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Barnard, Thomas Joseph

CPSO#: 31831

MEMBER STATUS
Expired: Resigned from membership as of 30 Jun 2019
CURRENT OR PAST CPSO REGISTRATION CLASS
None as of 09 Nov 2014

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education: The University of Rochester, 1977

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Dr. Tom Barnard Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Feb 23 2018

Medical Records Location

Instructions: Patients looking to obtain a copy of their medical record may contact the Windsor Cardiac Centre at: 519-250-4449.
Date Received: 06 Nov 2019


Medical Licences in Other Jurisdictions

Effective September 1, 2015, the College by-laws require the College to indicate on the register if the member has a licence or is registered to practise medicine in a jurisdiction outside Ontario, if this is known to the College.



USA - Michigan

Specialties

Specialty Issued On Type
No Speciality Reported

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 17 Jul 1980
Suspension of registration imposed: Discipline Committee Effective: 01 Jan 2007
Suspension of registration removed Effective: 01 Feb 2007
Transfer of class of certificate to: Restricted certificate Effective: 09 Nov 2014
Terms and conditions imposed on certificate Effective: 09 Nov 2014
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 16 Feb 2016
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 03 May 2016
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 04 May 2016
Terms and conditions amended by Inquiries, Complaints and Repo Effective: 22 Jul 2016
Terms and conditions amended by Discipline Committee Effective: 13 Feb 2017
Suspension of registration imposed: Discipline Committee Effective: 17 Mar 2017
Suspension of registration removed Effective: 17 Jul 2017
Expired: Resigned from membership. Expiry: 30 Jun 2019

Previous Hearings

Committee: Discipline
Decision Date: 23 Jul 2019
Summary:

On July 23, 2019, on the basis of an Agreed Statement of Facts and Admission, the Discipline Committee found that Dr. Thomas Joseph Barnard committed an act of professional misconduct, in that he has been found guilty of an offence that is relevant to his suitability to practice and has engaged in an act or omission relevant to the practice of medicine that, having regard to all circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

AGREED STATEMENT OF FACTS AND ADMISSIONS

Dr. Thomas Joseph Barnard (“Dr. Barnard”) is a 70 year old family physician practising in Windsor.

Dr. Barnard received his certificate of registration authorizing independent practice from the College of Physicians and Surgeons of Ontario (“College’) in July 1980. He was certified by the College of Family Physicians of Canada as a specialist in Family Medicine in July 1982, and as a specialist in Family Medicine (Emergency Medicine) in November 1984.

On January 20, 2017, Dr. Barnard signed a voluntary Undertaking with the College. The Undertaking was part of the resolution of a discipline proceeding, which involved allegations regarding, among other things, Dr. Barnard’s clinical care and prescribing practices. Pursuant to this Undertaking, Dr. Barnard agreed to cease practising family medicine and to limit his practice to the provision of cosmetic, aesthetic, and nutritional and lifestyle services. Dr. Barnard provided these services at a medical spa that he owned, the Fresh Medical Spa, in Windsor, Ontario (“Fresh Medical Spa”).

Disgraceful, Dishonourable or Unprofessional Conduct Re: Breach of Discipline Committee Order

Pursuant to the Undertaking referenced above, as of March 17, 2017, Dr. Barnard’s practice was restricted to aesthetic and cosmetic services and nutritional counselling. The Undertaking specified eleven services that he was permitted to provide. These included “injections of Botox for the reduction of wrinkles and superficial deformities”; and “injection of dermal fillers to replace lost volume and to correct deformities and scarring”.

By Order of the Discipline Committee, dated February 13, 2017, Dr. Barnard was suspended from practising medicine for a period of four months, commencing on March 17, 2017. On account of his suspension, Dr. Barnard arranged for a nurse to attend Fresh Medical Spa to provide cosmetic injections during this period. He also contacted a physician colleague to act as a medical supervisor and oversee the nurse. The colleague agreed, in principle, to act as the medical supervisor to the nurse during Dr. Barnard’s suspension. Dr. Barnard’s initial telephone call was the only contact anyone at Fresh Medical Spa had with the proposed medical supervisor regarding supervision.

In late March 2017, the College learned that a nurse was scheduled to attend Fresh Medical Spa on April 5, 2017 for the purpose of performing cosmetic injections. On April 5, 2017, two Compliance Case Managers from the College attended Fresh Medical Spa unannounced. The nurse was present and had performed 10 injections over approximately two hours. Staff members of Fresh Medical Spa informed the Compliance Case Managers that the nurse was being overseen by the proposed medical supervisor, and that she was to contact him directly with any questions or concerns regarding the injections.

