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THE FOLLOWING INFORMATION WAS OBTAINED FROM THE DOCTOR SEARCH SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO WWW.CPSO.ON.CA
Date: 11/05/21 8:42:22 AM

Gale, George Douglas

CPSO#: 23958

MEMBER STATUS
Active Member as of 30 Jul 1970
CPSO REGISTRATION CLASS
Restricted as of 21 Dec 2015

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Durham, 1958

Practice Information

Primary Location of Practice
Cloud Care Clinic
55 Dundas St. East
Toronto ON  M5B 1C6
Phone: (416)361-6000
Fax: (416)361-6044 Electoral District: 10

Additional Practice Location(s)

Pinnacle Health Sciences
4125 Lawrence Ave. East
Toronto ON  M1E 2S2
Canada
County: City of Toronto
Electoral District: 10

Wellmedica
7600 Weston Road
Woodbridge ON  L4L 8B7
Canada
Phone: (289)371-3500
County: Regional Municipality of York
Electoral District: 05

Wellmedica
90 Resolution Dr.
Unit 2
Brampton ON  L6W 0A7
Canada
Phone: (416)883-3877
County: Regional Municipality of Peel
Electoral District: 05

Spine Center
7611 Pine Valley Drive
Woodbridge ON  L4L 0A2
Canada
Phone: (905)850-7746
County: Regional Municipality of York
Electoral District: 05

Chronic Disease Clinic
2330 Kennedy Road
Suite 210
Toronto M1T 0A2
Canada
Phone: (416)335-1717
County: 
Electoral District: 

Professional Corporation Information


Corporation Name: Dr. George Gale Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Mar 2 2018

Specialties

Specialty Issued On Type
Anesthesiology Effective:01 Dec 1970 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Temporary Employment Practice Certificate Effective: 30 Jul 1970
Transfer of class of registration to: Independent Practice Certificate Effective: 02 Aug 1971
Transfer of class of certificate to: Restricted certificate Effective: 21 Dec 2015
Terms and conditions imposed on certificate by member Effective: 21 Dec 2015
Terms and conditions amended by member Effective: 14 Nov 2019
Terms and conditions amended by member Effective: 09 May 2020
Terms and conditions amended by member Effective: 06 Aug 2020
Terms and conditions amended by Discipline Committee Effective: 10 Aug 2020
Terms and conditions amended by Discipline Committee Effective: 18 Sep 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 18 Sep 2020 Active
 
(1 of 4)
Effective September 18, 2020, Dr. George Gale (CPSO # 23958) was unable to obtain a clinical supervisor and will cease to practice until such time as a clinical supervisor has been approved.  

(2 of 4)
            As from, August 10, 2020, by order of the Discipline Committee of the College
            of Physicians and Surgeons of Ontario, the following terms, conditions and
            limitations are imposed on the certificate of registration held by Dr. George
            Douglas Gale:

            a)    Clinical Supervision

                  i.    Within thirty (30) days of this Order, at his own expense, Dr. Gale
                        shall retain a College-approved clinical supervisor (the "Clinical
                        Supervisor") who shall sign an undertaking in the form attached
                        hereto as Schedule "A".  
                  
                  ii.   Commencing on the date of this Order and continuing until the end
                        of the six (6) month period of Moderate-Level Supervision set forth
                        in paragraph 3.c) below, Dr. Gale shall practise only under the
                        supervision of the Clinical Supervisor. 

                  iii.  Clinical Supervision of Dr. Gale's practice shall contain the
                        elements set forth in paragraphs 3.b) through 3.d) below.
                  
            b)    Reduced Practice Clinical Supervision

                  i.    Initially and until Dr. Gale starts to see more than ten (10)
                        patients per week, by way of telemedicine or otherwise, Dr. Gale
                        shall practice only under Reduced Practice Clinical Supervision,
                        during which time the Clinical Supervisor shall, at minimum:  
                  
                              1.    Review materials provided by the College and have an
                                    initial telephone or secure electronic video conference
                                    with Dr. Gale to discuss practice improvement
                                    recommendations;
                              2.    Thereafter, once every month:  (a) review all charts
                                    for the patients with whom Dr. Gale consulted over the
                                    preceding month; and (b) meet with Dr. Gale, in person,
                                    by telephone or secure video conference, to discuss any
                                    issues or concerns arising from the chart reviews;
                  
                              3.    Provide reports to the College once every month, or
                                    more frequently if the Clinical Supervisor has concerns
                                    about Dr. Gale's standard of practice or conduct;
                  
                              4.    Discuss with Dr. Gale any concerns the Clinical
                                    Supervisor may have arising from his discussions with
                                    Dr. Gale and chart reviews;
                  
                              5.    Make recommendations for practice improvements and
                                    ongoing professional development, and inquire into Dr.
                                    Gale's compliance with any recommendations; and
                  
                              6.    Keep a log of all patient charts reviewed along with
                                    patient identifiers.
                  
                  ii.   Dr. Gale shall provide the College with at least seven (7) days'
                        written notice of Dr. Gale's intention to see more than ten (10)
                        patients per week by way of telemedicine or otherwise ("Dr. Gale's
                        Return to Active Practice").  
                  
