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Michael, Essam Samy Naguib

CPSO#: 65577

Active Member as of 15 Dec 2020
Restricted as of 08 Sep 2020


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Former Name: No Former Name

Gender: Male

Languages Spoken: Arabic, English

Education:University of Cairo, 1982

Practice Information

Primary Location of Practice
4303 Village Centre Court
Mississauga ON  L4Z 1S2
Phone: (905) 949 6999
Fax: (905)949 6908 Electoral District: 05

Professional Corporation Information

Corporation Name: Dr. Essam Michael Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Dec 11 2009

Dr. E. Michael ( CPSO# 65577 )

Business Address:
210 - 12295 Highway 50
Bolton ON  L7E 1M2
Phone Number: (905) 857-1988

Business Address:
4303 Village Court Centre
Mississauga ON  L4Z 1S2
Phone Number: (905) 949-6999

Business Address:
300 Main Street North
Brampton ON  L6V 1P6
Phone Number: (905) 451-4333

Business Address:
105 - 400 Bronte Street South
Milton ON  L9T 0H7
Phone Number: (905) 693-1193

Business Address:
220 Dundas Street East
Suite 210
Belleville ON  K8N 1E2
Phone Number: (613) 962-7999

Hospital Privileges

Hospital Location
William Osler Health Centre Etobicoke General Site Toronto


Specialty Issued On Type
Obstetrics and Gynecology Effective:30 Jun 1994 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Jul 1992
Expired: Terms and conditions of certificate of registration Expiry: 30 Jun 1994
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 01 Jul 1994
Transfer of class of certificate to: Restricted certificate Effective: 08 Sep 2020
Terms and conditions imposed on certificate by Discipline Committee Effective: 08 Sep 2020

Previous Hearings

Committee: Discipline
Decision Date: 08 Sep 2020

On September 8., 2020, on the basis of an Agreed Statement of Facts and Admission, 
the Discipline Committee found that Dr. Essam Samy Naguib Michael (“Dr. Michael”) 
committed an act of professional misconduct in that he has been found guilty of an 
offence that is relevant to his suitability to practise. 
Dr. Michael is a 61-year-old obstetrician and gynecologist practicing in the Greater 
Toronto Area. He received his certificate authorizing independent practice from the 
College of Physicians and Surgeons of Ontario (the “College”) in 1994. 

 At the relevant time, Dr. Michael operated 4 fertility clinics in the Greater Toronto Area. 
 His primary clinic was located in Mississauga, with other offices in Brampton, Bolton, 
 and Milton. 

Provincial Offence Proceeding and Conviction 

 On November 14, 2018, Dr. Michael pleaded guilty to contravening s. 15 of the Health 
 Insurance Act by submitting billings to the Ontario Health Insurance Plan (“OHIP”), in the 
amount of $545,000, which did not comply with the requirements of the Schedule of 
Benefits, thereby committing an offence under the Health Insurance Act. The overbilling 
occurred over the period between January 1, 2007 and May 21, 2013. 
The proceeding took place at the Superior Court of Justice before Justice Dawson. The 
parties presented an Agreed Statement of Fact, which was read into the record. The 
Agreed Statement of Fact can be summarized as follows: 

   -   Billing code A935 requires that the physician spend a minimum of 50 minutes in 
      direct contact with the patient; 

   -  Between January 1, 2007 and May 21, 2013, Dr. Michael improperly billed OHIP for 
      numerous units of code A935 as he did not spend the requisite 50 minutes in direct 
      contact with the patient; 

   -  There is no dispute that Dr. Michael saw the patients for whom A935 was billed. 
      Rather than billing A935, he ought to have billed A205.  

   -  The amount of the overpayment is the difference between the two codes, which is 
A205 is the code for an Obstetrics and Gynaecology Consultation. A205 does not have a 
time requirement. A935 is a Special Surgical Consultation code. It can be billed by a 
surgeon who provides all the appropriate elements of a regular consultation and 
devotes at least fifty minutes exclusively to the consultation with the patient. 
 Dr. Michael admitted that he had submitted billings to OHIP in the amount of $545,000 
 that did not comply with the requirements of the Schedule of Benefits and was therefore 
 guilty of committing an offence under the Health Insurance Act, contrary to section 

 At the proceeding on November 14, 2018, Dr. Michael undertook through counsel to 
 repay the $545,000 to the Minister of Finance. A cheque from Dr. Michael’s counsel to 
 the Minister of Finance, dated November 21, 2018 confirms restitution in the amount of 

 The Crown and defence presented a joint submission on sentence, asking that the 
 minimum fine of $5000 be imposed. Justice Dawson accepted the joint submission and 
 ordered a fine of $5,000. 
 Circumstances of Overbilling 

 Dr. Michael delegated the responsibility of his OHIP billings to his staff.  
 Dr. Michael had inherited a billing system that allowed staff to enter shortcut keys 
 related to the type of patient visit, rather than directly entering the OHIP code. The billing 
 system then automatically populated billing codes based on the shortcut keys. A 
 forensic examination of Dr. Michael’s billing software demonstrated that the billing 
 codes associated with the shortcut keys were not always appropriate to the type of 
 patient visit.  
 One of the shortcuts used by staff was for “new patient”. This shortcut was entered by 
 staff when the visit pertained to a new fertility patient. The billing software 
 automatically populated the A935 code when this shortcut was entered, whether or not 
 Dr. Michael had spent the requisite 50 minutes with the patient as required by the 
 Schedule of Benefits. 
 Dr. Michael was unaware of this issue and its effect on his OHIP billing. Dr. Michael 
 nonetheless accepts responsibility for the improper billings submitted to OHIP. 

 Facts on Penalty 

In March 2020, the William Osler Health System (“William Osler”) reduced the availability 
of operating rooms for elective surgeries as a result of the COVID-19 pandemic. 
 Following this reduction in capacity, only two days per month were available for 
 OB/GYN surgeries. It is anticipated that William Osler will increase its capacity for 
 OB/GYN surgeries to one day per week beginning in September 2020. 

As a result of the reduction in operating room capacity between March and September 
2020, Dr. Michael has a backlog of 88 hospital-based surgeries he is scheduled to 
perform. These include surgeries for patients with gynecological conditions including 
infertility; significant pelvic pain secondary to endometriosis or large fibroids; and 
irregular and heavy periods related to conditions such as adenomyosis and submucosal 




The Committee ordered: 

-Dr. Michael is to be reprimanded; 

- Dr. Michael’s certificate of registration is to be suspended for a period of one (1) 
month, commencing from November 15, 2020 at 12:01 a.m. 

- The Registrar is to impose terms and conditions and limitations on Dr. Michael’s 
certificate of registration as set out in detail in the Order, (re: monitoring Dr. Michael’s 
OHIP billings) 

- Dr. Michael is pay to the College costs in the amount of $6,000.00 within 30 days of 
the date of the Order.

Decision: Download Full Decision (PDF)
Hearing Date(s): September 8, 2020


Source: Other
Active Date: February 5, 2019
Expiry Date:
Essam Michael was found guilty of the following offence:

1. Submitting billings to the Ontario Health Insurance Plan that did not comply with the requirements of the Schedule of Benefits, contrary to Section15 of the Health Insurance Act (Ontario).

DATE: November 14, 2018
SENTENCE: Fine of $5,000
Dr. Michael repaid $545,000 to the Minister of Finance.