On the same day, the Compliance Case Managers interviewed the proposed medical supervisor. He confirmed that he had not been contacted to arrange for consultations with patients or to review the procedures recommended by the nurse before they were performed. He was entirely unaware that the nurse was attending Fresh Medical Spa and performing injections on that day. Consequently, the nurse performed injections without the oversight of a medical supervisor.

The College retained a cosmetic dermatologist, Dr. Nowell Solish, to review the issues around supervision and delegation during Dr. Barnard’s suspension. Dr. Solish reviewed eleven charts of patients who attended at Fresh Medical Spa, as well as transcripts of interviews with the nurse and the proposed medical supervisor. He found no evidence that any patients were seen or reviewed by any physician in charge, and no evidence that any treatments or doses had been properly delegated to the nurse.

In his report Dr. Solish opined that, due to his suspension, Dr. Barnard could not be the physician in charge to either perform or delegate the injections. As such, a new physician-patient relationship with a physician other than Dr. Barnard was required for the purpose of assessing and delegating the injections. He further opined that “although Dr. Barnard requested that [the proposed medical supervisor] cover him during his suspension that no proper plan was in place. It appears that [the proposed medical supervisor] was not aware patients were being treated under his care and what his responsibilities were. It also appears that [the nurse] was not aware of these circumstances.”

Along with his report, Dr. Solish provided an addendum, dated November 28, 2017. In the addendum, Dr. Solish describes concerning practices by Dr. Barnard that he noted during his chart review, namely, injecting Botox that was brought in by a patient from home, injecting Botox after its date of expiration, and storing partial filler for future use instead of using fully on a single patient or discarding.

Convicted of an Offense Relevant to his Suitability to Practise

In 2009, the Ministry of Health and Long-Term Care (“MOHLTC”) notified the Ontario Provincial Police (“OPP”) regarding Dr. Barnard’s billing practices. According to the MOHLTC, Dr. Barnard had been billing a very significant number of time-based services (i.e., psychotherapy and counselling), which require direct patient contact for a prescribed period of time, pursuant to the Ontario Health Insurance Plan’s (“OHIP”) Schedule of Benefits. As a result, the OPP monitored Dr. Barnard’s billing activity for a three-day period: November 17 – 19, 2009. That monitoring revealed that Dr. Barnard billed the following amounts:

i. November 17, 2009: Dr. Barnard billed for 42.7 hours of time-based services. He was paid $5,690.55 for that day;
ii. November 18, 2009: Dr. Barnard billed for 36.97 hours of time-based services. He was paid $4,974.90 for that day; and,
iii. November 19, 2009: Dr. Barnard billed for 32.23 hours of time-based services. He was paid $4,309.20 for that day.

Dr. Barnard also billed for other, non-time-based services on those days.

As a result of the above information, the OPP conducted an investigation of all Dr. Barnard’s billing for a period of 33 months. The OPP investigation determined that between April 1, 2007 and December 29, 2009, Dr. Barnard claimed 15 – 19 hours of time-based services per day on 57 days. He claimed more than 19 hours of time-based services per day on 323 days. His total billings for the 380 days where he billed in excess of 15 hours between April 1, 2007 and December 29, 2009 were approximately $1.3 million.

As a result of the investigation, on May 27, 2010, Dr. Barnard was arrested by the OPP and charged with two counts of fraud over $5,000 under section 380(1) of the Criminal Code of Canada. He was released on a Promise to Appear and an Undertaking.

The OPP investigation, however, continued and revealed that between December 31, 2009 and September 9, 2010, Dr. Barnard submitted the following claims for time-based billing services:

i. On 6 days during this period, Dr. Barnard billed between 15 – 19 hours of time-based services per day. He billed $13,360 for those 6 days.
ii. On 28 days during this period, Dr. Barnard billed between 19 – 24 hours of time-based services per day. He billed $80,156 for those 28 days.
iii. On 138 days during this period, Dr. Barnard billed more than 24 hours of time-based services per day. He billed $595,034 for those 138 days.

Even after being charged on May 27, 2010, Dr. Barnard continued his improper billing practices. He was subsequently charged with two additional counts of fraud over $5,000 on November 30, 2010.

The College learned of the criminal fraud charges through articles that appeared in the Windsor Star newspaper, and from the OPP. The MOHLTC also contacted the College to advise of their ongoing concerns regarding Dr. Barnard’s billing of time-based K-Prefix codes and assessment fee codes which occurred after the first set of charges were laid. Dr. Barnard did not notify the College of these criminal charges, as he was required to do.

On May 31, 2017, all criminal fraud charges were withdrawn and Dr. Barnard pleaded guilty to one count of knowingly obtaining or attempting to obtain payments for an insured service that he was not entitled to obtain contrary to section 43(1) of the Ontario Health Insurance Act.