            c)    Modrate-Level Clinical Supervision

                  i.    Commencing from Dr. Gale's Return to Active Practice and continuing
                        for a period of six (6) months, Dr. Gale shall practise only under
                        Moderate-Level Clinical Supervision, during which time the Clinical
                        Supervisor shall, at minimum:
                  
                        1.    Meet with Dr. Gale once every two (2) weeks, at Dr. Gale's
                              Practice Location or another location approved by the
                              College, to review a minimum of fifteen (15) charts, to be
                              selected in the sole discretion of the Clinical Supervisor,
                              and discuss any issues or concerns arising therefrom with Dr.
                              Gale;
                  
                        2.    Provide reports to the College once per month, or more
                              frequently if the Clinical Supervisor has concerns about Dr.
                              Gale's standard of practice or conduct;
                  
                        3.    Discuss with Dr. Gale any concerns the Clinical Supervisor
                              may have arising from his meetings with Dr. Gale and chart
                              reviews;
                  
                        4.    Make recommendations for practice improvements and ongoing
                              professional development, and inquire into Dr. Gale's
                              compliance with any recommendations; and
                  
                        5.    Keep a log of all patient charts reviewed along with patient
                              identifiers.
                  
            d)    Other Elements of Clinical Supervision

                  i.    Throughout the period of Clinical Supervision, Dr. Gale shall abide
                        by the recommendations of the Clinical Supervisor, including but
                        not limited to, any recommended practice improvements and ongoing
                        professional development.
                  
                  ii.   If a Clinical Supervisor who has given an undertaking as set out in
                        Schedule "A" to this Order is unable or unwilling to continue to
                        fulfill its terms, Dr. Gale shall, within twenty (20) days of
                        receiving notice of same, obtain an executed undertaking in the
                        same form from a person who is acceptable to the College and ensure
                        that it is delivered to the College within that time.
                  
                  iii.  If Dr. Gale is unable to obtain a Clinical Supervisor in accordance
                        with this Order, he shall cease to practice until such time as he
                        has done so and this shall constitute a term, condition or
                        limitation on his certificate of registration and that term,
                        condition or limitation shall be included on the public register.
                  
                  iv.   Dr. Gale shall consent to the disclosure by his Clinical Supervisor
                        to the College, and by the College to his Clinical Supervisor, of
                        all information the Clinical Supervisor or the College deems
                        necessary or desirable in order to fulfill the Clinical
                        Supervisor's undertaking and Dr. Gale's compliance with this Order.
                  
            e)    Re-Assessment

                  i.    Approximately three (3) months after the completion of the period
                        of Clinical Supervision set out above, Dr. Gale shall undergo a
                        re-assessment of his practice, at his own expense, by a
                        College-appointed assessor (the "Assessor(s)).  The Assessor(s)
                        shall report the results of the re-assessment to the College.
                  
                  ii.   Dr. Gale shall cooperate fully with the Reassessment and with the
                        Assessor(s).  Dr. Gale shall consent to the disclosure to the
                        Assessor(s) of the reports of the Clinical Supervisor arising from
                        the supervision, and shall consent to the sharing of all
                        information between the Clinical Supervisor, the Assessor(s) and
                        the College, as the College deems necessary or desirable in order
                        to fulfill their respective obligations. 
                  
            f)    Monitoring 

                  i.    Dr. Gale shall inform the College of each and every location where
                        he practices, in any jurisdiction (his "Practice Location(s)")
                        within  five (5) days of this Order and shall inform the College of
                        any and all new Practice Locations within five (5) days of
                        commencing practice at that location.
                  
                  ii.   Dr. Gale shall cooperate with unannounced inspections of his
                        practice and patient charts by one or more College
                        representative(s) for the purpose of monitoring and enforcing his
                        compliance with the terms of this Order.
                  
                  iii.  Dr.  Gale shall consent to the College's making appropriate
                        enquiries of the Ontario Health Insurance Plan and/or any person or
                        institution that may have relevant information, in order for the
                        College to monitor and enforce his compliance with the terms of
                        this Order.
                  
                  iv.   Dr. Gale shall be responsible for any and all costs associated with
                        implementing the terms of this Order.
                  
            (3 of 4)
            As from August 6, 2020, the following is imposed as terms, conditions and
            limitations on the certificate of registration held by Dr. George Douglas Gale
            in accordance with an undertaking and consent given by Dr. Gale to the College
            of Physicians and Surgeons of Ontario:

                               UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
                                            ("Undertaking")
                                                  of
                                        DR. GEORGE DOUGLAS GALE
                                             ("Dr. Gale")
                                                  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; 
                  
                  "Discipline Committee" means the Discipline Committee of the College;
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                  "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register" means the College's register that is available to the
                  public. 
                  
            (2)   I, Dr. Gale, certificate of registration number 23958, am a member of the
                  College.

