Previous Hearings
Committee: Discipline
Decision Date: 30 Jan 2019
Summary:
On January 30, 2019, on the basis of an Agreed Statement of Facts and Admission, the
Discipline Committee found that Dr. Baranick committed an act of professional misconduct, in
that he has engaged in conduct or 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.
AGREED STATEMENT OF FACTS AND ADMISSION
Dr. Peter Paul Baranick is a 73 year-old physician who received his certificate of registration
authorizing independent practice on August 3, 1979. At the relevant time, Dr. Baranick practised
in Ottawa, Ontario.
In May 2015, the Inquiries, Complaints and Reports Committee considered a report of a
Registrar’s Investigation into Dr. Baranick’s practice relating to his prescribing. In September
2015, Dr. Baranick signed an undertaking stating, among other things, that he:
- Will not issue new prescriptions or renew existing prescriptions for narcotic drugs,
narcotic preparations, controlled drugs, benzodiazepines and other targeted substances,
and all other monitored drugs; and
- Shall post a sign in the waiting rooms of all of his practice locations advising of his
prescribing restriction.
Dr. Baranick practises at various locations of the Appletree Medical Clinics in Ottawa. On
October 2017, College staff attended Appletree Clinic A and noted that the signs were not
posted. Clinic staff advised that Dr. Baranick was not working there currently and that the sign
was posted whenever Dr. Baranick was working there. College staff were advised that he was
currently working at Appletree Clinic B. College staff then proceeded to Appletree Clinic B and
noted that signs were posted. Dr. Baranick was working at this location and spoke with College
staff. He advised that signs were posted when he came into the office to work.
In December 2017, the College sent a letter to Dr. Baranick’s counsel requesting that Dr.
Baranick post his prescribing restriction signs in the waiting rooms of all practice locations. By
letter dated December 2017, Dr. Baranick’s counsel indicated that having the signs posted when
Dr. Baranick is not working at a particular location “falls outside the spirit and intent of his
undertaking” and that there is no value in posting the signs if he is not present as it would cause
confusion amongst patients.
In December 2017, the College sent a letter to Dr. Baranick’s counsel requesting that he comply
with his undertaking and post the required signage at all locations regardless of whether he is
working there that day or not.
In January 2018, Dr. Baranick’s counsel advised that Dr. Baranick had posted his prescribing
restrictions signs at all practice locations. In January 2018, Dr. Baranick’s counsel was advised
that no further action would be taken as the College was advised that the signs were posted at all
locations.
In February 2018, College staff attended Appletree Clinic C. Clinic staff advised that Dr.
Baranick did not work there and therefore the sign was not posted. College staff was told that Dr.
Baranick was working at Appletree Clinic A. College staff attended Appletree Clinic A and did
not see the required sign posted. Appletree Clinic A staff advised that Dr. Baranick would be
working later that day and that the sign would be posted when he starts to work. College staff
advised the clinic staff that the sign is required to be posted at all times and the clinic staff person
said she would post the sign.
In February 2018, College staff attended Appletree Clinic A and Appletree Clinic D. The
required signs were posted at both these locations. College staff also attended Appletree Clinic
B, where signs were not posted.
By letter dated March 2018, Dr. Baranick’s counsel requested a variance of section 5(a) of his
undertaking, stating that Dr. Baranick should only be required to post his sign where he is
physically present on any given day.
In April 2018, the College sent a letter to Dr. Baranick’s counsel advising that despite previous
reassurances, recent compliance visits in February showed inconsistent practices at the various
Appletree Clinics where the required signage was not posted. The College reiterated that the
signs are expected to be up at all of Dr. Baranick’s practice locations at all times. The College
also advised that if the ICRC accepted the proposed wording, an amended undertaking would be
provided for signature.
The variance to the undertaking requested by Dr. Baranick was not granted by the College.
In January 2018, the College received data from the Narcotics Monitoring System for the period
of June 2016 to December 2017 related to Dr. Baranick’s prescribing.
In January 2018, the College contacted the pharmacies identified in Dr. Baranick’s Narcotics
Monitoring System data. The College requested copies of four prescriptions from the pharmacies
where the pharmacist advised that Dr. Baranick wrote the prescription after he had signed his
undertaking.
The College received three prescriptions signed by Dr. Baranick and dated November 2015,
January 2017, and December 2017. Each of the prescriptions was for a testosterone medication
that Dr. Baranick was prohibited from prescribing pursuant to the September 2015 Undertaking.
In February 2018, Dr. Baranick’s counsel advised that Dr. Baranick did not initiate the
prescriptions, but did refill them. He wanted to reassure the College that this was an honest
mistake and that he never intended to breach his undertaking. To prevent this from occurring
again, he had reviewed his undertaking and the lists of drugs and substances he is restricted from
prescribing.
Dr. Baranick admits the facts specified above and admits that, based on these facts, he has
engaged in conduct or 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, contrary to paragraph 1(1)33 of O. Reg. 856/93.
