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Malette, Paul Maurice Joseph

CPSO#: 54489

MEMBER STATUS
Active Member as of 16 Mar 2020
CPSO REGISTRATION CLASS
Restricted as of 16 Dec 2019

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
1280 Lasalle Blvd
Sudbury ON  P3A 1Y8
Phone: (705) 806-7915
Fax: (705) 521-0729 Electoral District: 08

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
Terms and conditions amended by member Effective: 04 Dec 2019
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
Suspension of registration removed Effective: 16 Mar 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
member Effective: 04 Dec 2019 Active
             As from December 4, 2019, the following are imposed as terms, conditions and
            limitations on the certificate of registration held by Dr. Paul Maurice Joseph
            Malette in accordance with an undertaking and consent given by Dr. Malette to
            the College of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                              DR. PAUL MAURICE JOSEPH MALETTE
                                          ("Dr. Malette")
                  
                                                to 
                  
                        COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
                                          (the "College")
                  
            A.    PREAMBLE

            (1)   In this Undertaking:

                  "Code" means the Health Professions Procedural Code, which is Schedule 2
                  to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as
                  amended; 
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Malette, certificate of registration number 54489, am a member of
                  the College.

            (3)   I, Dr. Malette, acknowledge that, following a public complaint, the
                  College conducted an investigation bearing File Number 1106151 (the
                  "Investigation") into in my practice of family medicine.

            B.    UNDERTAKING

            (4)   I, Dr. Malette, undertake to abide by the provisions of this Undertaking,
                  effective immediately.

            (5)   Professional Education 

                  (a)   I, Dr. Malette, undertake to participate in and successfully
                        complete all aspects of the detailed IEP, attached hereto as
                        Appendix "B", including all of the following professional education
                        (the "Professional Education"):
                  
                        (i)   a review and written summary of: 
                  
                              1.    The World Professional Association for Transgender
                                    Health ("WPATH") Standards of Care for the Health of
                                    Transsexual, Transgender, and Gender Nonconforming
                                    People; and
                  
                              2.    the College policy Maintaining Appropriate Boundaries
                                    and Preventing Sexual Abuse.
                  
                  (b)   I, Dr. Malette, undertake to complete this requirement by March 31,
                        2020.
                  
                  (c)   I, Dr. Malette, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the Professional Education.
                  
            C.    ACKNOWLEDGEMENT

            (6)   I, Dr. Malette, acknowledge that all appendices attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (7)   I, Dr. Malette, acknowledge and undertake that I shall be solely
                  responsible for payment of all fees, costs, charges, expenses, etc.
                  arising from the implementation of any of the provisions of this
                  Undertaking. 

            (8)   I, Dr. Malette, acknowledge that I have read and understand the
                  provisions of this Undertaking and that I have obtained independent legal
                  counsel in reviewing and executing this Undertaking, or have waived my
                  right to do so.

            (9)   I, Dr. Malette, acknowledge that the College may provide this Undertaking
                  to any Chief of Staff, or a colleague with similar responsibilities, at
                  any Practice Location ("Chief of Staff" or "Chiefs of Staff").

            (10)  I, Dr. Malette, acknowledge that a breach by me of any provision of this
                  Undertaking may constitute an act of professional misconduct and/or
                  incompetence, and may result in a referral of specified allegations to
                  the Discipline Committee of the College.

            (11)  I, Dr. Malette, acknowledge that this Undertaking constitutes terms,
                  conditions, and limitations on my certificate of registration for the
                  purposes of section 23 of the Code. 

            (12)  Public Register

                  (a)   I, Dr. Malette, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Malette, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (16)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                              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.
                  
                  (c)   I, Dr. Malette, acknowledge that this Undertaking remains in effect
                        until the College determines its terms are satisfied.
                  
            D.    CONSENT

            (13)  I, Dr. Malette, give my irrevocable consent to the College to provide the
                  following information to any person who requires this information for the
                  purposes of facilitating my completion of the Professional Education:

                  (a)   any information the College has that led to the circumstances of my
                        entering into this Undertaking;
                  
                  (b)   any information arising from any investigation into, or assessment
                        of, my practice; and 
                  
                  (c)   any information arising from the monitoring of my compliance with
                        this Undertaking.
                  
            (14)  I, Dr. Malette, give my irrevocable consent to the College to provide all
                  Chiefs of Staff with any information the College has that led to the
                  circumstances of my entering into this Undertaking and/or any information
                  arising from the monitoring of my compliance with this Undertaking.

            (15)  I, Dr. Malette, give my irrevocable consent to any persons who facilitate
                  my completion of the Professional Education any of the following:

                  (a)   any information relevant to this Undertaking;
                  
                  (b)   any information relevant for the purposes of monitoring my
                        compliance with this Undertaking; and/or  
                  
                  (c)   any information which comes to their attention in the course of
                        providing the Professional Education and which they reasonably
                        believe indicates a potential risk of harm to my patients.

Previous Hearings

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

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.