Doctor suspended for six months after asking patients not to pursue legal, regulatory action
The Ontario Physicians and Surgeons Discipline Tribunal has imposed a six-month suspension and a prohibition on prescribing ketamine and testosterone replacement therapy (TRT) on a doctor found to have harmed patients due to deficiencies in his knowledge, skill, and judgment.
College of Physicians and Surgeons of Ontario v Hart, 2026 ONPSDT 29, involved a disciplinary proceeding regarding a registrant who was a clinic’s sole owner and practising physician.
The evidence – comprising two patient complaints, assessors’ analyses of 34 other patients’ charts, and reports from the Ontario Health Insurance Plan (OHIP) – delved into issues with how the registrant prescribed ketamine, TRT, and other hormonal therapy.
Ketamine
Regarding ketamine, the evidence indicated that the registrant failed to properly assess and educate patients, obtain their consent, prescribe the proper dosage, or maintain records.
A patient reported severe adverse effects – including weakness, loss of balance, slurred speech, elevated heart rate, and dissociation – after the registrant provided false and inadequate information about ketamine.
This patient said she felt uncomfortable, coerced, intimidated, and harassed when the registrant pressured her not to bring a complaint against him before the College of Physicians and Surgeons of Ontario (CPSO).
According to another patient, who was undergoing ketamine-assisted psychotherapy (KAP), the registrant yelled at her and threatened to end their telephone appointment once he learned that she was in a car at the time.
Testosterone replacement therapy
Regarding TRT, the evidence provided that the registrant prescribed it when it was not indicated or was contraindicated, failed to ensure in-person visits over long periods on TRT, and failed to conduct the necessary tests, specifically digital rectal examinations for men over 40 years old.
Beyond problems with prescriptions
The evidence also indicated that the registrant:
- asked patients to sign a document agreeing not to take any legal action against him or file complaints before the CPSO
- ordered unnecessary tests
- failed to follow up on test results
- engaged in poor record-keeping
- failed to conduct due diligence in monitoring a billing agent’s work, resulting in unsupported OHIP billings
Suspension and prescribing prohibitions
In line with the parties’ joint submission on penalty, the Ontario tribunal imposed the following on the registered physician:
- a six-month suspension
- a reprimand
- certain terms, conditions, and limitations on his registration certificate, including a prohibition on prescribing ketamine and TRT
- clinical supervision for at least six months
- one-on-one individualized instruction in medical professionalism and ethics
- monitoring
- costs of $6,000, payable to the CPSO
In agreeing to the joint submission, the tribunal applied the relevant legal test and determined that the proposed penalty would not bring the administration of the professional discipline system into disrepute.
The tribunal urged the registrant to fundamentally alter the way he practised medicine to avoid appearing before the tribunal once more and facing tougher penalties.
Professional misconduct findings
The Ontario tribunal held that the registrant seriously or persistently disregarded his professional obligations and fell short of the standard of practice of the profession, pursuant to Ontario Regulation 856/93 under Ontario’s Medicine Act, 1991.
According to the tribunal, the registrant engaged in disgraceful, dishonourable, and unprofessional conduct when he:
- made patients sign a document agreeing to refrain from bringing legal action or CPSO complaints against him
- discouraged a patient from complaining before the CPSO, thus hindering its regulation of the profession in the public interest
- shouted at another patient
Ontario Physicians and Surgeons Discipline Tribunal’s prior cases
Here are some other recent disciplinary decisions by the Ontario Physicians and Surgeons Discipline Tribunal.
The tribunal issued a July 22 order to suspend a pediatrician for eight months for accessing an electronic medical records system shared by five hospitals to contact parents of newborns and offer circumcision services at a private clinic.
The tribunal granted a June 10 order to impose a reprimand and an eight-month suspension on a doctor who did not contest that he engaged in conduct toward two complainants that breached workplace policies and related legislation prohibiting sexual harassment.
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