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Malette, Paul Maurice Joseph

CPSO#: 54489

MEMBER STATUS
Suspended as of 16 Dec 2019
CPSO REGISTRATION CLASS
Restricted as of 16 Dec 2019
Flag: Indicates a concern or additional information

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, French

Education:McMaster University, 1984

Practice Information

Primary Location of Practice
Practice Address Not Available

Hospital Privileges

Hospital Location
Health Sciences North Sudbury

Specialties

Specialty Issued On Type
Family Medicine Effective: 10 Jun 2016 CFPC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1984
Transfer of class of registration to: Independent Practice Certificate Effective: 05 Jul 1985
Transfer of class of certificate to: Restricted certificate Effective: 05 Jul 2018
Terms and conditions imposed on certificate by Inquiries, Complaints and Repo Effective: 05 Jul 2018
Transfer of class of registration to: Independent Practice Certificate Effective: 13 Sep 2018
Transfer of class of certificate to: Restricted certificate Effective: 16 Dec 2019
Terms and conditions imposed on certificate by Discipline Committee Effective: 16 Dec 2019
Suspension of registration imposed: Discipline Committee Effective: 16 Dec 2019

Practice Restrictions Flag: indicates a concern or additional information

Registration Status: Suspended     Effective From: 16 Dec 2019


Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 16 Dec 2019 Active

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 29 Nov 2019
Summary:

On November 29, 2019, on the basis of an Agreed Statement of Facts and Admission (Liability), 
the Discipline Committee found that Dr. Paul Maurice Joseph Malette committed an act of 
professional misconduct in that he engaged in acts or omissions relevant to the practice of 
medicine that, having regard to all circumstances, would reasonably be regarded by members as 
disgraceful, dishonourable or unprofessional. 
 
Dr. Malette is a 63-year-old family physician practicing in Val Caron, Ontario. He obtained his 
certificate of registration authorizing independent practice from the College in 1985. Dr. Malette 
was Patient A’s family physician for many years. During the time she was his patient, Patient A 
suffered from a number of health challenges. 
 
In approximately 2005, Dr. Malette began hugging Patient A at the end of every appointment. 
These hugs occurred in Dr. Malette’s examination room. During some hugs, Dr. Malette’s cheek 
and/or lips made contact with Patient A’s cheek, giving Patient A the impression that he was 
trying to kiss her. Unbeknownst to Dr. Malette, the hugs were unwelcomed by Patient A, and 
they made her feel extremely uncomfortable. 
 
In September 2008, the College revised its policy on Maintaining Appropriate Boundaries and 
Preventing Sexual Abuse to include the guideline that physicians should avoid physical contact 
with patients except where required to perform medically necessary examinations. Dr. Malette’s 
routine hugging of Patient A was not in compliance with the College’s policy from September 
2008 onwards. 
 
Patient A’s medical records indicate that in 2009, Patient A complained to Dr. Malette of loss of 
libido and loss of sensation in her genital area. She subsequently returned to Dr. Malette with a 
complaint of numbness in the genitals inhibiting sexual functioning. Dr. Malette examined 
Patient A’s genitals. His examination included a bimanual examination, a Pap test, and palpation 
of Patient A’s vulva and clitoris. While he was palpating her genitals, Dr. Malette asked Patient 
A to compare the loss of sensation she was experiencing during his examination with the loss of 
sensation she experienced during sexual intercourse with her husband. Patient A was upset by his 
question. Dr. Malette did not adequately explain the examination and the purpose of his question 
to Patient A prior to the examination. The inadequate explanation caused Patient A to be 
alarmed. Dr. Malette hugged Patient A at the end of this appointment. 
 
Though Patient A remained Dr. Malette’s patient for several years, she did not return to him for 
another pelvic examination. Her next Pap test was not until six years later, with a female 
registered practical nurse. 
 
The College retained Dr. Carolyn Borins, a family physician, to opine as to whether Dr. 
Malette’s behaviour and remarks were of a clinical nature appropriate to the service provided. 
Dr. Borins opined that it is inappropriate of physicians to routinely initiate hugs of patients. Such 
hugs constitute an inappropriate boundary crossing, as there is a power differential inherent in 
the physician patient relationship. Hugs can be interpreted by patients in different ways, and even 
if a hug is well-intentioned, physicians cannot predict how the patient will interpret the hug. 
While showing comfort to patients is important, physicians can demonstrate caring and empathy 
in other ways to ensure no boundaries are crossed. Dr. Borins further opined that it is 
inappropriate to ask a patient to compare clinical touching to touching of a sexual nature by a 
romantic partner. Touching of a clinical nature is distinct from sexual touching, and the two are 
not comparable. Asking for such a comparison risks giving the patient the impression that the 
physician’s touch is of a sexual nature. 
 
DISPOSITION 
 
On November 29, 2019, in addition to its finding set out in paragraph 1 of its Order, the 
Discipline Committee ordered:  
 
   2. Dr. Malette attend before the panel to be reprimanded. 
       
   3. The Registrar to suspend Dr. Malette’s certificate of registration for a period of three (3) 
      months, commencing on December 16, 2019 at 12:01 a.m. 
    
   4. The Registrar to place the following terms, conditions and limitations on Dr. Malette’s 
      certificate of registration: 
       
      Suspension 
       
         (a) Dr. Malette shall comply with the College Policy “Closing a Medical Practice.” 
            
           PROBE 
             
        (b) Dr. Malette shall participate in the PROBE Ethics & Boundaries Program offered 
           by the Centre for Personalized Education for Professionals, by receiving a passing 
           evaluation or grade, without any condition or qualification. Dr. Malette will 
           complete the PROBE program within six (6) months of the date of the Order, and 
           will provide proof to the College of his completion, including proof of registration 
           and attendance and participant assessment reports, within one (1) month of 
           completing it. 
            
