Dr Byron Hyde, a doctor who has championed ME patients for decades, has license removed

Countrygirl

Senior Member
Messages
4,466
Likes
22,509
Location
UK
I am placing this under 'advocacy' as I am requesting that patients advocate for a ME doctor who has had his licence to practice removed for allegations which, I have been given to understand, are 'trumped-up' in order to get rid of him.

We all know of Dr Byron Hyde of Canada. He has worked tirelessly for 30 years, helping ME patients and is well known for ensuring members of the community are not rejected by their health insurers while he undertakes thorough tests that other doctors fail to undertake.

He has also written extensively on the subject of ME, including an encyclopaedia of ME which was free to download on the internet while he has another large book which is due out about now.

Here is a little about him from his Nightingale Foundation:
https://www.nightingale.ca/our-founder

Here is a list of helpful and interesting documents for patients from the foundation:

https://www.hfme.org/

Here is a very interesting talk by Byron Hyde.


Here is his little red book on ME which you can download: https://www.imet.ie/imet_documents/BYRON_HYDE_little_red_book.pdf

And do read this story of a UK child that was sectioned by doctors as a punishment following a complaint by her father and who Dr Hyde later correctly diagnosed:
https://drive.google.com/file/d/1qN5P6UNSiXefTN5BEQtxf1MFGCdAcfhn/view

There is a thread on it here:
https://forums.phoenixrising.me/thr...child-who-was-sectioned-by-her-doctors.58619/
https://doctors.cpso.on.ca/DoctorDetails/Byron-Marshall-Hyde/0016579-21364

I also have personal knowledge of Dr Hyde as he came all the way to SW England to try to rescue a patient whom he had diagnosed in Canada with severe ME and severe POTs, and several other conditions who had been sectioned by the local medics and is still locked away after eight years. He is a dedicated doctor who has fought against the BPS school and championed us for decades. Now he is being persecuted by the Canadian College of Physicians who have taken his licence to practice away. I wouldn't be at all surprised that, as one of the older generation, he wasn't familiar with keeping records on a computer, but the accusations, I have been reliably told from a source I trust, are a trumped up by a medical profession which is keen to get rid of a maverick who has served us to the very best of his ability for decades.

As you know, if you followed the good news yesterday, Canada has pledged to help ME patients at last and an important announcement was made by the Canadian Minister of Health which you can read about here: https://forums.phoenixrising.me/thr...s-aug-22-at-2pm-est.77397/page-2#post-2225858

I think Dr Hde deserves this community's support and I do encourage our Canadian members to request that the Health Minister listens to Dr Hyde, intervene in his case, if possible, and not let his decades of experience be wasted while he ends his career in ignominy at the age of 82. We owe him our support. It is a cruel way to end a career. Please don't let this happen without us fighting for him.

Here are some examples of the charges against him:
The College retained Dr. Mark Nassim to provide an opinion with respect to Dr. Hyde’s care and
treatment of patients. In his reports, Dr. Nassim opined that:

a) Dr. Hyde failed to maintain the standard of practice with respect to his medical record-
keeping in that:
i. His patient charts are not clearly written, are disorganized and often lack an easily
identifiable patient record;
ii. He fails to maintain chronological SOAP notes or other clearly delineated summaries
of patients’ investigations and medical condition(s), such as a Cumulative Patient
Profile, and does not include pertinent positive or negative findings, rationale for
ordering investigations or discussions with patients about the results;
iii. Dr. Hyde uses unprofessional language in his charts to describe his patients;

b) Dr. Hyde states that he practices “complex disease management” primarily involving
Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, which is outside the conventionally-
recognized scope of general or primary care practice;

f) Dr. Hyde lacked knowledge as to whether or not his electronic correspondence and
patient files are encrypted or stored in a secure fashion, despite the fact that he purported to
conduct an extensive telemedicine practice from Italy for several months each year.