Prior to the Ontario Court of Justice Proceedings on May 31, 2017, Dr. Barnard had signed an Undertaking with the College which prohibited him from billing OHIP and from providing any insured services to patients. Justice of the Peace A. Renaud was advised of this Undertaking during the joint submissions on sentencing. The Court imposed a global restitution fee of $600,000, of which Dr. Barnard had already paid $350,000, as well as a fine totalling $10,000.Dr. Barnard paid the remaining $250,000 of restitution and the fine by June 9, 2017.

Disgraceful, Dishonourable or Unprofessional Conduct Re: Medical Post Comment

On February 13, 2017, a hearing regarding Dr. Barnard was held before the Discipline Committee of the College. At the hearing, Dr. Barnard admitted that he failed to maintain the standard of practice of the profession in his care and treatment of 55 patients. He also pleaded no contest, and the Discipline Committee made the finding, that he engaged in disgraceful, dishonourable and unprofessional conduct with respect to two patients.

The following day, the Windsor Star published a news story regarding Dr. Barnard’s hearing at the College. The story referenced some of the evidence presented by the College at the hearing, including evidence related to a patient who had been prescribed narcotics by Dr. Barnard and who died of an overdose.

The Windsor Star article was circulated by the Medical Post via an e-newsletter on February 15, 2017. Shortly after it was circulated, a reader posted a comment on the news story that referenced Dr. Barnard’s “legacy of overprescribing”. Dr. Barnard posted a comment online in response to the reader’s comment. Dr. Barnard’s comment could be viewed by all healthcare providers across Canada who subscribed to the Medical Post at the time.

On February 16, 2017, the College learned of the comment posted by Dr. Barnard and immediately advised him that it viewed the post as containing highly confidential and personal information of a former patient and that this was a breach of patient privacy. Dr. Barnard was directed by the College to remove all references to confidential information that came to his attention in the course of providing care to patients, present or past.

On February 21, 2017, Dr. Barnard’s comment was edited to remove all information regarding the patient. The comment was nevertheless viewable in the original version for six days.

ADMISSIONS

Dr. Barnard admits the facts above, and admits that based on these facts:

i. he has committed an act of professional misconduct pursuant to clause 51(1)(a) of the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18 (the “Code”), as he has been found guilty of an offence that is relevant to his suitability to practice; and, ii. he has committed an act of professional misconduct pursuant to paragraph 1(1)33 of Ontario Regulation 856/93 made under the Medicine Act, 1991 (“O. Reg. 856/93”), in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

DISPOSITION

The Committee Ordered that:

- Dr. Barnard attend before the panel to be reprimanded.
- Dr. Barnard pay costs to the College in the amount of $6,000.00 within thirty (30) days of the date of this Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): July 23, 2019 1:00 p.m. start

 

Committee: Discipline
Decision Date: 13 Feb 2017
Summary:

On February 13, 2017, the Discipline Committee found that Dr. Thomas Joseph Barnard committed an act of professional misconduct in that he failed to maintain the standard of practice of the profession; and, he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

Dr. Barnard is a family physician practising in Windsor. He operates a family medicine practice called the Barnard Wellness Centre, at which he is the sole primary care physician, and also operates the Fresh Medical Spa, which is located at the same address as his family medicine practice.

Failed to Maintain the Standard of Practice Section 75(1)(a) Investigation into care of a single patient On October 18, 2012, the College received a letter from the Chief Coroner for Ontario, enclosing reports from a Coroner’s investigation of the death of a person who was a regular patient of Dr. Barnard’s between May 2000 and April 2012. The Coroner’s report indicated that the cause of death was a multi-drug toxicity, which included controlled substances that had been prescribed to the patient by Dr. Barnard.

Dr. Barnard failed to maintain the standard of practice of the profession in his care and treatment of the patient.

The College retained a family physician who found that Dr. Barnard demonstrated a lack of skill and did not meet the standard of practice for the following reasons:

- His information gathering was perfunctory;
- His histories were not sufficiently detailed;
- The physical examinations were cursory at best and appeared to be generated from a template. Often they were not relevant to the presenting complaint;
- There was no information about family history in his notes. It was gathered from the consultant reports;
- The patient's surgical history was not recorded except in the consultant's notes;
- He did not routinely ask about allergies;
- His assessments were not based on the history and physical findings; he often reiterated the patient's complaint rather than making a true diagnosis;
- The rationale for his treatment plans was difficult to understand;
- The Cumulative Patient Profile (“CPP”) at the front of the chart was difficult to read;
- The results of the patient's tests were not organized for easy retrieval; and
- He did not keep an up to date list of the medications that were prescribed and every consultant who looked after the patient had an incomplete or inaccurate list of her actual medications.

