profession in nine of the 10 charts reviewed; his knowledge and judgment with respect to hemorrhoid treatments fell below the standard of care of the profession; and providing these treatments exposed nine patients to potential harm. Upon reviewing 10 male patients’ charts, the medi- cal expert opined that Dr. Leung's record-keeping fell below the standard of practice of the profes- sion in all 10 cases. Dr. Leung met the standard of practice in his care of four out of 10 patients. In five of 10 patient charts reviewed, Dr. Leung displayed a lack of knowledge and judgment with respect to the hemorrhoid treatment. He was over treating hemor- rhoids without a period of conservative measures; the treatment protocol was not evidence-based and is not the standard of practice. Dr. Leung exposed five out of 10 patients to potential harm in performing a procedure on the perineum that was not indicated. 2017 INTERIM ORDER OF THE ICRC On January 18, 2017, allegations of Dr. Leung's professional misconduct were referred to the Disci- pline Committee. On February 10, 2017, the Inqui- ries, Complaints and Reports Committee (ICRC) made an interim order which included, among other things, the following requirements: • Dr. Leung is not to perform hemorrhoid procedures; • Dr. Leung is not to engage in any professional en- counters except in the presence of a practice monitor; • Dr. Leung is to maintain a log of all intimate examinations conducted and the indication for the examination and ensure his practice monitor veri- fies the accuracy; • Dr. Leung is to practise under the guidance of a clinical supervisor; and • Dr. Leung is to consent and submit to monitoring by the College. COMPLIANCE AND MONITORING On March 1, 2017, the College's Compliance Moni- toring and Supervision department conducted an un- announced compliance visit to Dr. Leung’s office. It was observed that the practice monitor did not have her own username for the electronic medical records system and was signing off patient encounter notes under Dr. Leung’s username. Once Dr. Leung was 70 DIALOGUE ISSUE 4, 2018 informed that he must provide the practice moni- tor with her own password that is unknown to other clinic users, he made the appropriate arrangements. On March 29, 2017, the College received a docu- ment from the practice monitor that Dr. Leung had given the practice monitor, authored by Dr. Leung. The Committee stated that the document made it clear that Dr. Leung had difficulty accepting the rationale behind the Order. The Committee viewed the document as a dishonourable display of factual inaccuracies and disrespect for the process by which the practice restrictions were ordered. The Committee further noted, based on the document, that Dr. Leung did not have insight into his practice deficiencies. ORDER The Discipline Committee ordered: a two-month period of suspension on Dr. Leung’s certificate of registration and a reprimand. The Committee also ordered extensive terms, conditions and limitations on Dr. Leung’s certificate of registration, includ- ing an agreement that he not perform hemorrhoid procedures and that he have a practice monitor present during patient encounters. Dr. Leung is also required, for a period of six months, to practise under the guidance of a clinical supervisor in respect of the indication for intimate examinations. In terms of education, Dr. Leung is required to successfully complete a one-on-one course to address the sensitiv- ity of patients with regards to intimate examinations and complete a medical record-keeping course. Dr. Leung shall also submit to a reassessment at six and 18 months. The Committee ordered Dr. Leung to pay costs to the College in the amount of $5,500.00. For complete details, please see the full decision at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. At the conclusion of the hearing, Dr. Leung waived his right to an appeal and the Committee administered the public reprimand.