            (3)   I, Dr. Gale, acknowledge that the ICR Committee referred allegations of
                  professional misconduct and incompetence against me to the Discipline
                  Committee in a Notice of Hearing dated September 27, 2019. 

            (4)   I, Dr. Gale, acknowledge that since November 14, 2019, I have not
                  performed any interventional pain procedures as set out in Appendix "A"
                  to this Undertaking.

            B.    UNDERTAKING

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

            (6)   Practice Restrictions

                  (a)   I, Dr. Gale, undertake to restrict my practice as follows:
                  
                        (i)   I will not perform any interventional pain procedures as set
                              out at Appendix "A" to this Undertaking.
                  
            (7)   Monitoring 

                  (a)   I, Dr. Gale, undertake to inform the College of each and every
                        location where I practise or have privileges, including, but not
                        limited to, any hospitals, clinics, offices, and any Independent
                        Health Facilities with which I am affiliated, in any jurisdiction
                        (collectively my "Practice Location" or "Practice Locations"),
                        within five (5) days of executing this Undertaking.  Going forward,
                        I further undertake to inform the College of any and all new
                        Practice Locations within five (5) days of commencing practice at
                        that location.
                  
                  (b)   I, Dr. Gale, undertake that I will submit to, and not interfere
                        with, unannounced inspections of my Practice Locations and patient
                        charts by a College representative for the purposes of monitoring
                        my compliance with the provisions of this Undertaking.
                  
                  (c)   Dr. Gale, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP, and/or any person or institution
                        that may have relevant information, in order for the College to
                        monitor my compliance with the provisions of this Undertaking.
                  
                  (d)   I, Dr. Gale, acknowledge that I have executed the OHIP consent
                        form, attached hereto as Appendix "B".
                  
            C.    ACKNOWLEDGEMENT

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

            (9)   I, Dr. Gale, 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. 

            (10)  I, Dr. Gale, 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.

            (11)  I, Dr. Gale, acknowledge that the College will 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").

            (12)  I, Dr. Gale, 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.

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

            (14)  Public Register

                  (a)   I, Dr. Gale, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Gale, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (14)(a) above, the
                        following summary shall be posted on the Public Register during the
                        time period that this Undertaking remains in effect:
                  
                        Dr. Gale was referred to the Discipline Committee on allegations of
                        professional misconduct and incompetence.  In the face of these
                        allegations, Dr. Gale agreed that he will not perform any
                        interventional pain procedures as set out in Appendix "A" to his
                        Undertaking. 
                  
            D.    CONSENT

            (15)  I, Dr. Gale, 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.

            (16)  I, Dr. Gale, give my irrevocable consent to all Chiefs of Staff to
                  disclose to the College, and to one another, any information relevant to
                  this Undertaking and/or relevant for the purposes of monitoring my
                  compliance with this undertaking.

            (4 of 4)
            As from May 9, 2020, the following are imposed as terms, conditions and
            limitations on the certificate of registration held by Dr. George Douglas Gale
            in accordance with an undertaking and consent given by Dr. Gale to the College
            of Physicians and Surgeons of Ontario:

                                    UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
                                                      ("Undertaking")
                                                                 of

                                                DR.  GEORGE DOUGLAS GALE
                                                      ("Dr. Gale")

                                                            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; 

                              "NMS" means the Drug Program Services Branch, the Narcotics
            Monitoring
                              System implemented under the Narcotics Safety and Awareness
            Act, 2010,
                              S.O. 2010, c. 22, as amended;

                              "OHIP" means the Ontario Health Insurance Plan;

                              "Public Register" means the College's register that is
            available to the
                              public.

                        (2)   I, Dr. Gale, certificate of registration number 23958, am a
            member of the
                              College. 

                        (3)   I, Dr. Gale, acknowledge that the College conducted an
            investigation
                                bearing File Number 1104917 (the "Investigation") into
            whether I engaged
                                in professional misconduct and/or am incompetent in my
            general medicine
                                practice, including in my delegation to non-members.

                        B.    UNDERTAKING

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

                        (5)   Practice Restriction   

                              (a)   I, Dr. Gale, undertake that I will cease all practice
            relating to
                                    Cannabis, as defined in the Cannabis Act, S.C. 2018, c.
            16, and
                                    regulations made thereunder, including, without
            limiting the
                                    generality of this restriction, 

                                    (i)   The prescription, dispensing or administration of
            Cannabis;

                                    (ii)  Signing medical documents pursuant to the
            Cannabis
                                          Regulations, SOR/2018-144, or any equivalent
            documents
                                          pursuant to such statutues or regulations as may
            be in effect
                                          from time to time (collectively "Cannabis
            documents"), or
                                          participating in any way in the preparation,
            issuance or
                                          support of Cannabis documents, except for the
            sole and
                                          limited purpose of referring patients to other
            healthcare
                                          providers; 

                                    (iii) Any counselling, assessment or treatment of
            patients that in
                                          any way relates to Cannabis, except for the sole
            purposes of
                                          referring patients to other healthcare providers
            for such
                                          counselling, assessment or treatment. 