The family physician also opined that Dr. Barnard: lacked knowledge about the risks of polypharmacy and the risks of treating chronic pain with opioid analgesics; demonstrated a lack of judgment by continuing to prescribe drug combinations with known risks of harm, by continuing to prescribe narcotics when it was obvious that the patient was unable to control her use and the medication was doing more ‘to her’ than ‘for her’, and by continuing to provide the patient with large numbers of narcotics when he knew the patient was unable to prevent theft by her husband.

On November 9, 2014, Dr. Barnard signed an undertaking to the College restricting him from prescribing any Narcotics, Controlled Drugs, Benzodiazepines/Other Targeted Substances and all other Monitored Drugs and Narcotics Preparations, with the exception of Tylenol with codeine #3 in limited amounts.

Section 75(1)(a) Investigation into prescribing practices
 
The College conducted a broader investigation into Dr. Barnard’s prescribing practices with respect to 25 patients. A family physician retained by the College concluded that Dr. Barnard’s care of 11 patients did not meet the standard of practice and that he demonstrated various degrees of a lack of knowledge, skill or judgment. He opined that in 7 charts the care provided posed a potential risk of exposing patients to harm or injury and, of these 7, the risk of harm was particularly high with respect to 4 patients.

The four cases in which it was concluded that the risk of exposing the patient to harm or injury was particularly high were those in which:

- A patient was receiving frequent morphine injections as well as other narcotics while she was pregnant;
- A patient who had severe migraine headaches was receiving frequent morphine injections as well as nasal butorphanol, the amounts of which were well in excess of recommended guidelines for non-cancer pain;
- A patient was receiving very frequent morphine injections for chronic pelvic pain, much in excess of recommended guidelines; and
- A patient’s chart contained indications from anonymous phone calls that he was selling his medication and a letter from the Children’s Aid Society expressing concern of large amounts of narcotic medication in a household with small children.

Dr. Barnard failed to maintain the standard of practice of the profession in his care of 11 patients.

Section 75(1)(a) Investigation regarding broader patient care

On September 18, 2012, the College received information regarding Dr. Barnard from the Ministry of Health and Long-Term Care (MOHLTC) as a result of a review of his medical records for services completed in 2009. MOHLTC medical advisors identified clinical concerns with respect to Dr. Barnard’s patient care.

The College retained a family physician to provide an opinion regarding the standard of care provided by Dr. Barnard to 37 patients. The family physician concluded that the standard of care was not met in any of the cases reviewed and that Dr. Barnard displayed a lack of knowledge and judgement in each case. She also opined that Dr. Barnard’s clinical practice and conduct exposed all but one of the patients whose care was reviewed to a risk of harm. The conclusions were based, in part, on the following concerns:

- Dr. Barnard’s administration of human chorionic gonadotropin (“HCG,” known colloquially as “human growth hormone”) for weight loss in the management of obesity despite it being discredited and rejected by the medical community;
- Numerous, significant examples of disjointed and episodic care with poor recordkeeping and judgment that impairs the provision of an adequate diagnosis and case management;
- Certain use of “off label” prescribing and potentially harmful prescribing (including prescribing HCG as described above; potentially harmful prescribing of narcotics for non-cancer pain; prescribing benzodiazepines with narcotics; Methotrexate and Plaquenil without indication; prescribing hormone replacement therapy without appropriate documentation and assessment; prescribing high doses of vitamin D; prescribing iron and high doses of vitamin B without indication);
- Failure to meet the standard in his documentation of consent for “off label” or potentially harmful prescribing, and other failures of documentation;
- Lack of documentation of appropriate follow-up on test results;
- Failing to document history, physical examination, diagnosis, and informed consent when prescribing complementary and alternative medicines, and prescribing some such medicines which he knew had no medical evidence for use, such as HCG; and
- The use of excessive laboratory testing in the absence of clear documentation of medical need.

In December 2015, the College requested updated patient records from Dr. Barnard for 10 patients whose care had been reviewed. It was found that Dr. Barnard’s care did not meet the standard of practice in any of the charts reviewed and that his care continued to display a lack of knowledge, skill and judgment.

Dr. Barnard failed to maintain the standard of practice of the profession in his care of 37 patients as described above.

Investigation Regarding Patient A

Patient A became Dr. Barnard’s patient in the Barnard Wellness Centre in May 2012. Patient A had a history of testosterone levels having been documented as low by other physicians as recently as 2011, but it was very high based on the initial bloodwork ordered by Dr. Barnard in May 2012.

