As from August 6, 2019, the following is imposed as terms, conditions and
limitations on the certificate of registration held by Dr. Josee Michaud in
accordance with an undertaking and consent given by Dr. Michaud to the College
of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. JOSEE MICHAUD
("Dr. Michaud")
to
COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
(the "College")
A. PREAMBLE
(1) In this Undertaking:
"Code" means the Health Professions Procedural Code, which is Schedule 2
to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as
amended;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the
public.
(2) I, Dr. Michaud, certificate of registration number 94660, am a member of
the College.
(3) I, Dr. Michaud, acknowledge that the College conducted an investigation
bearing File Number 7215865 (the "Investigation") into whether I engaged
in professional misconduct and/or am incompetent in my cardiology
practice.
B. UNDERTAKING
(4) I, Dr. Michaud, undertake to abide by the provisions of this Undertaking,
effective immediately.
(5) Clinical Supervision
(a) I, Dr. Michaud, undertake to practise under the guidance of a
clinical supervisor or clinical supervisors acceptable to the
College (the "Clinical Supervisor" or "Clinical Supervisors"), for
at least seven (7) months ("Clinical Supervision"). Clinical
Supervision shall cease only upon approval from the College.
During the period of high level supervision (as defined below), the
Clinical Supervisor must be an interventional cardiologist.
(b) I, Dr. Michaud, acknowledge that I have reviewed the Clinical
Supervisor's undertaking, attached hereto as Appendix "A", and
understand what is required of the Clinical Supervisor. The
Clinical Supervisor will, at minimum:
(i) Facilitate the education program set out in the
Individualized Education Plan ("IEP"), attached hereto as
Appendix "B";
(ii) Review the materials provided by the College and within
fourteen (14) days of signing his or her undertaking at
Appendix "A" conduct an initial visit to all of my office
Practice Locations to review and provide feedback on patient
management and systems issues, including but not limited to:
1. timely triage of referrals;
2. timely triage of information regarding patients,
including test results;
3. timely dictation of and reporting on procedures,
investigations, diagnostic testing, and
consultations to referring physicians;
4. confidential and effective patient record
management and storage; and
5. effective communication with staff.
(iii) Meet with me at my office Practice Location, or another
location approved by the College, once every week for the
first month of Clinical Supervision ("high level
supervision"). Following the month of high level
supervision, upon the recommendation of the Clinical
Supervisor and with the approval of the College, the
frequency of meetings may be reduced to once every two (2)
weeks for a period of three (3) months ("moderate level
supervision"). Following the three (3) months of moderate
level supervision, upon the recommendation of the Clinical
Supervisor and with the approval of the College, the
frequency of meetings may be reduced to once every month for
a period of three (3) months ("low level supervision");
(iv) Review at least fifteen (15) of my patient charts at every
meeting;
(v) Discuss any concerns arising from the chart reviews;
(vi) Make recommendations to me for practice improvements and
ongoing professional development and inquire into my
compliance with the recommendations;
(vii) Perform any other duties, such as reviewing other documents
or conducting interviews with staff or colleagues, that the
Clinical Supervisor deems necessary to my Clinical
Supervision; and
(viii)Submit written reports to the College after every meeting, or
more frequently if the Clinical Supervisor has concerns about
my standard of practice.
(c) I, Dr. Michaud, acknowledge that the charts reviewed shall be selected by
the Clinical Supervisor based on the educational needs identified in the
IEP, attached hereto as Appendix "B", and any concerns that may arise
during the period of Clinical Supervision.
(d) I, Dr. Michaud, undertake to cooperate fully with the Clinical
Supervision of my practice, conducted under the term of this Undertaking
and Appendix "A" to this Undertaking, and to abide by the recommendations
of my Clinical Supervisor, including but not limited to, any recommended
practice improvements and ongoing professional development.
(e) I, Dr. Michaud, undertake to ensure that Appendix "A" to this Undertaking
is signed and delivered to the College within thirty (30) days of the
date I execute this Undertaking.
(f) I, Dr. Michaud, undertake that if a person who has given an undertaking
in Appendix "A" to this Undertaking is unable or unwilling to continue to
fulfill its provisions, I 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.