                        (6)   I, Dr. Gale, undertake to inform the College of each and
            every location
                              at which I practise or have privileges, including, but not
            limited to,
                              any hospitals, clinics, offices, and any Independent Health
            Facilities
                              with which I am affiliated, in any jurisdiction (collectively
            my
                              "Practice Location" or "Practice Locations"), within five (5)
            days of
                              executing this Undertaking.  Going forward, I further
            undertake to inform
                              the College of any and all new Practice Locations within five
            (5) days of
                              commencing practice at that location.

                        (7)   Posting a Sign 

                              (a)   I, Dr. Gale, undertake that I shall post a sign in all
            waiting
                                    rooms in all my Practice Locations, in a clearly
            visible and secure
                                    location, in the form set out at Appendix "A".  For
            further
                                    clarity, this sign shall state as follows: 

                                          IMPORTANT NOTICE

                              Dr. Gale is prohibited from practising in relation to
            Cannabis,
                              including: 

                                    (i)   The prescription, dispensing or administration of
            Cannabis;

                                    (ii)  Signing medical documents pursuant to the
            Cannabis
                                          Regulations, SOR/2018-144, or any equivalent
            documents, or
                                          participating in any way in the preparation,
            issuance or
                                          support of Cannabis documents, except for the
            sole and
                                          limited purpose of referring patients to other
            healthcare
                                          providers; 

                                    (iii) Any counselling, assessment or treatment of
            patients that in
                                          any way relates to Cannabis, except for the sole
            purposes of
                                          referring patients to other healthcare providers
            for such
                                          counselling, assessment or treatment.

                              Further information may be found on the College of Physicians
            and
                              Surgeons of Ontario website at www.cpso.on.ca

                              (b)   I, Dr. Gale, undertake to post a certified translation
            in any
                                    language in which I provide services, of the sign
            described in
                                    section (8)(a) above, in all waiting rooms in all my
            Practice
                                    Locations, in a clearly visible and secure location, in
            the form
                                    set out at Appendix "A". 

                              (c)   I, Dr. Gale, undertake to provide the certified
            translation
                                    described in section (8)(b), to the College within
            thirty (30) days
                                    of executing this Undertaking.

                              (d)   I, Dr. Gale, undertake that if I elect, after the
            execution of this
                                    Undertaking, to provide services in any other language,
            I will
                                    notify the College prior to providing any such
            services. 

                              (e)   I, Dr. Gale, undertake to provide to the College the
            certified
                                    translation described in section (8)(c) prior to
            beginning to
                                    provide services in any language described in section
            (8)(d).

                        C.    ACKNOWLEDGEMENT

                        (8)   I, Dr. Gale, acknowledge that all schedules attached to or
            referred to in
                              this Undertaking form part of this Undertaking.

                        (9)   I, Dr. Gale, 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.

                        (10)  I, Dr. Gale, 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.

                        (11)  I, Dr. Gale, acknowledge that the College will 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").

                        (12)  I, Dr. Gale, 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.

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

                        (14)  Public Register

                              (a)   I, Dr. Gale, acknowledge that, during the time period
            that this
                                    Undertaking remains in effect, this Undertaking shall
            be posted on
                                    the Public Register.

                              (b)   I, Dr. Gale, acknowledge that, in addition to this
            Undertaking
                                    being posted in accordance with section (15)(a) above,
            the
                                    following summary shall be posted on the Public
            Register during the
                                    time period that this Undertaking remains in effect:

                                          A College investigation was conducted into
            whether Dr. Gale
                                          engaged in professional misconduct or is
            incompetent in his
                                          general medicine practice, including his
            delegation to
                                          non-members. As a result of the investigation,
            Dr. Gale has
                                          ceased all practice related to Cannabis. 

                                          Dr. Gale must post a clearly visible sign in the
            waiting
                                          rooms of all Practice Locations, which states as
            follows: 

                                    IMPORTANT NOTICE

                                    Dr. Gale is prohibited from practicing in relation to
            Cannabis,
                                    including: 

                                    (i)   The prescription, dispensing or administration of
            Cannabis;

                                    (ii)  Signing medical documents pursuant to the
            Cannabis
                                          Regulations, SOR/2018-144, or any equivalent
            documents, or
                                          participating in any way in the preparation,
            issuance or
                                          support of Cannabis documents, except for the
            sole and
                                          limited purpose of referring patients to other
            healthcare
                                          providers; 

                                    (iii) Any counselling, assessment or treatment of
            patients that in
                                          any way relates to Cannabis, except for the sole
            purposes of
                                          referring patients to other healthcare providers
            for such
                                          counselling, assessment or treatment.

                                    Further information may be found on the College of
            Physicians and
                                    Surgeons of Ontario website at www.cpso.on.ca

                        D.    CONSENT

                        (15)  I, Dr. Gale, undertake that I will submit to, and not
            interfere with,
                                 unannounced inspections of my Practice Locations and
            patient charts by
                                 the College and to any other activity the College deems
            necessary in
                                 order to monitor my compliance with the provisions of this
            Undertaking.