Dr. Barnard treated Patient A, including continually prescribing testosterone injections from July 2012 until April 2013, when Dr. Barnard severed the doctor-patient relationship.

The College retained a family physician with a focus in men’s health, including testosterone deficiency, to review Dr. Barnard’s care in regard to Patient A, who found that Dr. Barnard did not meet the standard of practice of the profession in that he:

- Displayed poor documentation and recordkeeping of his thought process and/or discussions with Patient A;
- Failed to adequately counsel Patient A in the hazards of continued steroid use;
- failed to try to have Patient A adhere to a more traditional protocol for testosterone replacement, with lower initial dosing and further titration based on serum testosterone levels and/or symptom management, and escalated the dosage of testosterone without monitoring hematocrit; and
- Demonstrated poor judgment in embarking on an unorthodox treatment plan of high dosing with little monitoring that, while for the most part it worked along with the desires and with the consent of the patient, was not in the best long term interests of the patient.

Dr. Barnard failed to maintain the standard of practice of the profession in his care of Patient A.

Investigation Regarding Patients B and C

Patient B became Dr. Barnard’s patient in March 2012 and Patient C became Dr. Barnard’s patient in February. Dr. Barnard terminated both patients from his practice.

Dr. Barnard treated Patient B for chronic pain. He prescribed Lyrica, Cymbalta, Botox injections, vitamin injections and testosterone injections beginning in May 2012. Dr. Barnard did not record Patient B’s serum testosterone levels before prescribing testosterone injections.

The College retained a family physician to review the care provided by Dr. Barnard to Patients B and C, who opined that the care provided to both patients fell below the standard of the 4 profession based on a lack of skill, knowledge and judgement and that Dr. Barnard’s care exposed them to harm. Specifically, Dr. Barnard:

- Demonstrated a lack of skill in the quality and quantity of his information gathering, in his record keeping and in his performance of proper physical assessments;
- Demonstrated a lack of knowledge when he increased Patient C’s dose of thyroxine and added Cytomel without evidence of thyroid deficiency;
- Demonstrated a lack of knowledge when he prescribed Flagyl to Patient C without indication;
-Demonstrated a lack of knowledge in failing to identify the significance of Patient C’s rising erythrocyte sedimentation rate (“ESR”) (which with other symptoms was suggestive of an autoimmune disorder); and
- Demonstrated poor judgment in failing to comply with College guidelines for record keeping, prescribing drugs and the use of alternative therapies.

The College retained a second family physician with some knowledge of and interest in complementary and alternative medicine, to provide an opinion regarding Dr. Barnard’s care of Patients B and C, having regard to the College’s Complementary/Alternative Medicine Policy. With regard to Patient B, the family physician opined that Dr. Barnard’s use of testosterone and vitamin injections was unconventional and not supported by any scientific evidence of which he was aware. Dr. Barnard had failed to clearly indicate the diagnosis although he treated chronic pain syndrome with an associated neuropathy. Dr. Barnard did not document valid informed consent for his unconventional therapeutic interventions.

With respect to Patient C:

- Dr. Barnard’s care of Patient C’s inflammatory disorders falls within the realm of complementary medicine;
- Dr. Barnard failed to provide an appropriate clinical assessment with regard to Patient C. He recorded no clear working diagnosis or treatment plan;
- Dr. Barnard failed to document a conventional diagnosis;
- He did not record any evidence of informed consent having been obtained for the unconventional therapeutic interventions;
- He failed to address the patient’s elevated ESR; and
- Despite the poor assessment and review of Patient C, his care did not demonstrate a lack of knowledge or skills. However, Dr. Barnard showed poor judgment by failing to document more appropriate patient counselling regarding the unconventional therapies being utilized.

Dr. Barnard failed to maintain the standard of practice of the profession in his care of Patients B and C.

Investigations Regarding Patients D, E and F

Patients D, E and F, who were a mother and her two children, became Dr. Barnard’s patients in the Fall/Winter of 2010/2011, and continued as his patients until November 2013.

The College retained a family physician to review the standard of care provided by Dr. Barnard to Patients D, E and F, who concluded that Dr. Barnard did not meet the standard of practice of the profession in relation to Patients D, E and F and that he demonstrated a lack of knowledge and skill. Examples of Dr. Barnard’s lack of knowledge and skill include:

- a lack of knowledge of appropriate testing and investigations for specific symptoms. Among other things, Dr. Barnard repeatedly ordered a broad spectrum of tests on Patients D, E and F without indication, including broad annual testing for Patient D, and ordered specific tests that were not inappropriate based on the patient’s age or lack of suitability as a screening tool;
- a lack of knowledge in treating asthma in children with respect to Patients E and F, where those patients received oral medications without any clear indication for their use and without corresponding use of inhaled medications;
- a lack of knowledge in the use of antibiotics, including prescribing incorrect doses and prescribing in cases where antibiotics are not indicated;
- a lack of knowledge in prescribing with respect to dosage of Topamax;
- a lack of knowledge of the treatment of anxiety for Patient D, and giving inappropriate treatment for the same; and
- a lack of skill in the documentation of visits, including incomplete or absent charting of history, physical examinations and assessments that seemed to be in an identical template for nearly every visit, missing vital signs, and a lack of any differential diagnosis and treatment plan in any of the entries.

