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Barnard, Thomas Joseph

CPSO#: 31831

MEMBER STATUS
Expired: Resigned from membership as of 30 Jun 2019
CPSO REGISTRATION CLASS
None as of 30 Jun 2019
Flag: Indicates a concern or additional information

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

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 Flag: indicates a concern or additional information

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 


                                      2 
 
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 
judgment 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. 
 


                                      3 
 
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.  
 


                                      5 
 
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.  


                                      6 
 
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 on 
          his 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 


                               8 
              
   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.  


                               9 
              
       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. 
 
 


                                      10


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 Flag: indicates a concern or additional information

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: Member
Active Date: March 27, 2018
Expiry Date:
Summary:
Criminal Finding(s)

If, on or after June 1, 2015, a member is found guilty under the Criminal Code of Canada or the Ontario Health Insurance Act, the College By-laws require certain information about the finding of guilt to be posted on the register if the information is known to the College.

The following are findings of guilt made against this member on or after June 1, 2015, as known to the College, together with the corresponding information:

On May 31, 2017, Thomas J. Barnard plead guilty 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. Dr. Barnard was ordered to pay a fine of $8,000, plus a victim surcharge of $2,000, and restitution to the Minister of Finance in the amount of $250,000.


Source: ICR Committee
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)