Unprofessional communications, boundary violations, and conflict of interest

Dr. Hyde is the founder of a charitable foundation. Dr. Hyde wrote newsletters for his charitable foundation, which he mailed to the patients in his medical practice. (The ME Nightingale Foundation)

In these newsletters, Dr. Hyde provided his personal opinions that the compensation of
physicians in Canada is inadequate, complained about the College’s requirements of physicians, solicited patients to make donations to his charitable foundation, (what charity doesn't???) and disclosed inappropriate personal information about himself and of his patients.
The remainder of the charges can be found here: https://doctors.cpso.on.ca/DoctorDetails/Byron-Marshall-Hyde/0016579-21364

Dr Hyde , at 82, feels he cannot challenge these accusations. I can imagine he would feel overwhelmed by the challenge at his age and it would also probably be very costly.

I do hope we have some members here who will do what they can to ensure Dr Hyde knows the community is grateful for his championship over the decades and do what they can to bring this injustice to the attention of the Minister of Health, especially given that we are in favour at the moment.

Thank you!
 

valentinelynx

Senior Member
Messages
1,024
Likes
2,694
Location
Tucson
This is tragic. From what I've read of Dr. Hyde, he is one of those rare treasures of medicine, a master diagnostician. His MO, if I remember correctly, has been to discover from what diseases his patients are truly suffering, and that he finds very few of them have ME (he doesn't believe that "CFS" is a real disease, but a label applied to misdiagnosed patients). He has the perseverance and skill to make diagnoses of rare diseases when most doctors go for the easy answers.
 

Daffodil

Senior Member
Messages
5,585
Likes
5,899
this is a joke. they let some doctors who actually have affairs with patients keep their license (maybe suspend it temporarily). this is just an obvious attempt by the province to avoid paying for the tests dr. Hyde orders. just awful. they do the same thing to lyme doctors here.

they always trump up record keeping -related accusations when they want to do this. they did the same once to dr. levine in NYC i think..
 

Countrygirl

Senior Member
Messages
4,466
Likes
22,509
Location
UK
I have written an email to a doctor who is in touch with him, and have suggested Dr Hyde at least writes a statement/rebuttal of the accusations addressed to the patient community. The reason I have requested this is that I think we could then at least write in praise of Dr Hyde to the College of Physicians and cc the Minister of Health. I think we are capable of that, at least.

What do people think? It would be so wrong to allow this injustice to stand without taking some action to mitigate the pain and injury that has been caused to Dr Hyde.
 

Daffodil

Senior Member
Messages
5,585
Likes
5,899
I have written an email to a doctor who is in touch with him, and have suggested Dr Hyde at least writes a statement/rebuttal of the accusations addressed to the patient community. The reason I have requested this is that I think we could then at least write in praise of Dr Hyde to the College of Physicians and cc the Minister of Health. I think we are capable of that, at least.

What do people think? It would be so wrong to allow this injustice to stand without taking some action to mitigate the pain and injury that has been caused to Dr Hyde.
it is nice to do but i do not think it will make a difference. i remember reading about one lyme doctor whose patients testified that he had saved their lives etc but he still lost license.

revoking a license is a huge step to take...they must have wanted to do this for a long time. how bizarre. i hope he appeals it.
 

GypsyGirl

Senior Member
Messages
165
Likes
377
Location
North Carolina
I have written an email to a doctor who is in touch with him, and have suggested Dr Hyde at least writes a statement/rebuttal of the accusations addressed to the patient community. The reason I have requested this is that I think we could then at least write in praise of Dr Hyde to the College of Physicians and cc the Minister of Health. I think we are capable of that, at least.

What do people think? It would be so wrong to allow this injustice to stand without taking some action to mitigate the pain and injury that has been caused to Dr Hyde.
If Dr. Hyde writes a response, maybe a petition (that supportive parties can sign online) or a rough form letter (that patients can easily adapt if they don't have the brainpower to create from scratch)? Writing letters from scratch take significant brainpower for me, but if there's a cause I want to support that's easy to read and all I have to do is sign, I'll always be willing to do it - and think others would too.

I'm not Canadian, and not familiar with Dr. Hyde, but ME/CFS has so few advocates that this speaks to me. Medicine needs to hear from ME/CFS patients, and speaking up and giving feedback matters, even if it doesn't make an immediate difference. At the very least, perhaps the doctor will hear from patients that his methods were worthwhile and helpful to those with ME/CFS and his work much appreciated.
 