Dr. Barnard failed to maintain the standard of practice of the profession in his care of Patients D, E. and F.

Disgraceful, Dishonourable and Unprofessional Conduct

Patient B became Dr. Barnard’s patient in 2012 and his wife, Patient C, became Dr. Barnard’s patient in 2013. During a double appointment in 2013, attended by both Patient B and C, Dr. Barnard became upset when asked to complete a Functional Abilities Form for Patient B. He told Patient B to “come back when you have your head screwed on right”. Patient B and C left the office. A few days later, they received a letter from Dr. Barnard sent by courier terminating both patients from his practice. The letter and termination were unexpected. Prior to the termination, Dr. Barnard had requested a consultation with a specialist for Patient C. Shortly after the last appointment, and before receiving the termination letter, Patient C received a call from Dr. Barnard’s office indicating the date and time for the specialist consultation. On the scheduled date in July, Patient B and Patient C attended at the specialist’s office for the consultation.

However, when they arrived they were told that although Patient C had been booked for an appointment, it had been cancelled. Dr. Barnard did not advise Patient C at any time that he had cancelled her consultation with the specialist.

Dr. Barnard engaged in disgraceful, dishonourable and unprofessional conduct in the manner in which he terminated Patients B and C from his practice, in cancelling Patient C’s specialist consultation and in failing to notify her of the cancellation.

Dr. Barnard entered into an undertaking to the College on January 20, 2017, by which he has agreed, among other things, that, effective March 17, 2017, he shall no longer practice family medicine and shall no longer bill the Ontario Health Insurance Plan. Dr. Barnard may only provide certain aesthetic and cosmetic services and may provide nutritional counselling. Dr. Barnard shall post a clearly visible sign in the waiting rooms of all his Practice Locations, which states as follows: "Dr. Barnard must not practise family medicine or provide any OHIP-insured service.”

Disposition

On February 13, 2017, the Discipline Committee ordered and directed that:

- The Registrar suspend Dr. Barnard’s certificate of registration for a period of four (4) months commencing on March 17, 2017 at 12:01 a.m.
- The Registrar impose the following terms, conditions and limitations on Dr. Barnard’s certificate of registration:

a. Dr. Barnard shall not prescribe or recommend human chorionic gonadotropin (“HCG”) for the purpose of weight loss to any individual;
b. Dr. Barnard shall have clinical interactions with no more than a total of forty-eight (48) patients per day, at a rate of no more than six (6) patients per hour within each hour;
c. Dr. Barnard shall execute the Prescribing Resignation Letter to Health Canada, which is attached hereto as Schedule “A” (the “Resignation Letter”) to the Order, and shall consent to the College sending the Resignation Letter to Health Canada onhis behalf;
d. Dr. Barnard shall not issue new prescriptions or renew existing prescriptions for any of the following substances:

i. Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
ii. Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
iii. Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
iv. Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(A summary of the above-named drugs [from Appendix I to the Compendium of 7 Pharmaceuticals and Specialties] is attached hereto as Schedule “B” to the Order; and the current regulatory lists are attached hereto as Schedule “C” to the Order)
v. All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22 as noted in Schedule “D” to the Order); and as amended from time to time.

e. Dr. Barnard shall, by July 17, 2017, retain a clinical supervisor or supervisors (the “Clinical Supervisor”) acceptable to the College, who will sign an undertaking in the form attached hereto as Schedule “E” to the Order. For a period of four (4) months thereafter, Dr. Barnard may practise only under the supervision of the Clinical Supervisor. Clinical supervision of Dr. Barnard’s practice shall contain the following elements:

