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Medicine Act, 1991
Loi de 1991 sur les médecins

ONTARIO REGULATION 856/93

PROFESSIONAL MISCONDUCT

Consolidation Period:  From December 3, 2010 to the e-Laws currency date.

Last amendment: 450/10.

Legislative History: 857/93, 115/94, 53/95, 450/10.

This Regulation is made in English only.

1. (1) The following are acts of professional misconduct for the purposes of clause 51 (1) (c) of the Health Professions Procedural Code:

1. Contravening a term, condition or limitation on the member’s certificate of registration.

2. Failing to maintain the standard of practice of the profession.

3. Abusing a patient verbally or physically.

4. Practising the profession while the member’s ability is impaired.

4.1 Practising the profession while the member knows that he or she has deficient clinical ability, as defined in section 26 of Ontario Regulation 114/94 (General) made under the Act.

4.2 Practising the profession during the period after the member is notified by the College that he or she has deficient clinical ability, as defined in section 26 of Ontario Regulation 114/94 (General) made under the Act, and before the member is notified by the College that he or she no longer has deficient clinical ability.

5. Having a conflict of interest.

6. Prescribing, dispensing or selling drugs for an improper purpose.

7. Discontinuing professional services that are needed unless,

i. the patient requests the discontinuation,

ii. alternative services are arranged, or

iii. the patient is given a reasonable opportunity to arrange alternative services.

8. Failing to fulfil the terms of an agreement for professional services.

9. Performing a professional service for which consent is required by law without consent.

10. Giving information concerning the condition of a patient or any services rendered to a patient to a person other than the patient or his or her authorized representative except with the consent of the patient or his or her authorized representative or as required by law.

11. Sharing fees with a person who has referred a patient or receiving fees from any person to whom a member has referred a patient or requesting or accepting a rebate or commission for the referral of a patient.

12. Failing to reveal the exact nature of a secret remedy or treatment used by the member following a proper request to do so.

13. Making a misrepresentation respecting a remedy, treatment or device.

14. Making a claim respecting the utility of a remedy, treatment, device or procedure other than a claim which can be supported as reasonable professional opinion.

15. Using a name other than the member’s name as set out in the register in the course of providing or offering to provide services within the scope of practice of the profession.

15.1 Without restricting the generality of paragraph 27, using a term, title or designation relating to a specialty or subspecialty of the profession in contravention of section 9 of Ontario Regulation 114/94 (General) made under the Act.

15.2 Without restricting the generality of paragraph 27, failing to include, in a clear and prominent manner and unabbreviated form, specialist or subspecialist information or the fact that the member is a general practitioner in any material that advertises, promotes or relates to the provision of any professional services by a member in contravention of section 9 of Ontario Regulation 114/94 (General) made under the Act.

16. Falsifying a record relating to the member’s practice.

17. Failing without reasonable cause to provide a report or certificate relating to an examination or treatment performed by the member to the patient or his or her authorized representative within a reasonable time after the patient or his or her authorized representative has requested such a report or certificate.

18. Signing or issuing, in the member’s professional capacity, a document that the member knows or ought to know is false or misleading.

19. Refusing to perform a medically necessary service unless all or part of the fee is paid before the service is performed.

20. Charging a fee for services not performed, but a member may charge for the cancellation of an appointment less than twenty–four hours before the appointment time or, in psychotherapy practice, in accordance with any reasonable written agreement with the patient.

21. Charging a fee that is excessive in relation to the services performed.

22. Charging a fee for a service that exceeds the fee set out in the then current schedule of fees published by the Ontario Medical Association without informing the patient, before the service is performed, of the excess amount that will be charged.

23. Charging a block or annual fee, which is a fee charged for services that are not insured services as defined in section 1 of the Health Insurance Act and is a set fee regardless of how many services are rendered to a patient.

23.1 Charging a fee for an undertaking not to charge for a service or class of services.

23.2 Charging a fee for an undertaking to be available to provide services to a patient.

24. Failing to itemize an account for professional services,

i. if requested to do so by the patient or the person or agency who is to pay, in whole or in part, for the services, or

ii. if the account includes a commercial laboratory fee.

25. Failing to issue a statement or receipt when requested by a patient or his or her authorized representative.

26. Selling or assigning any debt owed to the member for professional services, but a member may accept a credit card to pay for professional services and may make a general assignment of debts as collateral for a loan to finance his or her medical practice.

26.1 Pledging, mortgaging or in any other way encumbering or granting security in the member’s interest in a medical record required to be kept under the Act.

27. Contravening the Act, the Regulated Health Professions Act, 1991 or the regulations under either of those Acts.

27.1 Without restricting the generality of paragraph 27, failing, by act or omission, to comply with any duty or requirement under Part XI (Inspection of Premises where Certain Procedures are Performed) of Ontario Regulation 114/94 (General) made under the Act.

28. Contravening a federal, provincial or territorial law, a municipal by-law or a by-law or rule of a public hospital if,

i. the purpose of the law, by-law or rule is to protect public health, or

ii. the contravention is relevant to the member’s suitability to practise.

29. Permitting, counselling or assisting a person who is not a member of the College to perform acts which should be performed by a member.

30. Failing to respond appropriately or within a reasonable time to a written inquiry from the College.

31. Influencing a patient to change his or her will or other testamentary instrument in favour of a member.

32. Being subjected to the withdrawal or restriction of rights or privileges under the Narcotic Control Act (Canada) or the Food and Drugs Act (Canada) or the regulations under either of those Acts, unless by the member’s own request.

33. An act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

34. Conduct unbecoming a physician.  O. Reg. 856/93, s. 1 (1); O. Reg. 857/93, s. 1 (1); O. Reg. 115/94, s. 1; O. Reg. 53/95, s. 1; O. Reg. 450/10, s. 1.

(2) Despite paragraph 10 of subsection (1), it is not professional misconduct for a member to give information about a patient, including access to the patient’s records,

(a) to a practitioner of a health profession for the purpose of providing care to the patient; or

(b) to a person for the purpose of research or health administration or planning if the member reasonably believes that the person will take reasonable steps to protect the identity of the patient.  O. Reg. 856/93, s. 1 (2).

(2.1) Paragraphs 23, 23.1 and 23.2 of subsection (1) do not apply in a case where a member charges a fee to a third party for a third party service under the Health Insurance Act.  O. Reg. 857/93, s. 1 (2).

(3) A member shall be deemed to have committed an act of professional misconduct if the governing body of a health profession in a jurisdiction other than Ontario has made a finding of incompetence or professional misconduct or a similar finding against the member, and the finding is based on facts which would, in the opinion of the College, be grounds for a finding of incompetence as defined in section 52 of the Code or would be an act of professional misconduct as defined in subsection (1).  O. Reg. 856/93, s. 1 (3).

(4) A member shall be deemed to have committed an act of professional misconduct if,

(a) the governing body of a health profession in a jurisdiction other than Ontario has provided records to the College evidencing that an allegation of professional misconduct or incompetence or a similar allegation has been made against the member and he or she has entered into an agreement or compromise with the governing body in order to settle the matter without a finding of misconduct or incompetence or a similar finding being made;

(b) the College is satisfied that the records are authentic, accurate and complete; and

(c) the act or omission that is the subject of the allegation would, in the opinion of the College, be an act of professional misconduct as defined in subsection (1), or would constitute incompetence as defined in section 52 of the Code.  O. Reg. 856/93, s. 1 (4).

2. Omitted (provides for coming into force of provisions of this Regulation).  O. Reg. 856/93, s. 2.