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Goldstein, Sol Julian

CPSO#: 21457

MEMBER STATUS
Suspended as of 27 Jun 2019
CPSO REGISTRATION CLASS
Restricted as of 16 Apr 2019
Flag: Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English, Hebrew, Yiddish

Education:Dalhousie University, 1963

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Sol Goldstein Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Jan 05 2009

Shareholders:
Dr. S. Goldstein ( CPSO# 21457 )

Business Address:
254 Viewmount Avenue
Toronto ON  M6B 1V2
Phone Number: (416) 929-3287

Specialties

Specialty Issued On Type
Psychiatry Effective: 03 Dec 1968 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 03 Jul 1968
Transfer of class of certificate to: Restricted certificate Effective: 16 Apr 2019
Terms and conditions imposed on certificate by member Effective: 16 Apr 2019
Terms and conditions amended by Discipline Committee Effective: 19 Jun 2019
Suspension of registration imposed: Discipline Committee Effective: 27 Jun 2019

Practice Restrictions Flag: indicates a concern or additional information

Registration Status: Suspended     Effective From: 27 Jun 2019


Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 27 Jun 2019 Active

Previous Hearings Flag: indicates a concern or additional information

Committee: Discipline
Decision Date: 19 Jun 2019
Summary:

On June 19th, 2019, the Discipline Committee found that Dr. Goldstein committed an act of 
 professional misconduct 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, and that he failed to maintain the standard of 
 practice of the profession. 
  
 Background 
  
 Dr. Goldstein is an 80-year-old psychiatrist practicing in Toronto, Ontario, who received his 
 certificate of registration authorizing independent practice in 1968. 
  
 On the basis of information received from the Health Services Branch of the Ontario Ministry 
 of Health and Long-Term Care (the “Ministry”) identifying concerns with Dr.  Goldstein’s 
 recordkeeping and billing practices, as well as other information, the College commenced an 
 investigation under section 75(1)(a) of the Health Professions Procedural Code to obtain a 
 broader view of Dr. Goldstein’s psychiatry practice. 
 
Investigation of Dr. Goldstein’s Practice 
 
The College retained Dr. Ahmed Boachie (“Dr. Boachie”), a psychiatrist and Assistant 
Professor in the Department of Psychiatry at the University of Toronto, to opine on Dr. 
Goldstein’s psychiatry practice including his documentation and billing practices. Dr. Boachie 
reviewed 24 patient charts, the associated OHIP billing for 21 patients, and certain other 
information. 
 
Dr. Boachie opined that Dr. Goldstein’s documentation practices fell below the standard of 
practice of the profession in all 24 of the charts reviewed. In particular, he noted that: 
 
       There is a clear pattern for concern regarding Dr. Goldstein’s assessment, 
       documentation, and billing practices. It is practically ubiquitous that: 
        
       a)    Notes are handwritten and difficult to decipher...; 
       b)    Notes are very short, or sometimes there is no note at all, but only a date and 
             time period for the appointment; and 
       c)    Although Dr. Goldstein can clearly assess and formulate mental health 
             disorders, as is evident when he writes letters regarding patients for insurance 
             or legal purposes, there are no assessment notes or formulations written in the 
             chart notes. Nor are there treatment plans. 
        
       These practices would make it very difficult for another psychiatrist to take over care of 
       one of Dr.Goldstein’s patients, should he be unavailable to them. These documentation 
       practices do not meet minimum standards of care. 
  
 Dr. Boachie also opined that Dr. Goldstein’s billing practices failed to meet the standard of 
 practice of the profession. He noted: 
  
      With regard to billing practices, there were numerous cases in which dates of treatment 
      that were billed to OHIP did not have corresponding dates and/or chart notes in the 
      patients’ files. In some cases, billing dates were not in sequence, not even roughly in 
      sequence, but all over the place. These concerns require further investigation. 
 
Dr. Boachie interviewed Dr. Goldstein and submitted a further report following that interview. 
He noted that: 
 
      Dr. Goldstein appeared to have a very good memory of events when prompted, but 
      because of inadequate documentation there were still certain cases where we could not 
      get a clear idea why many decisions were made. He could also not give any appropriate 
      explanation for the discrepancies in OHIP billing described in my first report. 
 
Dr. Boachie, in his reports, raised certain issues with regard to Dr. Goldstein’s patient charts in 
assessments conducted for use in family court or in cases of family conflict. As Dr. Boachie did 
not practice in this area, the College retained Dr. Anthony Pignatiello, the Associate 
Psychiatrist-in-Chief at the Hospital for Sick Children, to review certain patient records 
previously reviewed by Dr. Boachie. Dr. Pignatiello reviewed five patient charts and 
interviewed Dr. Goldstein. 
 