i. Dr. Barnard shall facilitate review by the Clinical Supervisor of twenty (20) patient charts per month or, should Dr. Barnard treat fewer than twenty (20) patients in any month, the charts of all patients with whom he had clinical interactions in that month, and shall permit the Clinical Supervisor to directly observe him in practice for one half-day per month, with the Clinical Supervisor providing a report every two (2) months to the College.
ii. Dr. Barnard shall meet with the Clinical Supervisor at least once per month or more frequently if requested by the Clinical Supervisor, to: discuss the results of the Clinical Supervisor’s review of patient charts and direct observation of Dr. Barnard’s practice; discuss Dr. Barnard’s care, treatment plans, and follow-up; identify any issues or concerns regarding Dr. Barnard ’s care, treatment plans, or follow-up, discuss and receive recommendations for improvement and professional development.
iii. Dr. Barnard shall fully cooperate with, and shall abide by any recommendations of, his Clinical Supervisor, including but not limited to any recommended practice improvements and ongoing professional
development.
iv. If a Clinical Supervisor who has given an undertaking in the form attached at Schedule “E” to this Order is unwilling or unable to continue to fulfill its terms, Dr. Barnard shall, within twenty (20) days of receiving notice of same, obtain an executed undertaking in the same form from a similarly qualified person who is acceptable to the College and ensure that it is delivered to the College within that time.
v. If Dr. Barnard is unable to obtain a Clinical Supervisor in accordance with paragraph 5(v) or paragraph 5(v)(d) of this Order, he shall cease practising medicine immediately until such time as he has done so, and the fact that he has ceased practising medicine will constitute a term, condition or limitation on his certificate of registration until that time.

f. Approximately six (6) months after the completion of Clinical Supervision, Dr. Barnard shall undergo a reassessment of his practice by a College-appointed assessor (the “Assessor”). The assessment may include a review of Dr. Barnard’s patient charts, direct observation, interviews with staff and/or patients, one or more interviews with Dr. Barnard, and/or a formalized evaluation. The results of the assessment shall be reported to the College after which Dr. Barnard shall abide by any recommendations made by the Assessor by which the College has requested Dr. Barnard to abide.
g. Dr. Barnard shall consent to such sharing of information among the Assessor, the Clinical Supervisor, and the College as any of them deem necessary or desirable in order to fulfill their respective obligations and in order to monitor Dr. Barnard’s compliance with this Order and with any terms, conditions or limitations on his certificate of registration.
h. Dr. Barnard shall consent to the College providing any Chief(s) of Staff or a colleague with similar responsibilities, such as a medical director, at any location where he practises (“Chief(s) of Staff”) with any information the College has that led to this Order and/or any information arising from the monitoring of his compliance with this Order.
i. Dr. Barnard 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.
j. Dr. Barnard shall maintain an up-to-date daily log of every patient with whom he has a clinical interaction, which shall include the patient’s name, the date, and the hour within which the clinical interaction occurred (“Patient Log”). Dr. Barnard shall maintain the original Patient Log and shall send a copy to the College at the end of every calendar month.
k. Dr. Barnard shall cooperate with unannounced inspections of his Practice Location(s) and patient charts by a College representative(s) for the purpose of monitoring and enforcing his compliance with the terms of this Order.
l. Dr. Barnard shall post a sign in the waiting room(s) of all his Practice Locations, in a clearly visible and secure location, in the form set out at Schedule “F” to the Order, and a certified translation of the same in any language in which he provides services, with Dr. Barnard providing such certified translation to the College within thirty (30) days of this Order or, should he later begin providing services in another language, prior to doing so. For further clarity, this sign shall state as follows:

IMPORTANT NOTICE
Dr. Barnard must not prescribe:
- Narcotic Drugs
- Narcotic Preparations
- Controlled Drugs
- Benzodiazepines or Other Targeted Substances
- All Other Monitored Drugs.

Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca m. Dr. Barnard shall consent to the College making enquiries of the Ontario Health Insurance Plan (“OHIP”), 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 (“NMS”), and/or any person who or institution that may have relevant information, in order for the College to monitor and enforce his compliance with the terms of this Order and any terms, conditions or limitations on Dr. Barnard’s certificate of registration.

n. Dr. Barnard shall be responsible for any and all costs associated with implementing the terms of this Order.
- Dr. Barnard attend before the panel to be reprimanded.
- Dr. Barnard pay to the College costs in the amount of $5,000.00, within thirty (30) days of the date of this Order.


Decision: Download Full Decision (PDF)
Hearing Date(s): February 13, 2017

 

Committee: Discipline
Decision Date: 28 Nov 2006
Summary:

On November 28, 2006, the Discipline Committee found that Dr. Barnard had committed an act of professional misconduct in that he had engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional. In particular, the Discipline Committee found that from 2003 to September 2004, Dr. Barnard administered block fees for uninsured services in his office practice in a manner which would reasonably be regarded by members as unprofessional.