Gingergrrl

Senior Member
Messages
14,664
Likes
43,752
Writing letters from scratch take significant brainpower for me, but if there's a cause I want to support that's easy to read and all I have to do is sign, I'll always be willing to do it - and think others would too.
This is a great idea and I agree that most people will not have the time or ability to write individual letters but if there was a world-wide petition, I know that many people would sign it.

@Countrygirl Do you know if there will be something like this?

I'm not Canadian, and not familiar with Dr. Hyde, but ME/CFS has so few advocates that this speaks to me.
I'm also not Canadian but was familiar with Dr. Hyde through many posts on PR and have a friend who has seen him. I wrote this in the other thread, but what I really appreciated about Dr. Hyde was that he ran thorough testing of other conditions to rule in or out ME/CFS vs. most American doctors who just label the patient with "CFS" and kick them out the door (and I don't mean the few American specialists who of course are the exception). Dr. Hyde found alternative diagnoses for many of his patients so they were able to get proper treatments.
 

Kati

Patient in training
Messages
5,497
Likes
19,624
Take a good look at the charges- they are not subjective charges. It can all be proven.

Failure to Maintain the Standard of Practice of the Profession

The College retained Dr. Mark Nassim to provide an opinion with respect to Dr. Hyde’s care and
treatment of patients. In his reports, Dr. Nassim opined that:

a) Dr. Hyde failed to maintain the standard of practice with respect to his medical record-
keeping in that:
i. His patient charts are not clearly written, are disorganized and often lack an easily
identifiable patient record;
ii. He fails to maintain chronological SOAP notes or other clearly delineated summaries
of patients’ investigations and medical condition(s), such as a Cumulative Patient
Profile, and does not include pertinent positive or negative findings, rationale for
ordering investigations or discussions with patients about the results;
iii. Dr. Hyde uses unprofessional language in his charts to describe his patients;

b) Dr. Hyde states that he practices “complex disease management” primarily involving
Myalgic Encephalomyelitis and Chronic Fatigue Syndrome, which is outside the conventionally-
recognized scope of general or primary care practice;

c) Dr. Hyde takes diagnostic approaches that are not supported or corroborated by
conventional practice, and orders investigations the results of which are nonspecific and yield no
discernible constructive findings;

d) Dr. Hyde failed to follow currently accepted guidelines for the detection of prostate
cancer, including in ordering PSA testing;

e) Dr. Hyde lacked knowledge of opioid or benzodiazepine treatment contracts, despite
prescribing long-term benzodiazepines to patients;

f) Dr. Hyde lacked knowledge as to whether or not his electronic correspondence and
patient files are encrypted or stored in a secure fashion, despite the fact that he purported to
conduct an extensive telemedicine practice from Italy for several months each year.

Dr. Melvin Borins was retained to provide an opinion specifically with respect to Dr. Hyde’s
psychotherapy practice. In his reports, Dr. Borins opined that:

a) Dr. Hyde failed to record what is required of a practitioner providing psychotherapy, such as
a mental status exam, diagnosis, his psychotherapeutic treatment plans, his interventions and
the patient’s response to treatment;

b) In one case, where Dr. Hyde billed OHIP for providing psychotherapy 49 times between
2006 and 2016, Dr. Borins found only one adequate psychotherapy note;

c) In five cases, Dr. Borins could find no evidence in the charts that Dr. Hyde performed any
psychotherapy, despite Dr. Hyde’s numerous billings between 2005 and 2016.

d) In one case, Dr. Hyde prescribed addictive medications and opioids, including Dilaudid,
quietapine, clonazepam, and hydromorphone, without documenting the patient’s progress,
and how the psychotherapy he was providing was assisting the patient. He failed to properly
monitor the patient for risk of addiction, overdose and suicide. This displayed a lack of
judgment.

Dr. Hyde’s inappropriate care and treatment of his employee

Individual B was employed by Dr. Hyde. While Individual B was Dr. Hyde’s employee, Dr.
Hyde:

a) prescribed medication to Individual B on six occasions, including a prescription for a
tricyclic antidepressant; and

b) billed OHIP for providing treatment to Individual B on eight occasions, including for
psychotherapy on seven of those occasions, between April 2009 and August 2010.