AGREED STATEMENT OF FACTS RELEVANT TO PENALTY
Dr. Baranick entered into the September 2015 Undertaking as a result of a College investigation
into his prescribing practices.
As a result of the investigation, the Inquiries, Complaints and Reports Committee of the College
(“the ICRC”) accepted Dr. Baranick’s September 2015 Undertaking to give up his narcotics
prescribing privileges and required Dr. Baranick to attend at the College to be cautioned in
person.
Dr. Baranick’s Discipline History
On June 12, 2017, the Discipline Committee found that Dr. Baranick had failed to meet the
standard of practice of the profession. The discipline hearing arose out of a reassessment of Dr.
Baranick’s practice pursuant to an Undertaking with the College that Dr. Baranick signed on July
10, 2013 (the “July 2013 Undertaking”). The College’s assessor opined that Dr. Baranick failed
to meet the standard of practice of the profession with respect to his record-keeping, assessment
and management of community acquired infections, infant care, and chronic illness such as
arthritis, diabetes and hypercholesterolemia. Dr. Baranick admitted the allegations.
The Discipline Committee accepted a joint submission on penalty and ordered a reprimand, a 2-
month suspension of Dr. Baranick’s certificate of registration, and terms, conditions and
limitations on Dr. Baranick’s certificate of registration, including that he complete a
comprehensive Continuing Medical Education program focusing on the areas of concern raised
by the assessor, that he continue to limit his practice to no more than six patients per hour, and
that he undergo a six-month period of clinical supervision followed by a re-assessment of his
practice. The Discipline Committee also ordered that Dr. Baranick pay costs to the College at the
tariff rate.
The reassessment of Dr. Baranick’s practice took place in November and December 2018. The
College's assessor reviewed twenty patient charts and conducted a telephone interview with Dr.
Baranick. The College's assessor concluded that for all twenty patient charts reviewed, Dr.
Baranick had met the standard of care of the profession and had displayed appropriate
knowledge, skills and judgment.
DISPOSITION
The Discipline Committee ordered that:
- The Registrar suspend Dr. Baranick’s certificate of registration for a period of 1 month,
commencing immediately.
- Dr. Baranick appear before the panel to be reprimanded.
- Dr. Baranick to pay costs to the College in the amount of $6,000.00 within 30 days of the
date of this Order.
Decision: Download Full Decision (PDF)
Hearing Date(s): January 30, 2019 1:00 p.m . start
Committee: Discipline
Decision Date: 12 Jun 2017
Summary:
On June 12, 2017, the Discipline Committee found that Dr. Baranick committed an act of
professional misconduct in that he has failed to maintain the standard of practice of the
profession.
Dr. Baranick is a family physician practising at Appletree Medical walk-in Clinics in Ottawa. He
obtained his medical degree from the University of Ottawa in 1973 and has held an independent
practice certificate with this College from 1979 to 1982 and from 1989 to present.
2012 Practice Re-Assessment
On February 15, 2010, Dr. Baranick signed an Undertaking with the College to practice under
Clinical Supervision, to successfully complete Medical Record-Keeping and Ethics courses, and
to undergo a re-inspection of his practice.
The College retained an independent medical expert to conduct the re-assessment of Dr.
Baranick’s practice pursuant to the 2010 Undertaking. The medical expert indicated that
although Dr. Baranick is an experienced clinician who has worked in primary patient care for
most of his career, he has recently made the transition from working in the Emergency
Department of a hospital to seeing unscheduled patients in a number of ambulatory clinics.
The medical expert reported that Dr. Baranick admitted that he sees too many patients during his
shifts, and this may be one factor that has resulted in poor notations on the charts of his patients.
The medical expert noted that Dr. Baranick recently took one of the College’s courses on record-
keeping and should be familiar with the College’s guidelines. In addition, the medical expert was
surprised that Dr. Baranick did not seem familiar with “SOAP” format advocated by the College,
and that he rarely uses that format to help him structure his patient assessments.
The medical expert concluded that Dr. Baranick fails to meet the standard of practice of a
competent practitioner in his care of patients. Specifically, he found that beyond charting issues:
- Dr. Baranick's care displays a lack of medical knowledge of clinical conditions commonly
seen in the walk-in setting, including upper respiratory tract infections, eye and ear problems,
genito-urinary conditions and asthma. This hampers Dr. Baranick’s abilities to appropriately
assess patients and to effectively manage their problems.
- Dr.Baranick’s assessment of ocular problems exemplifies that in some instances Dr.
Baranick’s care displays a lack of skill.
- Dr. Baranick’s care displays a lack of judgment in management of patients requesting repeats
of prescription drugs, with the potential to expose such patients to harm.
The medical expert recommended that:
- Dr. Baranick make efforts to limit the number of patients seen during his shifts, that he make
efforts to identify areas of clinical weakness in addition to those identified during the medical
expert’s reassessment process, and that he take steps to increase his medical knowledge.