                        (16)  I, Dr. Gale, give my irrevocable consent to the College to
            make
                              appropriate enquiries of OHIP, NMS, and any person who or
            institution
                              that may have relevant information, in order for the College
            to monitor
                              my compliance with the provisions of this Undertaking.

                        (17)  I, Dr. Gale, acknowledge that I have executed the OHIP and
            NMS consent
                                 forms, attached hereto as Appendix "B" and Appendix "C",
            respectively.

                        (18)  I, Dr. Gale, 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 any
            information
                                arising from the monitoring of my compliance with this
            Undertaking.




Previous Hearings

Committee: Discipline
Decision Date: 10 Aug 2020
Summary:

On August 10, 2020, on the basis of an Statement of Uncontested Facts and Plea of No 
 Contest (Liability), the Discipline Committee found that Dr. George Douglas Gale (“Dr. 
 Gale”) committed an act of professional misconduct in that he has failed to maintain 
 the standard of practice of the profession, under paragraph 1(1)2 of Ontario Regulation 
856/93 made under the Medicine Act, 1991. 
 
FACTS 
 
Background  
 
Dr. Gale is an 85-year-old anesthesiologist. He graduated from the University of Durham 
in the United Kingdom in 1958 and received his certificate of registration authorizing 
independent practice from the College of Physicians and Surgeons of Ontario (the 
“College”) in 1971.    
    
In his annual renewals filed with the College between 2013 and 2018, Dr. Gale described 
that he spends 90% of his clinical practice in the area of chronic pain management 
without general/spinal anesthesia. At the relevant times, a large portion of Dr. Gale’s 
practice was devoted to injection therapies for chronic pain, including but not limited to 
nerve block and trigger point injections.   
 
Registrar’s Investigation  
 
In October 2014, the College received information from an Associate Medical Health 
 Officer with Toronto Public Health regarding an adverse event experienced by a 91-year-
old patient following a shoulder joint pain injection performed by Dr. Gale. In November 
2014, the Inquiries, Complaints and Reports Committee of the College (the “ICRC”) 
approved an appointment of investigators under section 75(1)(a) of the Health 
Professions Procedural Code (the “Code”) to investigate whether Dr. Gale engaged in 
professional misconduct or is incompetent in his pain management practice.   
 
As part of its investigation, the College retained a medical inspector to provide an 
opinion regarding Dr. Gale’s pain management practice. In a report dated August 5, 
2015, the medical inspector raised significant concerns regarding Dr. Gale’s standard of 
practice and opined that in 19 out of 25 charts that he reviewed, Dr. Gale’s care exposed 
his patients to harm or injury. 
 
Undertaking and Clinical Supervision 
 
As a result of the Registrar’s Investigation, on December 21, 2015, Dr. Gale signed an 
Undertaking with the College that required him to practice under the guidance of a 
clinical supervisor for nine months, engage in professional education, and submit to a 
reassessment of his practice approximately six months following his clinical 
 supervision. In January 2016, the ICRC accepted Dr. Gale’s December 21, 2015 
 Undertaking and also required Dr. Gale to attend before the ICRC to be cautioned in 
 person on the prevention, diagnosis and treatment of infection.   
     
 Pursuant to his December 21, 2015 Undertaking, Dr. Gale practiced under the guidance 
of a Clinical Supervisor from February 2016 to November 2016.   
 
Failure to Maintain the Standard of Practice  
  
 Following Dr. Gale’s clinical supervision, the College retained Dr. George Evans, MD, 
 FRCPC Anesthesiology and Chronic Pain, to conduct the reassessment of Dr. Gale’s 
 practice pursuant to Dr. Gale’s December 21, 2015 Undertaking with the College. Dr. 
 Evans is an Anesthesiologist and Chronic Pain Physician at the Ottawa Hospital and has 
 served as the Ottawa Hospital’s Pain Fellowship Director and Pain Residency Director.   
  
 Dr. Evans prepared a report dated April 19, 2018, based on a review of 15 medical 
 charts and an interview with Dr. Gale. Subsequently, Dr. Evans provided an addendum 
 report to respond to the questions of whether the care provided by Dr. Gale met the 
 standard of practice of the profession and whether a risk of harm or potential risk of 
 harm was identified. Dr. Evans’ initial report and his addendum report were provided in 
 one report, dated July 26, 2018. 
     
 Dr. Evans opined that in seven out of the 15 charts he reviewed, the care provided to the 
 patient by Dr. Gale did not meet the standard of practice. Dr. Evans further opined that 
 eight out of the 15 charts displayed a lack of knowledge; three out of the 15 charts 
 displayed a lack of judgment; three out of the 15 charts displayed a lack of skill; and 
 seven out of the 15 charts indicated clinical practice, behaviour or conduct which 
 exposes or is likely to expose Dr. Gale’s patients to harm.  In his report, Dr. Evans 
 expressed the following concerns, among others: 
  
    -  Dr. Gale’s knowledge and appropriate use of nerve blocks appeared to be 
       inadequate. 
          