Despite prescribing to Individual B, and billing OHIP for treating Individual B, Dr. Hyde did not
maintain a patient chart for Individual B.

Unprofessional communications, boundary violations, and conflict of interest

Dr. Hyde is the founder of a charitable foundation. Dr. Hyde wrote newsletters for his charitable
foundation, which he mailed to the patients in his medical practice.

In these newsletters, Dr. Hyde provided his personal opinions that the compensation of
physicians in Canada is inadequate, complained about the College’s requirements of physicians,
solicited patients to make donations to his charitable foundation, and disclosed inappropriate
personal information about himself and of his patients.

Patient A was a patient of Dr. Hyde’s between approximately 2008 and 2014. In appointments
with Patient A, Dr. Hyde disclosed his and other patients’ health information, questioned the
competency of other physicians, and complained about physicians’ remuneration and about the
College, including the College’s record-keeping requirements.

Block Fee for Uninsured Services

When Patient A first became a patient of Dr. Hyde’s, Dr. Hyde charged her $1,500, purportedly
as a block fee for services that are not covered by OHIP. In doing so, Dr. Hyde failed to comply
with the OHIP Schedule of Benefits, and the College’s policy on Block Fees and Uninsured
Services by:

a) improperly charging Patient A a block fee charged to cover the constituent elements of one
or more insured services;

b) failing to provide her with the alternative of paying for each service individually at the time
that it was provided; and

c) failing to offer the block fee in writing indicating the services that were and were not covered
by the block fee, and failed to provide her with a copy of the policy to ensure that she was
fully informed of her payment options.

Delay in Responding to Request for Patient Chart and Inappropriate Fee

In September 2013, Patient A’s lawyer wrote to Dr. Hyde requesting a copy of her chart, which
Patient A was required to produce for the purpose of motor vehicle litigation, enclosing a
direction authorizing Dr. Hyde to release it to the lawyer.

Patient A did not obtain any portion of her chart from Dr. Hyde until July 2014, despite having
made multiple requests for it both directly to Dr. Hyde and to his secretary, and despite attending
at Dr. Hyde’s office numerous times specifically for this purpose.

In July 2014, Dr. Hyde’s assistant informed Patient A that her chart was available to be picked
up, and that the fee would be $825. Dr. Hyde’s first invoice to Patient A, indicated that the $825
fee was for “medical-legal work”. When Patient A raised a concern with Dr. Hyde that his fee
was excessive, and that she had not requested that he do any medical-legal work, he provided a
revised invoice indicating that he had charged her $825 “to organize all patient data into a
comprehensive chart and copy the entire file at the request of [Patient A]’s lawyer”, and that this
had taken him four hours.
Then, at the bottom, this:

ADMISSION

Dr. Hyde admits the facts above, and admits that, based on these facts, he engaged in
professional misconduct under:


a) paragraph 1(1)2 of Ontario Regulation 856/93 made under the Medicine Act, 1991, in that
he failed to maintain the standard of practice of the profession; and

b) paragraph 1(1)33 of O Reg. 856/93, in that he engaged in acts or omissions relevant to
the practice of medicine that would be regarded by members as disgraceful,
dishonourable or unprofessional.


AGREED STATEMENT OF FACTS RELEVANT TO PENALTY

Dr. Hyde entered into an undertaking to the College on July 5, 2019, by which he agreed to
resign from the College, and not to apply or re-apply for registration as a physician to practise

medicine in Ontario or any other jurisdiction, effective July 9, 2019.
Dr Hydes pleads guilty to the charges. And while many patients felt they had a great doctor, this doctor did not obey the rules of his profession, such as maintain adequate records, sharing medical records in duly time, and monitoring prescription of opiates and barbiturates. These are just a few examples. Then the foundation scheme is a bit problematic in the light there has not been any research publication despite it being a research foundation.

This was not a lynching. It was the College of physicians who takes patient safety and professional code of conduct seriously. In Canada, to be a physician you have to play by the rules.