         Practice Monitor 
             
        (c) Dr. Malette shall not conduct any pelvic, genital and/or rectal examination of any 
           patient, of any age, in any jurisdiction, unless the examination takes place in the 
           continuous presence and under the continuous observation of a monitor who is a 
           regulated health professional acceptable to the College under paragraphs 4(d) and 
           4(e) below. 
            
        (d) In respect of his office-based practice (City of Lakes Family Health Team – Val 
           Caron Clinic), Dr. Malette shall retain a Practice Monitor acceptable to the 
           College who has executed the Practice Monitor’s undertaking in the form attached 
           to the Order as Appendix “A”. 
      
            
 (e) In respect of his hospital-based practice (Health Sciences North – Sudbury), Dr. 
    Malette shall retain a Supervising Practice Monitor acceptable to the College who 
    has executed the Supervising Practice Monitor’s undertaking in the form attached 
    to the Order as Appendix “B”. 
     
 (f) Dr. Malette shall inform his patients of the indication for any pelvic, genital 
    and/or rectal examination that he may perform, and shall document the discussion 
    in the corresponding patient chart. 
                   
(g) Dr. Malette shall ensure that both in respect of his office-based practice and his 
    hospital-based practice the Practice Monitors maintain a log of all pelvic, genital 
    and/or rectal examinations he conducts in the form attached to the Order as 
    Appendix “B,” including listing the indication Dr. Malette described to his patient 
    for any pelvic, genital and/or rectal examination performed and confirming that 
    Dr. Malette has documented the discussion in the corresponding patient chart. Dr. 
    Malette shall maintain up to date copies of the Logs by ensuring copies are made 
    at the end of each business day, and shall make them available to the College 
    upon request. Dr. Malette shall ensure that the original Logs are submitted to the 
    College on a monthly basis. 
                    
 (h) Dr. Malette shall ensure that each patient with whom he intends to conduct a 
    pelvic, genital and/or rectal examination is directly notified, prior to the 
    examination, of the details of the restriction described in paragraph 4(c). 
                    
 (i) Dr. Malette shall post a sign in all waiting rooms, examination rooms and 
    consulting rooms of his office-based practice in a clearly visible and secure 
    location, in the form set out in Appendix “C”, that states: “Dr. Paul Malette must 
    not conduct pelvic, genital and/or rectal examinations of any kind unless in the 
    continuous presence of and under the continuous observation of a practice 
    monitor acceptable to the College of Physicians and Surgeons of Ontario. Dr. 
    Malette must not be alone with patients during pelvic, genital and/or rectal 
    examinations. Further information may be found on the College website at 
    www.cpso.on.ca.” 
                    
 (j) Dr. Malette shall provide each patient with whom he intends to conduct a pelvic, 
    genital and/or rectal examination in his hospital-based practice with a copy of the 
   sign in the form set out at Appendix “C” to the Order. Dr. Malette shall ensure 
   that prior to the pelvic, genital and/or rectal examination, the patient (or their next 
   of kin if the patient is incapable) initials the sign, along with the date of their 
   signature, and that a copy of the initialed and dated sign is maintained in the 
   patient chart. 
                   
(k) Dr. Malette shall obtain a certified translation, in any language in which he 
   provides services, of the sign described in paragraph 4(i). He shall post it in all 
   waiting rooms, examination rooms and consulting rooms, in all of his office-
   based practice locations, in a clearly visible and secure location, in the form set 
          out at Appendix “C” to the Order. He shall have copies readily available to him in 
         his hospital-based practice, in the form set out at Appendix “C” to the Order. 
    
      (l) Dr. Malette shall provide the certified translation described in paragraph 4(k), to 
         the College within thirty (30) days of the date of the Order. 
    
      (m) Dr. Malette shall inform the College of each and every location at which he 
         practises or has privileges including, but not limited to hospitals, clinics, offices, 
         and any Independent Health Facilities with which Dr. Malette is affiliated, in any 
         jurisdiction (collectively “Practice Location” or “Practice Locations”), within five 
         days of the Order. Going forward, Dr. Malette shall undertake to inform the 
         College of any and all new Practice Locations within five days of commencing 
         practice at that location. If Dr. Malette carries on an office- or clinic-based 
         practice at a new Practice Location, the provisions of paragraphs 4(c), (d), (f), (g), 
         (h), (i), (k), and (l) above describe the practice monitoring arrangements that will 
         be required at that location. If Dr. Malette carries on a hospital-based practice 
         involving seeing in-patients and/or emergency department patients at a new 
         Practice Location, the provisions of paragraph 4(c), (e), (f), (g), (h), (j), (k), and 
         (l) above describe the practice monitoring requirements that will be required that 
         that location. 
    
      (n) Dr. Malette shall submit to and shall not interfere with unannounced inspections 
         of his Practice Locations and to the inspection of patient records by the College 
         and to any other activity the College deems necessary in order to monitor his 
         compliance with the provisions of the Order. 
    
      (o) Dr. Malette shall execute the OHIP consent form, in the form attached at 
         Appendix “E” to the Order. 
    
5. Dr. Malette to pay costs to the College in the amount of $10,370 within 30 days of the 
   date of the Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): November 29, 2019

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: December 4, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Paul Maurice Joseph Malette to the College of Physicians and Surgeons of Ontario, effective December 4, 2019:

Following a public complaint, the College conducted an investigation into in Dr. Malette’s practice of family medicine. As a result of the investigation:

Dr. Malette will engage in professional education in transgender health and maintaining appropriate professional boundaries.