- Dr. Baranick’s practice be supervised by a clinician whose practice is more closely aligned
with that of Dr. Baranick and that his practice be subsequently reassessed.
2013 Practice Assessment
On April 17, 2013 the Inquiries, Complaints and Reports Committee considered the expert’s
report and directed another Undertaking for Dr. Baranick to restrict his practice to no more than
6 patients per hour, to complete the Comprehensive Family Practice Review (CFPR) course, to
practice under supervision of a Clinical Supervisor, and to undergo a comprehensive practice
reassessment.
An independent medical expert who conducted the comprehensive practice assessment opined
that although Dr. Baranick is an experienced physician who has undergone reassessment and
remediation of his practice in previous years, he still fails to meet the standard of practice of the
profession in his record keeping due to legibility concerns and in not providing enough detail
about some presenting complaints. Also, Dr. Baranick does not meet the standard of practice of
the profession in assessing and managing community acquired infections, infant care, and
chronic illness, such as arthritis, diabetes, and hypercholesterolemia. The medical expert
concluded that Dr. Baranick demonstrates a lack of knowledge, skill, and judgment in these areas
which have a potential to cause harm.
On June 12, 2017, the Committee ordered and directed that:
- The Registrar suspend Dr. Baranick’s certificate of registration for a period of two (2) months
effective immediately.
- The Registrar to impose the following terms, conditions and limitations on Dr. Baranick’s
certificate of registration:
(a) Dr. Baranick shall, within six (6) months of the end of the period of the suspension,
complete a comprehensive Continuing Medical Education (CME) program acceptable
to the College focusing on the areas of concern raised in the report of the College
assessor dated March 30, 2016;
(b) Dr. Baranick shall limit his practice to no more than six (6) patients per hour;
Clinical Supervision
(c) Within sixty (60) days of the date of this Order, Dr. Baranick shall obtain a clinical
supervisor acceptable to the College, who will supervise Dr. Baranick for a period of
six (6) months, and who will sign an undertaking in the form attached to this Order as
Appendix A (“Clinical Supervisor”);
(d) The Clinical Supervision shall be at a moderate level for six (6) months, commencing
on the date following the expiry of the suspension of Dr. Baranick’s certificate of
registration. The Clinical Supervisor will meet with Dr. Baranick bi-weekly and
review a minimum of ten (10) of Dr. Baranick’s patient charts, discuss Dr.
Baranick’s patient care, treatment plan and follow-up, identify any concerns
regarding the care, treatment plan and follow-up and make recommendations for
improvement;
(e) Within three (3) months after the completion of the Clinical Supervision, Dr.
Baranick will submit to a reassessment of his practice (the “Reassessment”) by an
assessor or assessors selected by the College (the “Assessor(s)”). The Reassessment
may include a chart review, direct observation of Dr. Baranick’s care, interviews with
colleagues and co-workers, feedback from patients and any other tools deemed
necessary by the College. Dr. Baranick shall abide by all recommendations made by
the Assessor(s), and the results of the Reassessment will be reported to the College
and may form the basis of further action by the College;
(f) Dr. Baranick shall cooperate fully with the Clinical Supervision and abide by all
recommendations of his Clinical Supervisor(s) with respect to practice improvements
and education;
(g) Dr. Baranick shall consent to the disclosure by the Clinical Supervisor to the College,
and by the College to his Clinical Supervisor, of all information the Clinical
Supervisor or the College deems necessary or desirable in order to fulfill the Clinical
Supervisor’s undertaking and to monitor Dr. Baranick’s compliance with this Order.
This shall include, without limitation, providing the Clinical Supervisor with any
reports of any assessments of Dr. Baranick’s practice in the College’s possession;
(h) If a Clinical Supervisor who has given an undertaking in Schedule “A” to this Order
is unable or unwilling to continue to fulfill its terms, Dr. Baranick 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;
(i) If Dr. Baranick is unable to obtain a Clinical Supervisor in accordance with
paragraphs 4(b) or 4(g) of this Order, he shall cease practising medicine until such
time as he has done so, and the fact that he has will constitute a term, condition or
limitation on his certificate of registration until that time;
(j) Dr. Baranick shall co-operate with unannounced inspections and shall consent to the
monitoring of his OHIP billings of his Practice by a College representative(s), for the
purpose of monitoring and enforcing his compliance with the terms of this Order;
(k) Dr. Baranick shall inform the College of each and every location that he practises or
has privileges, including, but not limited to, hospital(s), clinic(s) and office(s), in any
jurisdiction within fifteen (15) days of this Order, and shall inform the College of any
and all new Practice Locations within fifteen (15) days of commencing practice at
that location; and
(l) Dr. Baranick shall be responsible for any and all costs associated with implementing
the terms of this Order.
- Dr. Baranick attend before the panel to be reprimanded.
- Dr. Baranick pay to the College costs in the amount of $5,500.00, within thirty (30) days of the
date of this Order.
Decision: Download Full Decision (PDF)
Hearing Date(s): June 12, 2017