Patients deserve access to competent physicians, and have a right to certain standards of care. Privacy, ethical care, and safety concerning the use and monitoring of scheduled substances are all important both for patients and for the profession of medicine.
 
Last edited:

Alvin2

The good news is patients don't die the bad news..
Messages
1,394
Likes
3,887
Patients deserve access to competent physicians, and have a right to certain standards of care. Privacy, ethical care, and safety concerning the use and monitoring of scheduled substances are all important both for patients and for the profession of medicine.
I'm just going to say this. This was designed to take him out of practice because he was investigating an unrecognized illness that has no official sanction and is considered to be Munchausen syndrome. Also he was past retirement age and the college attempts to remove anyone thats too old, incompetence is a good once because its very believable that old people lose their faculties...

If you go looking for skeletons or things you can pin on someone you can often interpret your way to making them stick, especially when your organization is judge, jury and executioner. And your target cannot afford an expensive lawyer.
The medical records bit is laughable, his records are better then most doctors since he takes a life history and they are computerized (at least his modern ones, who knows what he was doing decades ago).

Many will disagree with his theories about ME, many can disagree with Dr Davis or Dr Naviaux of any of the researchers working on ME. If our goal is to extinguish everyone who comes up with a theory we don't like then we should prepare to never have a treatment. We should be skeptical and challenge everyone to prove their theories because bad theories will lead nowhere and we can't live like that. Are his theories any good, i wish i could say yes or no. Once we know enough about ME we will be able to answer that question but we need lots of good brains working on it and coming up with theories that we desperately need the money to prove or disprove. That said arguing people should be extinguished backstopped by governments who think ME is fake means we are out to hurt ourselves while believing we are not.

It is possible the government is now preparing to go after all patients who saw him to make sure they lose any disability benefits they have because ME is fake by using their "insufficient" medical records. Many may end up wishing they were insufficient.
 
Last edited:

Kati

Patient in training
Messages
5,497
Likes
19,624
Here is a publication from the College of physicians of Ontario about professionalism: https://www.cpso.on.ca/admin/CPSO/m...nd-guidance/practice-guide/practice-guide.pdf

the proof of the burden is explained in detail. There would be other concerns I am sure, and what we are seeing is the tip of the iceberg.

When a patient complain, the college has a duty to investigate the practice of the professional. They have found many problems and Dr Hyde agreed with the analysis. He has agreed to close his practice and to pay over 10,000$ in fees. In other cases (mostly when the doctor is much younger) there may be formal reprimands, mandatory courses and supervised practice for a period of time.

Every single doctor in Canada regardless of where they practice must follow the rules, the code of ethics and the practice guidelines which are black on white and easily accessible to them. The College has a duty to protect patients from harm and in this case undue expenses (825$ for clinical notes).

This ruling is fair and Dr Hyde should have known better.
 
Last edited by a moderator:

Alvin2

The good news is patients don't die the bad news..
Messages
1,394
Likes
3,887
the proof of the burden is explained in detail. There would be other concerns I am sure, and what we are seeing is the tip of the iceberg.
I wish those governments would go after the PACErs with this kind of zeal, its not like they are not acting disgracefully and below medical ethics, David Tuller has made their cases for them and i would challenge them to fact check Tuller's reporting.
 
Last edited by a moderator:

Kati

Patient in training
Messages
5,497
Likes
19,624
I defend the right to competent care based on evidence and science. I also believe all professionals should follow guidelines and standards for safe and ethical care. We are in desperate need for science here, validated biomarkers that are based on consensus rather than only available from one place on the whole planet. We are in desperate need for peer reviewed science and integration of ME as a disease in mainstream medicine, not on the fringes.

I defend the right to competent, ethical and free health care for all Canadians for whatever ails you. And i will encourage physicians to be advocates for their patients and consider becoming researchers to find effective treatments for all. Sounds like we are moving in this direction as of yesterday.
 
