Post-offence Misconduct can Impact Disciplinary College Penalty

The case of a Guelph psychiatrist who was stripped of his licence to practice after the College of Physicians and Surgeons of Ontario found that he had engaged in the sexual abuse of a patient, highlights how post-offence misconduct behaviour can influence how a regulatory body approaches a penalty for their actions, Lonny Rosen tells AdvocateDaily.com.

“The message to all health professionals here is if they have engaged in misconduct, they must avoid making the situation worse by making threats or offering rewards to avoid accountability for their misconduct,” he tells the online legal publication. Rosen, partner at Rosen Sunshine LLP, says by engaging in threatening behaviour or offering rewards "they will ensure that they receive a more severe penalty instead of having the chance to receive a more lenient penalty from the discipline committee of their regulatory body.”

On Mar. 21, the College’s discipline committee found that Dr. George Glumac “committed an act of professional misconduct in that he engaged in the sexual abuse of a patient; failed to maintain the standard of the profession; and 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.”

The committee also found the psychiatrist to be incompetent and to have failed to maintain the standard of practice. The committee, in its decision, noted that Glumac began in 2008 to treat Patient A, who has a history of chronic pain, limited mobility and a history of childhood sexual abuse. He also treated the woman’s husband, who has a developmental disorder, and one of the couple’s children, who has special needs.

In early 2009, the psychiatrist began seeing Patient A alone without her family. Glumac made personal disclosures to Patient A, including details about his wife, medical history and his childhood. He began these sessions by praying with Patient A, either by placing his hands on her shoulders and invoking a blessing or having her kneel on the floor at his feet with her body between his knees, placing his hand on her head, said the committee's decision.

During these sessions, he referred to Patient A as his “little buddy.”

The discipline committee said Glumac touched Patient A inappropriately several times, including when she was recovering at a respite facility from a mastectomy in December 2009.

He “embraced her, placing his arms around her waist and rear end, kissing her neck, her ears, her mouth, and her lips for about 15 minutes,” said the committee’s decision.

A few days later, Glumac returned to the respite centre and the two went into an empty bedroom and lay down on a bed together “in a spooning position.” When “she felt his erection pressing against her,” Patient A asked him to leave.

In addition, the committee said Glumac borrowed $20,000 from Patient A and her husband for a charitable organization, but Glumac later admitted to them that the funds were for his real estate management and investment company. When he didn’t repay the funds, the couple said they would report him to the College, said the committee's decision.

Glumac then threatened to stop providing medications to Patient A and offered to pay the couple an additional $20,000 if they didn’t report him to the College, the decision said.

They reported him in June 2012.

Glumac repaid the money he owed to Patient A by July 2012. An expert retained by the committee, identified as Dr. C. in the decision, concluded that Glumac “poses a risk to other patients” and “does not have requisite skills to manage opioids, and should not be doing so.” Rosen points to the Health Professions Procedural Code of the Regulated Health Professions Act, which generally describes the sexual abuse of a patient as:

(a) sexual intercourse or other forms of physical sexual relations between the member and the patient,

(b) touching, of a sexual nature, of the patient by the member, or

(c) behaviour or remarks of a sexual nature by the member towards the patient. The same legislation notes that a panel can revoke the member’s certificate of registration if the sexual abuse consisted of, or included, any of the following,

i. sexual intercourse,

ii. genital to genital, genital to anal, oral to genital, or oral to anal contact,

iii. masturbation of the member by, or in the presence of the patient,

iv. masturbation of the patient by the member,

v. encouragement of the patient by the member to masturbate in the presence of the member. 1993, c. 37, s. 14 (3).

Rosen says while the discipline committee found that Glumac did sexually abuse Patient A, the abuse was not of the “frank type of sexual abuse that carries with it the mandatory penalty of (licence) revocation. He could therefore have sought and potentially received a more lenient penalty for that conduct – revocation was the most severe penalty available but it wasn’t mandatory in this case.”

Rosen says it’s important to note that the doctor attempted to use both threats and promises of payment to avoid a report to the College.

“As a result, what could have been a lengthy suspension (for sexual abuse) ended up being revocation (for sexual abuse and other misconduct), which is the harshest penalty available to the College,” he says.

Rosen notes that in this case, the physician was also found to have been incompetent and to have engaged in billing improprieties, and this would also have impacted significantly on the penalty order.