   -  With respect to two patients, Dr. Gale provided an excessively vague diagnosis 
      and/or lack of appropriate diagnosis: 
  
    -  In Chart #4, Dr. Gale provided an excessively vague diagnosis of “biomechanical 
       disorder of the spine” with no reference to any level, i.e., cervical, thoracic, lumbar 
       or sacral.   
                    
    -  In Chart #10, Dr. Gale continued providing frequent nerve blocks despite minimal 
       effect and minimal changes in the patient’s function.  The patient was eventually 
       assessed by an orthopedic spine surgeon, who did not recommend injections 
      other than a possible trial of facet injections and who believed that the patient’s 
   leg pain may be vascular in nature and not radicular pain.  The patient eventually 
   underwent successful vascular surgery.   
              
-  With respect to Charts #6 and 10, Dr. Gale performed multiple sciatic nerve 
   blocks on the patient with no indication for the blocks. With respect to Chart #6, 
   there was no diagnosis to justify the blocks and Dr. Gale continued performing 
   the blocks with minimal relief and a lack of notes justifying the   practice.   
       
-  With respect to Charts #3, 8, 9, 10, 11 and 13, Dr. Gale performed sciatic nerve 
   blocks with low volume and no image guidance or nerve stimulation. Sciatic 
   nerve blocks performed with low volumes and no image guidance or stimulation 
   are unlikely to block the sciatic nerve and puts the patient at increased risk of 
   injection into other deep structures, vessels, and nerves, and other 
   complications.    
              
-  Dr. Gale appeared to have a lack of knowledge in that a small volume, i.e. 3 cc, 
   would be able to block the sciatic nerve or pudendal nerve without ultrasound 
   guidance, fluoroscopic guidance or with the use of a nerve stimulator. Normal 
   volume for this type of block even under image guidance or nerve stimulation is 
   15 - 20 cc for therapeutic procedures. Using a volume of less than 5 cc is not 
   likely to block the sciatic nerve without image guidance.   
              
-  In Charts #1, 3, 6, 8, 9, 10, 11 and 13, Dr. Gale’s chart notes were inadequate in 
   relation to the procedures provided, technique of blocks provided, which sterile 
   prep solution was used, needle(s) size and gauge, which nerve was injected or 
   how it was localized, and/or local anesthetic amounts used. Patient chart notes 
   should adequately describe the technique used and needle size and length, so 
   that if there are any complications, it would be easier for Dr. Gale or another 
   physician to differentiate and work up potential complications with greater 
   accuracy.   
              
-  With respect to multiple patients, Dr. Gale performed multiple weekly injections 
   on the patient with minimal relief and a lack of notes justifying the practice. For 
   example: 
              
         -With respect to Chart #6, the patient underwent multiple weekly injections 
         despite that various progress notes describe the patient’s pain relief from 
         the blocks at only 10% or 20% for hours. There is no note justifying the 
         continued use of frequent blocks with such a small amount of relief.   
                
         -With respect to Chart #8, Dr. Gale continued multiple level weekly nerve 
         blocks despite that the progress notes describe minimal to no pain relief 
         and, according to the patient, no effect on life. Dr. Gale’s notes describe 
         improvements in all functional areas of functional status, despite the 
             patient’s reports that the blocks only help minimally and for minimal 
             duration and did not make any significant life change.   
  
          -With respect to Chart #10, Dr. Gale continued weekly injections despite that 
          the patient was only getting 20% to 30% pain relief for 1-2 days or less. Dr. 
          Gale’s notes described improved areas of function but no actual description 
          of any improvements.   
  
          According to Dr. Evans, if a patient fails to have adequate relief after nerve 
          blocks on two occasions, no further blocks in the same area should be 
          offered. The physician caring for the patient should re-examine and re-assess 
          the diagnosis and re-evaluate if nerve blocks are indicated. Failing to stop 
          doing procedures when there is inadequate response puts patients at 
          unnecessary risks of complications and pain from the injections themselves.     
        
       -Dr. Gale failed to appropriately refer patients to other specialists. For example: 
       
            -With respect to Chart #1, Dr. Gale referred the patient for epidural 
            steroids, which was not appropriate or indicated. A referral for other 
            interventions such as SI joint injection/ablation, facet injection or ablation 
            would have been more appropriate. Dr. Gale did not appear to know that 
            axial pain or spondylosis is not a reason for referral to neurosurgery or for 
            epidural injections. In the referral, there is no noted radicular pain/disc 
            herniation, which would be a diagnosis where epidural steroids are 
            appropriate. Furthermore, the patient was referred to a 
            neurosurgery/surgical consultation service that does not do epidural 
            steroids.  
                   
            -With respect to Chart #6, Dr. Gale continued to perform multiple weekly 
            injections with minimal relief and no consideration or referral for a 
            possible more lasting treatment such as facets blocks or ablation, SI 
            injection with steroids under imaging guidance or possible ablation. 
 
      -Dr. Gale appeared to over rely on EMG testing to diagnose radicular pain or 
      radiculopathy that could benefit from epidural steroids or surgical evaluation.   
          