Last edited by a moderator:

Alvin2

The good news is patients don't die the bad news..
Messages
1,394
Likes
3,887
I defend the right to competent care based on evidence and science. I also believe all professionals should follow guidelines and standards for safe and ethical care. We are in desperate need for science here, validated biomarkers that are based on consensus rather than only available from one place on the whole planet. We are in desperate need for peer reviewed science and integration of ME as a disease in mainstream medicine, not on the fringes.
I agree. I would love to have more money to do research to figure out the disease mechanism of ME. Is Dr Hyde correct or is he way off? I would like to know. If he is wrong then we need to figure out what is right. If he is right then we need to move on to figuring out treatments (Dr Hyde does not offer any, he only did diagnostics).

I defend the right to competent, ethical and free health care for all Canadians for whatever ails you. And i will encourage physicians to be advocates for their patients and consider becoming researchers to find effective treatments for all. Sounds like we are moving in this direction as of yesterday.
The investigations of Dr Hyde are many years older then yesterday.
I have been prescribed CBT/GET recently. I assume that physician will now lose their medical license.
When pigs fly
 

Kati

Patient in training
Messages
5,497
Likes
19,624
The investigations of Dr Hyde are many years older then yesterday
Where are the peer-reviewed publications? And I am not saying there was nothing good in Dr Hyde. I am saying that the investigation of the college were fair and seemingly accurate because he agreed with its results.
I have been prescribed CBT/GET recently
i am so very sorry. We deserve competent care. It starts with building knowledge, getting biomarkers, identify subgroups and start thinking of clinical trials. We are literally starting from scratch but the momentum is building.
 

Alvin2

The good news is patients don't die the bad news..
Messages
1,394
Likes
3,887
Where are the peer-reviewed publications?
Where is the money?
If i had millions to spend i would spend it very wisely to prove or disprove reasonable theories. I would also like to know what is causing the signal in Dr Davis' nanoneedle, if some of the drugs Dr Klimas wants to trial are worth funding, if the brain investigations by Dr Younger suggest more research areas and so on. As Dr Davis(?) said they are not short of ideas, they are short on funds to investigate them and keep the field moving forward.

I am saying that the investigation of the college were fair and seemingly accurate because he agreed with its results.
What costs less, a 10K fine or a high priced lawyer who charges hundreds of dollars an hour who needs to review every patient you met over a 50 year long career because the college is reviewing all them to to find a reason to drive you out because ME is a fake disease?

i am so very sorry. We deserve competent care. It starts with building knowledge, getting biomarkers, identify subgroups and start thinking of clinical trials. We are literally starting from scratch but the momentum is building.
Thanks.
I agree that we need to move forward rapidly, but its ridiculous to see double standards, physicians who lie to us, dont know the current research and produce fraudulent research are protected by their employers and governments. Lets cashier them out of employment. Why is this not happening?
 

Countrygirl

Senior Member
Messages
4,466
Likes
22,509
Location
UK
I'm just going to say this. This was designed to take him out of practice because he was investigating an unrecognized illness that has no official sanction and is considered to be Munchausen syndrome. Also he was past retirement age and the college attempts to remove anyone thats too old, incompetence is a good once because its very believable that old people lose their faculties...

If you go looking for skeletons or things you can pin on someone you can often interpret your way to making them stick, especially when your organization is judge, jury and executioner. And your target cannot afford an expensive lawyer.
The medical records bit is laughable, his records are better then most doctors since he takes a life history and they are computerized (at least his modern ones, who knows what he was doing decades ago).

Many will disagree with his theories about ME, many can disagree with Dr Davis or Dr Naviaux of any of the researchers working on ME. If our goal is to extinguish everyone who comes up with a theory we don't like then we should prepare to never have a treatment. We should be skeptical and challenge everyone to prove their theories because bad theories will lead nowhere and we can't live like that. Are his theories any good, i wish i could say yes or no. Once we know enough about ME we will be able to answer that question but we need lots of good brains working on it and coming up with theories that we desperately need the money to prove or disprove. That said arguing people should be extinguished backstopped by governments who think ME is fake means we are out to hurt ourselves while believing we are not.

It is possible the government is now preparing to go after all patients who saw him to make sure they lose any disability benefits they have because ME is fake by using their "insufficient" medical records. Many may end up wishing they were insufficient.
I have received further information of which I cannot say much just yet, but the good news is that the battle is far from over and the trumped-up charges, for that is what they are, will be challenged .