The Discipline Committee ordered and directed:

1. the Registrar to suspend Dr. Barnard's certificate of registration for two (2) months, commencing January 1st, 2007, one month of which will be suspended if Dr. Barnard complies with the following conditions:
(1) Dr. Barnard will administer block fees for uninsured services in a manner that is consistent with the College's policy on block fees and uninsured services. In particular, Dr. Barnard will;
(i) provide patients with the alternative of paying for each uninsured service individually at the time that the service is provided;
(ii) inform patients of his billing practices and obtain patients' agreement to any fee before providing an uninsured service;
(iii) offer the option of a block fee in writing, indicating the services that are covered by the block fee and providing examples of those (if any) that are not covered;
(iv) either provide patients with a copy of the College's policy on block fees and uninsured services, or inform them how they may obtain a copy;
(v) provide patients with a written statement indicating the fees that will be charged for each service, if patients choose to pay for each uninsured service at the time it is provided rather than pay a block fee;
(vi) obtain written consent from patients for the payment option chosen, and maintain the written consent as part of patients' records;
(vii) use the form set out in Schedule A attached to this Order to obtain consent for block fees;
(viii) charge any block fee for uninsured services to cover a period of not less than three (3) months and not more than twelve (12) months;
(ix) give patients the opportunity to rescind the decision to pay a block fee within a week of their original decision, in which case they will be required to pay for the services individually as provided;
(x) not discontinue seeing a patient or refuse to see a new patient because that person chooses not to pay a block fee; and
(xi) not offer to, or provide preferential services to patients who agree to pay a block fee.

(2) Dr. Barnard will cooperate with inspections of his practice by representatives of the College for a period of nine (9) months after completion of the suspension, solely for the purpose of ensuring compliance with this order. Such inspections shall be conducted with at least 24 hours notice being given to Dr. Barnard before each visit. If any problems with Dr. Barnard's block fee practices are discovered within the 9-month time period, the College is entitled to extend the monitoring inspections for a further six (6) months.

2. Dr. Barnard pay to the College costs in the amount of $2,500.00.

3. The results of this proceeding be included in the register.


Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): Nov 28, 2006

Concerns

Source: Member
Active Date: June 30, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Thomas Joseph Barnard to the College of Physicians and Surgeons of Ontario, effective June 30, 2019:

Dr. Barnard was referred to the Discipline Committee on allegations that he was found guilty of an offence relevant to his suitability to practise, and that he engaged in disgraceful, dishonourable or unprofessional conduct. College investigations were also conducted into whether Dr. Barnard engaged in professional misconduct and/or was incompetent in his cosmetic and family practice. After the allegations were referred to the Discipline Committee and prior to the hearing, and in the face of the allegations from the College investigations, Dr. Barnard resigned from the College and has agreed never to apply or re-apply for registration as a physician in Ontario.
Download Full Document (PDF)

 

Source: Other
Active Date: March 27, 2018
Expiry Date:
Summary:
FINDINGS OF GUILT
Thomas Barnard was found guilty of the following offence:

1. To knowingly obtaining or attempting to obtain payment for any insured service that he was not entitled to obtain, contrary to Section 43(1) of the Health Insurance Act, and thereby committed an offence pursuant to Section 44 of the said Act.

DATE: May 31, 2017
SENTENCE: Fine of $8,000, Victim surcharge of $2,000; restitution of $250,000 to the Minister of Finance

 

Source: FSMB (USA)
Notice Type Discipline Findings in Other Jurisdictions
Active Date: December 14, 2016
Summary: Where a disciplinary finding is made against a member on or after September 1, 2015 by a medical regulatory or licensing authority in a jurisdiction outside Ontario, the College By-laws require certain information about the finding to be posted on the register, if the finding is known to the College. The following are non-Ontario disciplinary findings made against this member, as known to the College, together with the corresponding information: On December 7, 2016, the Medical Board of California accepted Dr. Barnard’s surrender of his medical license in California effective December 14, 2016. The surrender was considered a disciplinary action against Dr. Barnard by the Board. Dr. Barnard was being reviewed by the Medical Board of California for violation of the California Business and Professions Code due to disciplinary action taken against him by the College of Physicians and Surgeons of Ontario. Dr. Barnard is not allowed to practice medicine in California. The College was notified of this finding by a report received on December 12, 2016.

 

Source: Compliance and Monitoring Department
Active Date: September 15, 2016
Expiry Date:
Summary:
Caution-in-Person:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a "caution-in-person" is required by the College by-laws to be posted on the register, along with a note if the decision has been appealed. A “caution-in-person” disposition requires the physician to attend at the College and be verbally cautioned by a panel of the Committee. The summary will be removed from the register if the decision is overturned on appeal or review. Note that this requirement only applies to decisions arising out of a complaint dated on or after January 1, 2015 or if there was no complaint, the first appointment of investigators dated on or after January 1, 2015.
Download Full Document (PDF)