Dr. Gale’s Interim Undertaking Restricting his Practice 
 
On November 14, 2019, Dr. Gale entered into an Undertaking with the College in lieu of 
the ICRC making an interim order under section 25.4 of the Code. Dr. Gale’s November 
14, 2019 Undertaking restricts him from performing interventional pain procedures.  
  
  
 PENALTY 
  
 FACTS 
  
 The facts on penalty were as follows: 
  
 Dr. Gale’s History with the College 
  
 Discipline History with the College 
  
 On December 3, 2001, following a hearing, the Discipline Committee of the College 
 found that Dr. Gale failed to meet the standard of practice of the profession. Dr. Gale 
 appealed the findings and penalty to the Divisional Court. In a judgment dated October 
 10, 2003, the Divisional Court set aside a portion of the Discipline Committee’s findings. 
 The Divisional Court upheld the Discipline Committee’s finding that Dr. Gale failed to 
 maintain the standard of practice of the profession based on his care and treatment of 
 one patient and his use of heavy sedation/general anesthesia with nerve blocks. The 
 Divisional Court remitted the issues of liability it had set aside, as well as penalty, for 
 consideration before a differently constituted panel of the Discipline Committee. The 
 Discipline Committee reconsidered the matter on May 10, 2004. The College did not 
 conduct a new hearing into the liability issues set aside by the Divisional Court. Based 
 on a joint submissions to penalty, the Discipline Committee ordered that Dr. Gale 
 undertake an assessment of his competence through a Specialty Assessment Program 
 by the Quality Assurance Committee (“QAC”) of the College, that Dr. Gale comply with 
 the QAC’s recommendations, and that Dr. Gale comply with any terms, conditions and 
 limitations which the QAC may direct the Registrar to impose on his certificate of 
 Registration. 
  
 Past Inquiries, Complaints and Reports Committee and Complaints Committee 
Decisions 
 
In September 2001, the Complaints Committee of the College considered the 
investigation of a complaint made by another member of the College. That member 
complained about comments that Dr. Gale had made in a medical publication. The 
Complaints Committee cautioned Dr. Gale in writing to refrain from referring to his 
colleagues in an unprofessional manner.  
 
In June 2009, the Inquiries, Complaints and Reports Committee of the College (the 
“ICRC”) considered an investigation of Dr. Gale’s practice after information was received 
from the College’s Quality Assurance Committee that Dr. Gale may be incompetent 
regarding his chronic pain management practice. The ICRC determined that no action 
would be taken with respect to the matter.  
 
In September 2010, the ICRC considered the investigation of a complaint by one of Dr 
Gale’s patients. The patient complained, among other things, that Dr. Gale failed to 
provide adequate treatment in the management of her care in that he failed to wipe her 
arm with alcohol prior to administering nerve block injections and failed to take her 
blood pressure after the nerve block injections were given. The ICRC cautioned Dr. Gale 
in writing to ensure that he undertakes appropriate post-procedure monitoring of 
patients and that he documents same.  
 
On April 8, 2020, the ICRC considered the investigation of a complaint by a member of 
the public. The complainant was concerned about Dr. Gale’s role at a clinic at which an 
unlicensed individual was holding himself out to be a physician and prescribing medical 
marijuana. In response to the complaint, Dr. Gale signed an Undertaking with the 
College in which he agreed to restrict his practice by ceasing all practice relating to 
cannabis. A copy of the April 8, 2020 ICRC Decision and Reasons is attached at Tab 8 to 
the Agreed Statement of Facts (Penalty).  
 
Reports of Dr. Partridge and Dr. Evans 
 
Dr. Michael Partridge was asked for his opinion on Dr. Gale’s non-interventional pain 
practice. Dr. Partridge reviewed the 15 cases from Dr. Gale’s practice that were 
reviewed by Dr. George Evans as well as Dr. Evans’ expert opinion report dated July 26, 
2018. Based on Dr. Partridge’s review of the 15 cases reviewed by Dr. Evans, Dr. 
Partridge opined that Dr. Gale’s non-interventional pain practice is within the standard of 
care.  
 
Dr. Evans was provided with a copy of Dr. Partridge’s May 20, 2020 opinion report. In 
response to Dr. Partridge’s May 20, 2020 opinion report, Dr. Evans provided an 
Addendum Report dated June 9, 2020, that included the following comments: 
 
   -  In this report Dr. Micheal [sic] Partridge does not review any of the interventional pain 
      procedural care that was provided. This review of cases misses on significant amounts 
      of the practice and care provided by Dr Gale at that time. I don’t believe it is appropriate 
      to only asses a portion of the care provided at that time, in order to determine if Dr Gale’s 
      practice met the standard of care at that time. Therefor this review does not change my 
      opinion as previously stated (Reports dated July 26, 2018 and November 4, 2018). 
   -  … 
   -  In summary, the report by Dr. Micheal Partridge does not change my opinion in relation 
      to the care provided by Dr Gale at the time of the review. I would suggest after such a 
      significant change in his pain practice, that a new chart review would be needed in order 
      to determine if his current practice meets standard of care and does not expose patients 
      to undo [sic] risk. 
 