(g) I, Dr. Michaud, undertake that if I am unable to obtain a Clinical
Supervisor on the provisions set out under sections (5)(e) and/or (f)
above, I will cease practising medicine until such time as I have
obtained a Clinical Supervisor acceptable to the College.
(h) I, Dr. Michaud, acknowledge that if I am required to cease practise as a
result of section (5)(g) above this will constitute a term, condition or
limitation on my certificate of registration and that term, condition or
limitation will be included on the public register.
(6) Professional Education
(a) I, Dr. Michaud, undertake to participate in and successfully complete all
aspects of the detailed IEP, attached hereto as Appendix "B", including
all of the following professional education (the "Professional
Education"):
(i) The following courses:
1. Medical Record-keeping Course, University of Toronto -
www.cpd.utoronto.ca/recordkeeping/; and
2. Documentation: Charting Medical Records eLearning Module,
CMPA -
http://www.cmpa-acpm.ca/websurvey/userprofile.html?profileType=ela&lang=en&elaRedirect=DocumentationCharting/documentation_charting-e.html
3. Documentation II: Principles of Medical Record Keeping
eLearning Module, CMPA -
http://www.cmpa-acpm.ca/websurvey/userprofile.html?profileType=ela&lang=en&elaRedirect=DocumentationPrinciples/documentation_principles-e.html
4. Effective Team Interactions, Saegis -
https://saegis.solutions/en/programs/details/01t41000003u3ouAAA
(ii) Review, provide a written summary of and discuss with my Clinical
Supervisor the following:
1. Medical Records -
www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Medical-Records
2. Test Results Management
www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Test-Results-Management
3. Confidentiality of Personal Health Information
www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Confidentiality-of-Personal-Health-Information
Other self-study
4. Steps to enhance practice efficiency: Part 1 -measuring
patient flow (OMA)
www.oma.org/wp-content/uploads/managingpatientworkflow_part1.pdf
5. Steps to enhance practice efficiency: Part 2 - from challenge
to solution (OMA)
www.oma.org/wp-content/uploads/managingpatientworkflow_part2.pdf
6. Guide to enhancing referrals and consultations between
physicians (CFPC, Royal College)
www.cfpc.ca/uploadedFiles/Resources/Resource_Items/Health_Professionals/Guide%20to%20enhancing%20referrals%20and%20consultations%20between%20physicians.pdf
7. Review, written summary and discussion with the Clinical
Supervisor of the CPSO Practice Guide -
www.cpso.on.ca/Physicians/Policies-Guidance/Practice-Guide
(iii) individualized instruction in Professionalism satisfactory to the
College, with an instructor selected by the College; and
(iv) any additional professional education recommended by my Clinical
Supervisor.
(b) I, Dr. Michaud, undertake to provide proof to the College of my
successful completion of the Professional Education, including proof of
registration and attendance and participant assessment reports, within
one (1) month of completing it. I acknowledge that the College will
determine, in its sole discretion, whether I have successfully completed
the Professional Education.
(c) I, Dr. Michaud, undertake to complete the Professional Education by three
(3) months from the date I sign this Undertaking, or, if no satisfactory
program is available by that time, by the first possible opportunity
thereafter.
(d) I, Dr. Michaud, acknowledge that a report or reports may be provided to
the College regarding my progress and compliance with the Professional
Education.
(7) Reassessment of Practice
(a) I, Dr. Michaud, undertake that, approximately six (6) months after
the completion of the Clinical Supervision set out in section (5)
above and Appendix "A" to this Undertaking, I will submit to a
reassessment of my practice ("the Reassessment") by an assessor or
assessors selected by the College (the "Assessor" or "Assessors").
I acknowledge that the Reassessment may include a chart review,
direct observation of my care, interviews with colleagues and
co-workers, feedback from patients and any other tools deemed
necessary by the College.
(b) I, Dr. Michaud, undertake to co-operate fully with the
Reassessment, conducted under the term of this Undertaking.
(c) I, Dr. Michaud, acknowledge that my Clinical Supervisor may receive
and review the findings of the Assessor, and may discuss with the
Assessor any issues or concerns arising from the Reassessment.
(d) I, Dr. Michaud, acknowledge that the results of the Reassessment
will be provided to me and reported to the College and the
Reassessment may form the basis of further action by the College.