As with Dr. Boachie, Dr. Pignatiello’s review identified issues related to Dr. Goldstein’s 
documentation and billing. In particular, in his report Dr. Pignatiello commented: 
 
      The patient files of Dr. Goldstein reviewed were consistently very disorganized, unclear, 
      vague, often times with scant information provided. In some sections dates of service 
      were identified; however, no content was written. Two of the files had beginning 
      elements of an assessment note whereas with others there was no evidence of any 
      assessment. There was no clear approach to an impression, formulation or clear 
      management plan, nor was there any periodic review of the service provided or further 
      plans of action… There was also unclear documentation required for billing purposes 
 
Dr. Goldstein’s inadequate documentation and billing as set out in the reports of Dr. Boachie 
and Dr. Pignatiello is unprofessional. 
 
Relevant History 
 
On August 27, 1999, the General Manager of the Ontario Health Insurance Plan (“OHIP”), 
based on the recommendation of the Medical Review Committee of the College (the “MRC”), 
directed Dr. Goldstein to reimburse OHIP for billing in the amount of $54,705.49.  
 
Plea of No Contest 
 
Dr. Goldstein does not contest the above facts. Dr. Goldstein does not contest that these facts 
constitute professional misconduct, in that: 
 
      a)    he 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, under paragraph 1(1)33 of O. Reg. 
       856/93; and  
  
       b)    he failed to maintain the standard of practice of the profession in his care of  
       patients, under paragraph 1(1)2 of Ontario Regulation 856/93 made under the 
       Medicine  Act, 1991. 
  
 Agreed Statement of Facts Relevant to Penalty 

 In 2013, the Health Services Branch of the Ontario Ministry of Health and Long-Term Care (the 
 “Ministry”) requested repayment by Dr. Goldstein of certain OHIP claims in the amount of 
 $10,740, comprising those claims without any corresponding patient record for the encounter 
 billed, and those claims where the records were created months after the patient encounter.  
 Dr. Goldstein repaid approximately $7,500, comprising only those claims without any 
 corresponding patient record for the encounter billed. 
 
Disposition 
 
The Discipline Committee ordered that: 
  
    -  Dr. Goldstein attend before the panel to be reprimanded. 

    -  The Registrar suspend Dr. Goldstein’s certificate of registration for a period of three (3) 
       months, commencing from June 27, 2019 at 12:01am. 

    -  The Registrar place the following terms, conditions and limitations on Dr. Goldstein’s 
       certificate of registration: 

        a.   Dr. Goldstein shall comply with the College Policy #2-07 “Practice Management 
             Considerations for Physicians Who Cease to Practise, Take an Extended Leave of 
             Absence or Close Their Practice Due to Relocation”, a copy of which is attached 
             at Schedule “A” to this Order; 

       PROBE Program 

        b.   Dr. Goldstein shall participate in and unconditionally pass the PROBE Ethics & 
             Boundaries Program offered by the Centre for Personalized Education for 
             Professionals, with a report or reports to be provided by the provider to the 
             College regarding Dr. Goldstein’s progress and compliance. Dr. Goldstein shall 
             complete this requirement within six (6 months) of the date of this Order. 

       Clinical Supervision  

        c.   Within twenty (20) days of this Order, Dr. Goldstein shall retain a College-
             approved clinical supervisor or supervisors (the “Clinical Supervisor”) with 
     respect to his psychiatry practice, who has signed an undertaking in the form 
     attached hereto as Schedule “B”. 

d.   For a period of twelve (12) months commencing on the date that Dr. Goldstein 
     resumes practice following the suspension of his certificate of registration, Dr. 
     Goldstein may practise psychiatry only under the supervision of the Clinical 
     Supervisor (“Clinical Supervision”), who shall facilitate the education program 
     set out in the Individualized Education Plan (“IEP”), attached hereto as Schedule 
     “C”; as follows:   

e.   For an initial period of two (2) months, Dr. Goldstein will meet with the Clinical 
     Supervisor every week, at which meetings the Clinical Supervisor will:  

         i.    review a minimum fifteen (15) of Dr. Goldstein’s patient records, to 
               be selected at the sole discretion of the Clinical Supervisor, and the 
               associated OHIP claims submissions or planned OHIP claims 
               submissions, and discuss any issues or concerns arising from this 
               review with Dr. Goldstein; 

         ii.   make recommendations to Dr. Goldstein for practice improvements 
               and ongoing professional development, and inquire into Dr. 
               Goldstein’s compliance with the recommendations; and 

        iii.   keep a log of all patient charts reviewed along with patient 
               identifiers.   

f.   After the initial period of two (2) months, if the Clinical Supervisor is satisfied 
     that Dr. Goldstein’s patient records and associated OHIP billings reflect the 
     knowledge, skills and judgment necessary for Dr. Goldstein to practise in a less 
     highly supervised environment, the Clinical Supervisor may recommend to the 
     College that supervision be reduced for the balance of the Clinical Supervision 
     period of twelve (12) months. 

g.   Upon the recommendation of the Clinical Supervisor and approval of the College 
     of a reduction in supervision, Dr. Goldstein will meet with the Clinical Supervisor 
     every month, at which meetings the Clinical Supervisor will:  

           i.  review a minimum fifteen (15) of Dr. Goldstein’s patient records, to 
               be selected at the sole discretion of the Clinical Supervisor, and the 
               associated OHIP claims submissions or planned OHIP claims 
               submissions, and discuss any issues or concerns arising from this 
               review with Dr. Goldstein; 

          ii.  make recommendations to Dr. Goldstein for practice improvements 
               and ongoing professional development, and inquire into Dr. 
               Goldstein’s compliance with the recommendations; and 
            iii. keep a log of all patient charts reviewed along with patient 
                 identifiers.   