Meanwhile I am waiting for further advice of how we can help Dr Hyde which I should know in a few days.

It could be a nail-biting time for those whose insurance settlements were supported by Dr HB. More vested interested just like with the UK giverment and the PACE people.

This is far from over yet.
 

Countrygirl

Senior Member
Messages
4,466
Likes
22,509
Location
UK
I am saying that the investigation of the college were fair and seemingly accurate because he agreed with its results.

As fair as those of the UK's GMC, who told me when I wrote to them with case histories of ME patients who had and are suffering terribly at the hands of their doctors, some who had died, and some locked away that the patients' plight was not of any concern to them. Well, they have ME so not of interest as the system has ensured that they and the few doctors who support them are disenfranchised and have no right to demand protection from inappropriate and dangerous treatment and loss of liberty. All very fair.
 

GypsyGirl

Senior Member
Messages
165
Likes
377
Location
North Carolina
@Kati thank you for including the charges - useful and necessary information to know.

As I read the charges, it seems a lot of these violations were against emerging standards of the practice of medicine. Eg, SOAP notes have only been used since the 70's, and there was no medical standard of keeping notes before then. HIPAA laws were enacted in 1996. Privacy laws around technology are still emerging and not necessarily common knowledge. I've found many doctors don't know every single little nook and cranny of the entire running of their practice and would assume some of these things (like secured software) is built-in.

It's easy to see how an long-practicing old school doctor could easily accidentally (or flagrantly - I don't know statistics about how often such rules are broken) step outside these laws. Not an excuse for bad behavior, overstepping boundaries, or breaking laws! Like @Kati mentioned, as a physician you have to play by the rules.

As a fellow human being, I can imagine that's pretty difficult and there are some gray areas that are clear now that maybe weren't at the time. Can imagine how hard it is to keep up in a field that has changed very rapidly, with a lot of new tech and laws, with time for patients whittled down as more electronic record-keeping takes over doctors' time, figuring out ways to document with patients who don't neatly fit in the given boxes, and feeling like you're on the front lines with more and more sick & desperate patients coming in.

A response from the doc (even he doesn't or can't dispute these charges - which seems likely) gives context. If many patients were helped, there's a chance to see the value in it despite the rest, to pick out what worked.

Over the years, I've watched so many doctors struggle with the incessant paperwork, electronic files, authorizations, pre-authorizations, denials & appeals, etc etc etc. Some of the care that has helped me the most has been non-standard care, and doctors willing to give it a try. I hope they all filed their paperwork appropriately!

I don't think it's humanly possible to know every nook and cranny of a practice 100% of the time. No one polices their behavior 100% of the time either, and sometimes you guess wrong about what matters. These cases of doctors breaking laws, but perhaps still being generally good and or/helpful doctors, are growing pangs and a necessary step to set standards in place. As patients, we can acknowledge wrongdoing, and still acknowledge the good deeds done.
 

Kati

Patient in training
Messages
5,497
Likes
19,624
I don't think it's humanly possible to know every nook and cranny of a practice 100% of the time
For the grey area of practice, there are guidelines that are suggested. For instance, here are the recommendations for physicians in regards to the use of cannabis for medical use:
https://cpsbc.ca/site-search?search_api_multi_fulltext=Cannabis

Telemedicine
https://cpsbc.ca/files/pdf/PSG-Telemedicine.pdf

Use of opioids and barbiturates
https://cpsbc.ca/files/pdf/PSG-Safe-Prescribing.pdf

Note, the standards i provided are from British Columbia. There will be similar ones from Ontario.

@GypsyGirl while I agree with most of your post, i disagree about your nook and cranny comment, because it a physician is not sure of the college guidelines, there is a search link to quickly access guidelines. And if there is no guideline available for the particular problem the registrant can ask the question to the college for guidance.

Each physician need to register yearly and it is expected that they will remain up to date with the most recent guidelines which may not have existed the year before. And yet, for each physician, regardless where they practice, they must know how to maintain a medical record, what are the standards for prescribing opioids and barbiturates, and what method of communication is safe, what the requirements are for telemedicine and email communication. These are the basics of medicine.