(8) Monitoring
(a) I, Dr. Michaud, undertake to inform the College of each and every
location at which I practise or have privileges, including, but not
limited to, any hospitals, clinics, offices, and any Independent
Health Facilities with which I am affiliated, in any jurisdiction
(collectively my "Practice Location" or "Practice Locations"),
within five (5) days of executing this Undertaking. Going forward,
I further undertake to inform the College of any and all new
Practice Locations within five (5) days of commencing practice at
that location.
(b) I, Dr. Michaud, undertake that I will submit to, and not interfere
with, unannounced inspections of my Practice Locations and patient
records by a College representative for the purposes of monitoring
my compliance with the provisions of this Undertaking.
(c) I, Dr. Michaud, give my irrevocable consent to the College to make
appropriate enquiries of OHIP and/or any person who or institution
that may have relevant information, in order for the College to
monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. Michaud, acknowledge that I have executed the OHIP consent
form, attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(9) I, Dr. Michaud, acknowledge that all appendices attached to or referred
to in this Undertaking form part of this Undertaking.
(10) I, Dr. Michaud, acknowledge and undertake that I shall be solely
responsible for payment of all fees, costs, charges, expenses, etc.
arising from the implementation of any of the provisions of this
Undertaking.
(11) I, Dr. Michaud, acknowledge that I have read and understand the
provisions of this Undertaking and that I have obtained independent legal
counsel in reviewing and executing this Undertaking, or have waived my
right to do so.
(12) I, Dr. Michaud, acknowledge that the College will provide this
Undertaking to any Chief of Staff, or a colleague with similar
responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs
of Staff").
(13) I, Dr. Michaud, acknowledge that a breach by me of any provision of this
Undertaking may constitute an act of professional misconduct and/or
incompetence, and may result in a referral of specified allegations to
the Discipline Committee of the College.
(14) I, Dr. Michaud, acknowledge that this Undertaking constitutes terms,
conditions, and limitations on my certificate of registration for the
purposes of section 23 of the Code.
(15) Public Register
(a) I, Dr. Michaud, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Michaud, acknowledge that, in addition to this Undertaking
being posted in accordance with section (15)(a) above, the
following summary shall be posted on the Public Register during the
time period that this Undertaking remains in effect:
A College investigation was conducted into whether Dr.
Michaud engaged in professional misconduct and/or is
incompetent in her cardiology practice. As a result of the
investigation:
Dr. Michaud will practise under the guidance of a
Clinical Supervisor acceptable to the College for seven
(7) months.
Dr. Michaud will engage in professional education in
recordkeeping, practice management, and
professionalism.
Dr. Michaud's practice will be reassessed by an
assessor selected by the College approximately six (6)
months after the end of the period of Clinical
Supervision.
(c) I, Dr. Michaud, acknowledge that this Undertaking remains in effect until
the College determines its terms are satisfied.
D. CONSENT
(16) I, Dr. Michaud, give my irrevocable consent to the College to provide the
following information to any person who requires this information for the
purposes of facilitating my completion of the Professional Education and
to all Clinical Supervisors, and/or Assessors:
(a) any information the College has that led to the circumstances
of my entering into this Undertaking;
(b) any information arising from any investigation into, or
assessment of, my practice; and
(c) any information arising from the monitoring of my compliance
with this Undertaking.
(17) I, Dr. Michaud, give my irrevocable consent to the College to provide all
Chiefs of Staff with any information the College has that led to the
circumstances of my entering into this Undertaking and/or any information
arising from the monitoring of my compliance with this Undertaking.
(18) I, Dr. Michaud, give my irrevocable consent to any persons who facilitate
my completion of the Professional Education, and to all Clinical
Supervisors, Chiefs of Staff and Assessors, to disclose to the College,
and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant to the provisions of the Clinical
Supervisor's undertaking set out at Appendix "A" to this
Undertaking;
(c) any information relevant to the Reassessment;
(d) any information relevant for the purposes of monitoring my
compliance with this Undertaking; and/or
(e) any information which comes to their attention in the course of
providing the Professional Education and which they reasonably
believe indicates a potential risk of harm to my patients.