 Other Elements of Clinical Supervision   

  h.   Throughout the period of Clinical Supervision, Dr. Goldstein shall abide by all 
       recommendations of his Clinical Supervisor regarding his recordkeeping and 
       OHIP billing, practice improvements, and ongoing professional development. 

  i.   The Clinical Supervisor shall submit written reports to the College at least once 
       every month, or more frequently if the Clinical Supervisor has concerns about Dr. 
       Goldstein’s standard of practice. 

  j.   If a person who has given an undertaking in Schedule “A” to this Order is unable 
       or unwilling to continue to fulfill its provisions, Dr. Goldstein shall, within twenty 
       (20) days of receiving notice of the same, ensure that an executed undertaking is 
       delivered to the College in the same form from a similarly qualified person who is 
       acceptable to the College. 

  k.   If Dr. Goldstein is unable to obtain a Clinical Supervisor as set out in this Order, 
       he shall cease practising medicine until he has obtained a Clinical Supervisor 
       acceptable to the College. 

  l.   If Dr. Goldstein is required to cease to practise medicine as a result of section 
       (5)(k) above, this will constitute a term, condition or limitation on his certificate 
       of registration and that term, condition or limitation will be included on the public 
       register. 

Reassessment of Practice  

  m.   Approximately six (6) months after the completion of Clinical Supervision, Dr. 
       Goldstein shall undergo a reassessment of practice by a College-appointed 
       assessor (the “Assessor”). The re-assessment shall include a review of Dr. 
       Goldstein’s patient charts and associated OHIP claims submissions or planned 
       OHIP claims submissions. The results of the re-assessment shall be reported to 
       the College. 

  n.   Dr. Goldstein 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. 

Monitoring  

  o.   Dr. Goldstein shall inform the College of each and every location where he 
       practises, in any jurisdiction (his “Practice Location(s)”) 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. 
     p.   Dr. Goldstein shall cooperate with unannounced inspections of his practice, 
          patient charts and OHIP claims submissions by a College representative(s) for the 
          purpose of monitoring and enforcing his compliance with the terms of this Order. 

     q.   Dr. Goldstein shall consent to the College’s making appropriate enquiries of the 
          Ontario Health Insurance Plan and/or any person or institution that may have 
          relevant information, in order for the College to monitor and enforce his 
          compliance with the terms of this Order. 

     r.   Dr. Goldstein shall be responsible for any and all costs associated with 
          implementing the terms of this Order. 

-  Dr. Goldstein 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): June 19, 2019 at 9:00 a.m.

Concerns Flag: indicates a concern or additional information

Source: Member
Active Date: April 16, 2019
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Sol Julian Goldstein to the College of Physicians and Surgeons of Ontario, effective April 16, 2019:

College investigations were conducted into whether Dr. Goldstein engaged in professional misconduct and/or is incompetent in his psychiatry practice. As a result of the investigations:

Dr. Goldstein will engage in professional education in medical record-keeping and child custody and access assessments.

Dr. Goldstein will not conduct any new assessments of, nor provide treatment to, individuals who have been subject to or have engaged in parental alienation.

Dr. Goldstein will not provide opinion evidence about parental alienation to any third party, whether orally or in writing, in regards to individuals he has assessed or treated, except as required by law, in which case Dr. Goldstein will advise the relevant parties, in advance of providing such opinion evidence, to consult the College’s Public Register.

Dr. Goldstein will terminate his professional relationship with any individuals who he is currently assessing and/or treating who have been subject to or have engaged in parental alienation.

Dr. Goldstein will have in place a process to screen incoming assessments and patients for elements of parental alienation and to terminate assessments and/or patients where elements of parental alienation become apparent after the professional relationship has commenced.


Source: ICR Committee
Active Date: April 16, 2018
Expiry Date:
Summary:
Specified Continuing Education and Remediation Program:

A summary of a decision of the Inquiries, Complaints and Reports Committee in which the disposition includes a Specified Continuing Education and Remediation Program (“SCERP”) is required by the College By-laws to be posted on the register, along with a note if the decision has been appealed. A SCERP is one of the dispositions that the College’s Inquiries, Complaints and Reports Committee may make in connection with a matter before it, and this disposition requires the member to complete an education and remediation program specified for the member. A note will also be posted when all the elements of the SCERP have been completed. 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.

See PDF for the summary of a decision made against this member in which the disposition includes a SCERP:
Download Full Document (PDF)