Dr. Gale’s Undertaking 
 
Dr. Gale has entered into an undertaking to the College, dated August 6, 2020. Dr. Gale 
has undertaken not to perform any interventional pain procedures as set out in 
Appendix “A” to the Undertaking, effective immediately. 
 
The Committee ordered: 
-Dr. Gale is to be reprimanded; 
-The Registrar is to impose terms and conditions and limitations on Dr. Gale’s certificate 
of registration, including Clinical Supervision to be followed by a reassessment 
 
Dr. Gale is pay costs to the College of $6,000.00 within 90 days of the date of the Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): August 10, 2020 at 9:00 a.m.

 

Committee: Discipline
Decision Date: 10 May 2004
Summary:

 On May 10, 2004, the Discipline Committee found that Dr. Gale had committed acts of professional 
 misconduct in that he failed to maintain the standard of practice of the profession.

The 
 Committee ordered the following penalty:

1.	That Dr. Gale undertake at his own expense no earlier 
 than 6 months and no later than 12 months after he resumes practice, an assessment of competence 
 through a Specialty Assessment Program (SAP) by the Quality Assurance Committee (QAC) of the 
 College.

2.	That the QAC will be provided with:

(a)	 the reasons of the Divisional Court in 
 their decision rendered October 10, 2003; and
(b)	all relevant clinical information and evidence 
 arising out of Dr. Gale(s disciplinary proceeding to assist the QAC in designing an appropriate 
 assessment methodology;
and the assessment should consider and address the concerns identified in 
 the Divisional Court decision and focus on Dr. Gale(s practice (including, but not limited to, 
 pain management).

3.	That Dr. Gale shall comply forthwith with the QAC(s 
 recommendations.

4.	That Dr. Gale shall comply with any terms, limitations and conditions which 
 the QAC may direct the Registrar to impose on his certificate of registration.

5.	That in the 
 event Dr. Gale does not comply with paragraphs 1, 3, or 4, the Registrar shall suspend Dr. Gale(s 
 certificate of registration until evidence of compliance has been provided to the satisfaction of 
 the Registrar.


Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): May 10, 2004

 

Committee: Discipline
Decision Date: 03 Dec 2001
Summary:

 On December 3, 2001, the Discipline Committee found Dr. Gale guilty of professional misconduct for 
 failing to maintain the standard of practice, prescribing drugs for an improper purpose and 
 engaging in conduct that would reasonably be regarded by members of the profession as disgraceful, 
 dishonourable or unprofessional.  In addition, Dr. Gale was found guilty of incompetence.

On 
 December 11, 2001, Dr. Gale appealed to the Divisional Court. 

On March 15, 2002, the Discipline 
 Committee ordered that Dr. Gale be reprimanded, the fact of the reprimand to be recorded on the 
 register and that his certificate of registration be revoked immediately.

The Divisional Court 
 heard the appeal on February 13 and 14, 2003 and released its reasons on October 10, 2003. On 
 October 10, 2003, the Divisional Court upheld findings on failing to maintain the standard 
 regarding Dr. Gale's participation in the resuscitation of a patient and use of heavy 
 sedation/general anesthesia with nerve blocks, set aside findings of failing to maintain the 
 standard regarding the prescribing of opioids and use of a local anesthetic (Marcaine), set aside 
 the finding of incompetence as it was based on the totality of the findings on the other issues 
 and set aside the penalty of revocation.

The Divisional Court remitted the case to the College 
 for consideration before a differently constituted panel.


Decision: Download Full Decision (PDF)
Appeal: Decision Overruled
Appeal Decision Date: 10 Oct 2003
Hearing Date(s): 20 Jun 2001

Concerns

Source: Member
Active Date: August 6, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. George Douglas Gale to the College of Physicians and Surgeons of Ontario, effective August 6, 2020:

Dr. Gale was referred to the Discipline Committee on allegations of professional misconduct and incompetence. In the face of these allegations, Dr. Gale agreed that he will not perform any interventional pain procedures as set out in Appendix “A” to his Undertaking.

 

Source: Member
Active Date: May 9, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. George Douglas Gale to the College of Physicians and Surgeons of Ontario, effective May 9, 2020:

A College investigation was conducted into whether Dr. Gale engaged in professional misconduct or is incompetent in his general medicine practice, including his delegation to non-members. As a result of the investigation, Dr. Gale has ceased all practice related to Cannabis.

Dr. Gale must post a clearly visible sign in the waiting rooms of all Practice Locations, which states as follows:

IMPORTANT NOTICE

Dr. Gale is prohibited from practicing in relation to Cannabis, including:

(i) The prescription, dispensing or administration of Cannabis;
(ii) Signing medical documents pursuant to the Cannabis Regulations, SOR/2018-144, or any equivalent documents, or participating in any way in the preparation, issuance or support of Cannabis documents, except for the sole and limited purpose of referring patients to other healthcare providers;
(iii) Any counselling, assessment or treatment of patients that in any way relates to Cannabis, except for the sole purposes of referring patients to other healthcare providers for such counselling, assessment or treatment.

Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca