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Shapiro, Solomon Marc

CPSO#: 58937

MEMBER STATUS
Active Member as of 07 Aug 1987
CPSO REGISTRATION CLASS
Restricted as of 20 Feb 2020

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, French

Education:University of Ottawa, 1983

Practice Information

Primary Location of Practice
Suite 1038
790 Bay Street
P.O. Box 51
Toronto ON  M5G 1N8
Phone: (416) 323-9849
Fax: (416) 924-8208 Electoral District: 10

Additional Practice Location(s)

SickKids Ctre for Com'y Mental Hlth
114 Maitland Street
Toronto ON  M4Y 1E1
Canada
Phone: (416) 924-1164 Ext. 3339
Fax: (416) 924-8208
County: City of Toronto
Electoral District: 10

Professional Corporation Information


Corporation Name: Solomon Shapiro Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Mar 20 2003

Shareholders:
Dr. S. Shapiro ( CPSO# 58937 )

Business Address:
Suite 1038
790 Bay Street
P.O. Box 51
Toronto ON  M5G 1N8
Phone Number: (416) 323-9849

Business Address:
508 - 114 Maitland Street
Toronto ON  M4Y 1E1
Phone Number: (416) 924-1164

Specialties

Specialty Issued On Type
Psychiatry Effective:08 Jun 1987 RCPSC Specialist
Child and Adolescent Psychiatry Effective:23 Sep 2014 RCPSC Specialist

Registration History

Action Issue Date
First certificate of registration issued: Independent Practice Certificate Effective: 07 Aug 1987
Transfer of class of certificate to: Restricted certificate Effective: 20 Feb 2020
Terms and conditions imposed on certificate by member Effective: 20 Feb 2020
Terms and conditions amended by Discipline Committee Effective: 08 Sep 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
Discipline Committee Effective: 08 Sep 2020 Active
             (1 of 2) As from September 8, 2020, by order of the Discipline Committee of the
            College of Physicians and Surgeons of Ontario, the following terms, conditions
            and limitations are imposed on the certificate of registration held by
            Dr.Solomon Marc Shapiro:

            Clinical Supervision

            a.    Prior to resuming practice following the suspension of his certificate of
                  registration described above in paragraph 3, Dr. Shapiro shall retain, at
                  his own expense, a College-approved clinical supervisor, who will sign an
                  undertaking in the form attached hereto as Schedule "A" (the "Clinical
                  Supervisor");  

            b.    For a period of three (3) months commencing within thirty (30) days from
                  the date Dr. Shapiro resumes practice following the suspension of his
                  certificate of registration described above in paragraph 3, Dr. Shapiro
                  may practice only on terms of the Clinical Supervision set out herein and
                  in Schedule A;

            c.    Clinical Supervision of Dr. Shapiro's practice shall contain the
                  following elements:

                  (i)   An initial meeting with Dr. Shapiro to discuss the objectives for
                        the Clinical Supervision;
                  
                  (ii)  The Clinical Supervision will be three (3) months in duration and
                        consist of monthly meetings. At each meeting, the Clinical
                        Supervisor will review a minimum of 15 patient charts, selected in
                        the sole discretion of the Clinical Supervisor, to assess quality
                        of documentation and care and observe either a group or an
                        individual therapy session;
                  
                  (iii) the Clinical Supervisor will keep a log of all patient charts
                        reviewed along with patient identifiers; and
                  
                  (iv)  the Clinical Supervisor will provide a report to the College at the
                        end of the three months of Clinical Supervision, or more frequently
                        if the Clinical Supervisor has concerns about Dr. Shapiro's
                        standard of practice or conduct.
                  
            d.    Dr. Shapiro shall abide by the recommendations of the Clinical
                  Supervisor;

            e.    If a clinical supervisor who has given an undertaking as set out in
                  Schedule "A" to this Order is unable or unwilling to continue to fulfill
                  its terms, Dr. Shapiro shall, within twenty (20) days of receiving notice
                  of same, obtain an executed undertaking in the same form from a person
                  who is acceptable to the College and ensure that it is delivered to the
                  College within that time;

            f.    If Dr. Shapiro is unable to obtain a clinical supervisor in accordance
                  with this Order, he shall cease to practice until such time as he has
                  done so;

            g.    Dr. Shapiro shall consent to the disclosure by his 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
                  Dr. Shapiro's compliance with this Order;

            h.    Dr. Shapiro shall inform the College of each and every location where he
                  practices including but not limited to hospitals, clinics and offices, in
                  any jurisdiction (collectively his "Practice Location(s)), within fifteen
                  (15) days of the date he resumes practice following the suspension of his
                  certificate of registration described above in paragraph 3 above, and
                  shall inform the College of any new Practice Locations within fifteen
                  (15) days of commencing practice at that location, for the purposes of
                  monitoring his compliance with this Order;

            Re-Assessment

            i.    Approximately three (3) months after the completion of the period of
                  supervision as set out above Dr. Shapiro shall, at his own expense,
                  undergo a re-assessment by a College-appointed assessor (the
                  "Assessor(s)"). The re-assessment may include chart reviews and direct
                  observation of individual and group therapy sessions, interviews with Dr.
                  Shapiro, his colleagues and co-workers, feedback from patients and any
                  other tools deemed necessary by the College. The Assessor(s) shall submit
                  a written report on the results of the re-assessment to the College;

            j.    Dr. Shapiro shall cooperate fully with the Reassessment and with the
                  Assessor(s). Dr. Shapiro shall consent to the disclosure to the
                  Assessor(s) of the reports of the Clinical Supervisor arising from the
                  supervision, and shall consent to the sharing of all information between
                  the Clinical Supervisor, the Assessor(s) and the College, as the College
                  deems necessary or desirable; and, 

            k.    Dr. Shapiro shall consent to the College 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. 


            (2 of 2) As from February 20, 2020, the following are imposed as terms,
            conditions and limitations on the certificate of registration held by Dr.
            Solomon Marc Shapiro in accordance with an undertaking and consent given by Dr.
            Shapiro to the College of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                                    DR. SOLOMON MARC SHAPIRO
                                          ("Dr. Shapiro")
                  
                                                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; 
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                   "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Shapiro, certificate of registration number 58937, am a member of
                  the College. 

            (3)   I, Dr. Shapiro, acknowledge that following a public complaint, the
                  College conducted an investigation bearing File Number 1105046 (the
                  "Investigation") into my care of a patient in my psychiatry practice.

            (4)   I, Dr. Shapiro, acknowledge that, in addition to accepting this
                  Undertaking, the College will also deliver a caution in person. 

            B.    UNDERTAKING

            (5)   I, Dr. Shapiro, undertake to abide by the provisions of this Undertaking,
                  effective immediately.

            (6)   Clinical Supervision 

                  (a)   I, Dr. Shapiro, 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 six (6) months ("Clinical Supervision"). 
                  
                  (b)   I, Dr. Shapiro, 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 have an
                              initial meeting to discuss the objectives for the Clinical
                              Supervision and practice improvement recommendations;
                  
                        (iii) Meet with me at my Practice Location, or another location
                              approved by the College, once every two (2) weeks for a
                              minimum of three (3) months;
                  
                        (iv)  After a minimum of three (3) months of Clinical Supervision,
                              if my Clinical Supervisor recommends and the College approves
                              a reduction in the level of supervision, my Clinical
                              Supervisor will meet with me at my Practice Location, or
                              another location approved by the College, once every month
                              for a further three (3) months;
                  
                        (v)   Review at least fifteen (15) of my patient charts at every
                              meeting;
                  
                        (vi)  Observe one (1) group or individual therapy session at every
                              meeting, ensuring that both group and individual therapy
                              sessions are observed over the course of the Clinical
                              Supervision;
                  
                        (vii) Discuss any concerns arising from the chart reviews or
                              observed sessions;
                  
                        (viii)Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; 
                  
                        (ix)  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
                  
                        (x)   Submit written reports to the College at least once every
                              month for three (3) months or until the College approves a
                              reduction in the level of supervision, and then once at the
                              end of supervision, or more frequently if the Clinical
                              Supervisor has concerns about my standard of practice.
                  
                  (c)   I, Dr. Shapiro, 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", as well as
                        the areas of concern identified in the reports of the assessor
                        dated August 30, 2019 and November 5, 2019, and concerns that may
                        arise during the period of Clinical Supervision.
                  
                  (d)   I, Dr. Shapiro, 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. Shapiro, 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. Shapiro, 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. Shapiro, undertake that if I am unable to obtain a Clinical
                        Supervisor on the provisions set out under sections (6)(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. Shapiro, acknowledge that if I am required to cease practise
                        as a result of section (6)(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.
                  
            (7)   Professional Education  

                  (a)   I, Dr. Shapiro, 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)   Review, reflect and discuss with my Clinical Supervisor: 
                  
                              1.    CPSO's Boundary Violations policy; and
                  
                              2.    CPSO's Confidentiality of Personal Health Information
                                    policy.
                  
                        (ii)  PROBE: Ethics and Boundaries Program - Canada, by receiving a
                              passing evaluation or grade, without any condition or
                              qualification. I, Dr. Shapiro, will agree to abide by any
                              recommendations of the PROBE program; and 
                  
                        (iii) any additional professional education recommended by my
                              Clinical Supervisor.
                  
                  (b)   I, Dr. Shapiro, 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. Shapiro, undertake to complete this requirement within six
                        (6) months or, if no satisfactory program is available by that
                        time, at the first possible opportunity thereafter.
                  
                  (d)   I, Dr. Shapiro, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the Professional Education.
                  
            (8)   Monitoring 

                  (a)   I, Dr. Shapiro, 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. Shapiro, 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. Shapiro, 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. Shapiro, acknowledge that I have executed the OHIP consent
                        form, attached hereto as Appendix "C". 
                  
            C.    ACKNOWLEDGEMENT

            (9)   I, Dr. Shapiro, acknowledge that all appendices attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (10)  I, Dr. Shapiro, 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. Shapiro, 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. Shapiro, 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. Shapiro, 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. Shapiro, 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. Shapiro, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Shapiro, 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:
                  
                              Following a public complaint, a College investigation was
                              conducted into Dr. Shapiro's care of a patient in his
                              psychiatry practice. As a result of the investigation:
                  
                              Dr. Shapiro will practise under the guidance of a Clinical
                              Supervisor acceptable to the College for six (6) months. 
                  
                              Dr. Shapiro will engage in professional education in
                              maintaining boundaries and confidentiality.
                  
                  (c)   I, Dr. Shapiro, acknowledge that this Undertaking remains in effect
                        until the College determines its terms are satisfied.
                  
            D.    CONSENT
            (16)  I, Dr. Shapiro, 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:

                  (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. Shapiro, 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. Shapiro, give my irrevocable consent to any persons who facilitate
                  my completion of the Professional Education, and to all Clinical
                  Supervisors, and Chiefs of Staff, 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 for the purposes of monitoring my
                        compliance with this Undertaking; and/or  
                  
                  (d)   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.

Previous Hearings

Committee: Discipline
Decision Date: 08 Sep 2020
Summary:

On September 8, 2020, on the basis of an Agreed Statement of Facts on Liability, the 
Discipline Committee found that Dr. Shapiro committed an act of professional 
misconduct in that: he committed an act of professional misconduct in that he 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; and, in that he failed to maintain the standard of the 
profession. 
 
FACTS 
 
BACKGROUND 
 
Dr. Shapiro is a 61-year-old psychiatrist with a sub-specialty in child and adolescent 
 psychiatry who received his certificate of registration from the College of Physicians 
 and Surgeons of Ontario (the "College") on August 7, 1987.  
  
 At the relevant time, Dr. Shapiro was in private practice at an office in Toronto, Ontario. 
  
 Between approximately May 26, 2014 and the end of June 2014, Dr. Shapiro provided 
 psychiatric treatment to Patient A. 
  
 FACTS  
  
 The College Received a Mandatory Report 
  
 On May 6, 2015, the College received a mandatory report from a Staff Psychiatrist at the 
 Centre for Addiction and Mental Health, ("CAMH"), who had assessed Patient A in the 
 CAMH Emergency Assessment Unit.  
  
 The College Subsequently Received a Public Complaint 
  
 On February 3, 2016, the College received a public complaint from Patient A, regarding 
 his former psychiatrist, Dr. Shapiro. At the time of the complaint, Patient A was 28 years 
 old. It was ultimately determined by the College that Patient A was the same patient 
 referred to in the May 6, 2015, mandatory report from a Staff Psychiatrist at CAMH.  
 DISGRACEFUL, DISHONOURABLE OR UNPROFESSIONAL CONDUCT 
 Patient A's Psychotherapy with Dr. Shapiro 
  
 Patient A contacted Dr. Shapiro in approximately April or May 2014 asking for an 
 appointment. Dr. Shapiro telephoned Patient A late on a Friday evening and an 
 appointment was made for an initial assessment. Following an initial assessment 
 conducted on May 26 and 28, 2014, Patient A began seeing Dr. Shapiro for sessions 
 several times a week. Patient A was 26 years old at the time. The treatment included a 
 few one-on-one appointments but mainly consisted of having Patient A participate in 
 group sessions involving other patients of Dr. Shapiro. The group sessions sometimes 
 included psychiatry residents. Dr. Shapiro invited Patient A to attend group sessions 
 after the completion of the initial assessment. 
 As set out below, Dr. Shapiro's overall behaviour and clinical approach made Patient A 
 feel uncomfortable, isolated and emotionally distraught. The CAMH psychiatrist who 
 made the May 2015 mandatory report to the College stated that this culminated in 
 Patient A's admission to the CAMH Emergency Department. 
  
 At the initial assessment conducted by Dr. Shapiro, Patient A started crying.  Dr. Shapiro 
 directed Patient A to look him in the eyes. Patient A found this interaction very 
 uncomfortable as it was difficult to look into Dr. Shapiro's eyes while crying. Patient A 
 was particularly vulnerable at this point in his life. He was experiencing anxiety. He 
 trusted that Dr. Shapiro would assist him with his difficulties and provide emotional 
 support. At the conclusion of the initial assessment, Dr. Shapiro diagnosed Patient A as 
 suffering from chronic post-traumatic stress disorder, and documented various 
 stressors, including anxiety and social isolation.  
  
 Patient A was disturbed by Dr. Shapiro's clinical approach during group sessions which 
 included the use of terms such as "begging" and "commanding". Patient A found this 
 confusing and unsettling. Patient A understood that he needed to "beg" or "command" 
 the attention of other group members or Dr Shapiro to Dr. Shapiro's satisfaction, and 
 that if he did, Dr. Shapiro would provide positive reinforcement. Dr. Shapiro failed to 
 explain the rationale for this technique to Patient A, who was confused and disturbed by 
 this practice. Patient A felt that he did not have the opportunity to simply discuss his 
 concerns with Dr. Shapiro given that most of his sessions were with a group. 
 
On one occasion, Patient A tried to get Dr. Shapiro's attention in a group session by 
calling out Dr. Shapiro's first name, "Solomon", twice in a loud manner. Dr. Shapiro 
appeared to become irritated and made Patient A feel as if he could not participate at 
that time. Patient A broke down in tears in front of the group. 
 
Another technique used by Dr. Shapiro was called "Words", a form of "mindful 
communication". In this technique, Patient A was told to use words to describe his 
feelings. On at least one occasion when Patient A tried to express his feelings, Dr. 
Shapiro disagreed with the words Patient A used and with Patient A's interpretation of 
his own feelings, leaving Patient A feeling unvalidated and embarrassed. 
 
Dr. Shapiro made some inappropriate comments to Patient A, that contributed to his 
confusion and distress. On one occasion,  Dr. Shapiro referred to "the spirit", which 
Patient A took as a religious reference that made him uncomfortable. 
 
Dr. Shapiro hugged Patient A in his office, a hug that was not welcomed by Patient A. 
 
Festival Trip 
 
In the summer of 2014, Dr. Shapiro informed Patient A that he would be taking a one-
week vacation and that Patient A should make a plan for what he would be doing that 
week. Patient A became anxious at the thought of Dr. Shapiro's absence as he had been 
attending sessions 4-5 days per week with Dr. Shapiro and felt very dependent.  
 
Towards the end of the week, Dr. Shapiro told Patient A that he was attending a festival 
north of Toronto, and suggested that it might be good for Patient A to attend. Dr. 
Shapiro told Patient A that, if he attended, they would not be spending time together at 
the festival and other attendees would not know that he was Dr. Shapiro's patient. Dr. 
Shapiro told Patient A that if anyone asked, Patient A could be vague and say he knew 
Dr. Shapiro from Toronto. 
 
Patient A travelled alone to the festival.  
 
Patient A approached and interacted with Dr. Shapiro on numerous occasions at the 
festival. On a couple of occasions, Patient A approached Dr. Shapiro for counselling and 
support. On both occasions, Dr. Shapiro responded in a frustrated and impatient 
manner, resulting in Patient A doubting himself and feeling unworthy of being supported 
or helped. At one point, Dr. Shapiro criticized Patient A for swearing, stating that he (Dr 
Shapiro) was being undermined in his own efforts to stop swearing by the fact that 
Patient A was swearing. 
 
During the festival, Dr. Shapiro saw Patient A dancing with and kissing a woman. Dr. 
Shapiro made a comment to Patient A about this interaction. Patient A recalls the 
comment as being along the lines of, "oh that must have been terrible." Dr. Shapiro 
recalls making a comment based on his concern about Patient A becoming involved 
with someone he had just met. Patient A was confused by Dr. Shapiro's comment as his 
sexuality had never been in issue and he became worried about Dr. Shapiro's 
boundaries and wondered if Dr. Shapiro was attracted to him.  
 
Patient A attended several workshops run by Dr. Shapiro at the festival. Patient A also 
attended a workshop on gender identity that Dr. Shapiro said might be good for him to 
attend. This again confused Patient A as his gender identity was not in issue. During the 
festival Patient A experienced a pattern of Dr. Shapiro withholding his attention from 
Patient A until Patient A behaved and communicated in a manner approved by Dr. 
Shapiro. Another workshop was devoted to hugging (i.e. how to navigate hugging, 
including when it is not wanted).  Dr. Shapiro hugged some participants in the 
workshop, but not Patient A, leaving Patient A feeling as if he had displeased Dr. 
Shapiro. 
 
After the gender identity workshop, Dr. Shapiro spoke with Patient A using inappropriate 
phrases along the lines of, "your sentences are not short enough", and, "I'm a servant of 
God, use me." The religious connotation disturbed Patient A, as did Dr. Shapiro's 
 frustration and impatient tone of voice. Patient A tried to use the "begging" form of 
 communication to ask for help, saying "please help me". Minutes later, Dr. Shapiro 
 walked away from Patient A. Patient A felt abandoned.  
  
 Patient A broke down crying uncontrollably. Patient A was given help by a member of 
 the festival's Health and Safety team. Another festival attendee also came to help.  Dr. 
 Shapiro soon attended in the area where Patient A was being helped. The member of 
 the festival Health and Safety team and the other attendee left when Patient A had 
 settled down.  
  
 Later that same day, Dr. Shapiro requested that Patient A discuss with him in his vehicle 
 what had occurred. Patient A accepted Dr Shapiro's invitation. Patient A told Dr. Shapiro 
 that he did not feel safe around him. Dr. Shapiro said, "We are climbing a mountain 
 together, and you're just going to give up now?" Patient A got out of the car and walked 
 away.   
  
 Relationship after the Festival 
  
 Dr. Shapiro called Patient A within two days after he left the festival and encouraged 
 Patient A to come in for another appointment. Patient A told Dr. Shapiro that he still did 
 not feel safe around him. He finally agreed to see Dr. Shapiro but later changed his 
 mind.  
  
 Patient A did not attend any further appointments with Dr. Shapiro. 
  
 Summary - Disgraceful, Dishonourable or Unprofessional Conduct 
 
Dr. Shapiro engaged in disgraceful, dishonourable or unprofessional conduct towards 
Patient A, including by: 
 
   -  hugging Patient A  
   -  suggesting to Patient A that he attend a festival where Dr. Shapiro would be in 
      attendance; 
   -  suggesting to Patient A that he conceal the nature of their doctor-patient 
       relationship at the festival; 
    -  being frustrated and impatient with Patient A on occasion at the festival when 
       Patient A sought his help; 
    -  not responding adequately to Patient A's distress at the festival; 
    -  criticizing Patient A for swearing based on Dr. Shapiro's own desire to stop 
       swearing; 
    -  using imagery with religious overtones, and; 
    -  making comments that were unprofessional and misplaced. 
  
 FAILURE TO MAINTAIN THE STANDARD OF PRACTICE OF THE PROFESSION 
  
 Report of Dr. Taras Babiak 
  
 The College retained a Neuropathologist and Psychiatrist, Dr Taras Babiak, to provide an 
 independent opinion. On February 25, 2019, Dr. Babiak provided his report to the 
 College. In his report, Dr. Babiak opined as follows: 
 
1. Did the care Dr. Shapiro provided to the patient meet the standard of practice? 
 
"The care that Dr. Shapiro provided to the patient did not meet the standard of practice of 
the profession.  
 
As the patient's Psychiatrist Dr. Shapiro failed to consider the patient's fragilities and 
vulnerabilities in deciding what sort of experiences to implement for the patient, for the 
purpose being therapeutic, namely exposure to individual and group therapy. When the 
patient reached out to Dr. Shapiro for help in dealing with his emotional turmoil at the 
[festival], Dr. Shapiro kept pushing him away, injuring the patient further emotionally, 
motivated out of concern by Dr. Shapiro for the patient's potential for "outing" the nature 
of the relationship to others. While Dr. Shapiro may have been concerned about 
confidentiality in this instance, I believe he was more concerned about his boundary 
crossing with the patient being revealed.  
 
With regard to boundary crossings, these occurred as well prior to the events of 
the.festival. There was his rather over-familiar and flippant response to the patient's 
expression of admiration and idealization for him. There was late Friday night call to 
initiate contact with the patient, his inclusion of the patient to "sit in" in group, individual 
and couple sessions, after only a handful of sessions with him following his assessment - 
another series of serious boundary crossings. Offering the patient the choice of attending 
a festival where Dr. Shapiro would be present, as well and leading events, and then 
instructing the patient that he needed to keep the nature of their relationship to himself, 
was a very serious boundary crossing. While not sexual in nature, it is a violation of 
boundaries. It is a violation, in my opinion, because the patient was engaged by him in 
colluding with his Psychiatrist with what should not have occurred according to the 
Profession's standards of conduct. While it is up to Physicians to maintain their 
professional obligations and conduct with respect to confidentiality, it is up to our 
patients to choose whether and whom they wish to reveal their relationship with a 
Physician to. It is not the Physician's place to insist that patients protect their crossings 
or violations a boundary." 
 
From the standpoint of documentation, however, his records lack documentation of the 
lion's share of what contacts his patient and he had, and what he exposed his patient to. 
This clearly falls below the Profession's standard with respect to clinical documentation." 
 
2. Did Dr. Shapiro's care display any or all of the following:  
 
            lack of skill? 
 
"Yes, Dr. Shapiro's care did displayed [sic] a lack of skill in that he displayed a lack of 
ability to: 
 
   (a) exercise patience and restraint in his expectations for progress and outcomes in 
      the treatment of patients with Post-Traumatic Stress Disorder. He addressed his 
      remedial efforts and intentions with regard to his therapeutic hubris in his letter of 
      response to the patient's complaint and the Appendix. 
 
   (b) in the application of skills regulating his countertransference in response to 
      Patient A's idealization of him and his reaching out to him for support in a context 
      that the patient was unfamiliar with. Dr. Shapiro had set this problem up by 
      offering the patient the choice of attending the festival, after having "sit in" in 
      sessions with other patients. He first made him feel included, special and chosen, 
      and then he betrayed his trust, abandoned and pushed him away, making him feel 
      diminished and discardable. Dr. Shapiro was reacting instead of responding in a 
      considered manner, with the patient's emotional well-being in mind." 
 
lack of judgment? 
 
"Yes. Dr. Shapiro displayed a serious lack of judgment in the commission of boundary 
crossings with the patient in other patients' sessions, in his boundary violation regarding 
his requiring the patient keep the nature of their relationship to himself at the festival to 
protect his Psychiatrist's duty of confidentiality. In so doing, he retraumatized and 
overburdened the patient. First, he retraumatized the him [sic] by effectively rejecting and 
abandoning the patient the way his father had. Second, he overburdened him the way his 
mother had by putting the obligation to look after his Psychiatrist's duty to confidentially 
after having been rather loose with these boundaries in the clinical context. The patient, 
feeling that he had "fallen from grace", fell into a turmoil with psychotic reaction, and 
ended up in hospital." 
 
3. Does Dr. Shapiro's clinical practice, behaviour or conduct expose or is likely to expose 
his patients to harm or injury? 
 
"No, I believe they no longer do at this point. Given the insight, admissions and 
acknowledgement of how he injured the patient and could pose risks to other vulnerable 
patients that Dr. Shapiro details in his response letter and the remediation efforts that he 
 lists.I cannot say he still poses a risk. He has done this in the identified areas of 
deficiency in his clinical work and documentation. This is encouraging, in particular with 
 regard to boundary issues, their importance and management, where Dr. Shapiro has 
 done course work and ongoing supervision. His continued work, consultation and 
 supervision which he described with regard to boundary issues are and will be crucial for 
 facilitating the transfer of knowledge and skills in considered clinical judgment and safe 
 clinical practice."  
  
 PENALTY 

 The Committee ordered and directed: 

- Dr. Shapiro is to be reprimanded 

- Dr. Shapiro's certificate of registration is to be suspended for a period of six (6) months, 
commencing from October 1, 2020 at 12:01 a.m. 

- The Registrar is to impose terms, conditions and limitations on Dr. Shapiro's Certificate of 
Registration related to related to practice supervision and re-assessment 

- Dr. Shapiro is to pay costs to the College in the amount of $6,000 within 30 days of the date of 
the Order.

Hearing Date(s): September 8, 2020 at 1:00 p.m.

Concerns

Source: Member
Active Date: February 20, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Solomon Marc Shapiro to the College of Physicians and Surgeons of Ontario, effective February 20, 2020:

Following a public complaint, a College investigation was conducted into Dr. Shapiro's care of a patient in his psychiatry practice. As a result of the investigation:

Dr. Shapiro will practise under the guidance of a Clinical Supervisor acceptable to the College for six (6) months.

Dr. Shapiro will engage in professional education in maintaining boundaries and confidentiality.

 

Source: ICR Committee
Active Date: January 14, 2020
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)

 

Source: ICR Committee
Active Date: January 14, 2020
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)