The College of Physicians and Surgeons will review its policies on sexual abuse following a Star investigation into doctors who continue to practise after being found guilty of misconduct for sexually abusing patients.

Since September, the Star has reported on five physicians practising with gender restrictions. Each is facing a disciplinary hearing or has been found guilty of sexual abuse related to his practice.

“We’ve seen a lot of news in the media, and society being very concerned about sexual abuse, and we really felt it was time to look at our processes,” said incoming college president Dr. Carol Leet.

The college review will look into:

Whether there should be harsher penalties for sexual abuse findings that do not trigger a mandatory licence revocation.

Whether gender-based restrictions, such as being able to treat only male patients or see female patients with a chaperone, are appropriate.

Whether the college should automatically report sexual abuse complaints to the police.

Related:

Tougher action urged to probe doctors guilty of sex abuse

College won’t explain restrictions put on pediatrician convicted of sex assault

Next spring the college will also begin posting criminal convictions, any offences under the Health Insurance Act, and bail conditions put on doctors that affect their practice.

And it has launched consultations on whether to publicly post criminal charges, oral cautions to doctors and disciplinary findings in other jurisdictions.

Ontario Health Minister Eric Hoskins said in an email statement he was “encouraged” by the college’s decision to post criminal convictions.

The college, however, won’t make public any findings of guilt made before June 1, 2015, meaning doctors currently practising with criminal convictions won’t be affected.

Critics question why doctors found guilty of criminal offences should be able to practise at all.

Marilou McPhedran, a lawyer who chaired two provincial task forces on sexual abuse of patients, characterized the decision to inform the public about criminal convictions as “limited progress.”

“It is my considered opinion that physicians should not be able to continue to practise when convicted of assault of patients,” said McPhedran.

A Star investigation revealed Sarnia pediatrician, Dr. Kunwar Singh, continues to treat patients despite being convicted of 16 counts of sexual assault and indecent assault of patient’s mothers and nurses in 1991.

The Star has also learned that a Toronto family doctor who pleaded guilty to simple assault against two patients last year is practising until his disciplinary hearing in January.

Dr. Javad Peirovy, 44, was charged with six counts of sexual assault of female patients in 2010 and given a conditional discharge after pleading guilty to simple assault in two of those cases.

He pleaded not guilty to sexual assault in those cases and the other four charges were withdrawn.

Peirovy was “reckless” in not getting specific consent to placing his stethoscope on or around two patients’ nipple area, and in one case “incidental touching” of a patient’s nipples with his fingertips, according to a joint statement of facts read at his trial. He was given 18 months probation and ordered to attend counselling, complete 100 hours of community service and make a $600 charitable donation.

Peirovy did not respond to requests for comment.

Health minister Hoskins told the Star that sexual assault and abuse is “unequivocally unacceptable.”

“I have zero tolerance for any criminal sexual behaviour and will — after a thorough review by experts and victims’ advocates — make any and all necessary changes to ensure Ontarians are protected,” he said.

This will be examined as part of a review Hoskins ordered this fall of the Regulated Health Professions Act (RHPA), following the Star’s investigation of sexual abuse by doctors. The decades-old legislation covers all 23 provincial health regulatory bodies.

Currently there is no automatic licence revocation for criminal offences by doctors, only for certain sexual acts with patients. Those acts include sexual intercourse, oral-to-genital contact, genital-to-genital contact, genital-to-anal contact and masturbation.

When it comes to sexual abuse outside those defined acts, such as inappropriately touching a patient’s breasts, the college has discretion to revoke a licence but is not required to do so.

“We certainly don’t hesitate to go for revocation if it’s warranted,” said Leet, adding that college counsel can ask for this but ultimately it’s the disciplinary panel’s decision.

McPhedran questions how the college uses its powers, noting it requires physicians applying for membership to undergo a criminal record check.

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“Why would there be a higher standard for entering practice compared to the standard when somebody is already practising?” she asks.

Before the college can determine a penalty for Peirovy, it must go forward with a disciplinary hearing in January to prove the actions constitute professional misconduct.

The disciplinary panel will hear allegations of sexual abuse against Peirovy from the same six patients who brought sexual assault charges against him. The allegations include inappropriately touching the breasts and/or nipples of all six patients and placing a stethoscope on or around the nipples of three patients, according to the college’s notice of hearing document. In one case, he is also alleged to have asked the patient out on a date.

In 2011, the college put a gender-based restriction on his licence: Peirovy must have a nurse with him at all times while treating female patients.

Peirovy is one of 20 doctors in Ontario with a gender-based restriction on his licence. Regardless of his criminal conviction, college spokesperson Kathryn Clarke said this restriction was put on Peirovy as the college tries to impose the “least restrictive” conditions that still “provide public protection” until the disciplinary panel hears the allegations.

McPhedran says the college has the power to take stronger action immediately, especially since a decision has been made in court that suggests public safety may be at risk.

“The college clearly has the discretion to suspend his practice,” said McPhedran.

She noted the college took more than a year to conduct its own hearing, falling “short of the legislative standard for timely procedures in such cases per the RHPA and its Procedural Code.”

McPhedran said responsibility to keep the public safe also lies with the government. The RHPA delegates responsibility to govern doctors to the college, but a clause in the legislation says the minister may make regulations “governing the issue, renewal, suspension, revocation and expiration of certificates of authorization.”

McPhedran said this discretion can be used in cases where the college’s actions seem “too lax” to protect the public.

“This ministerial discretion may also need to be exercised to address when CPSO decision-makers opt to let doctors … continue to practise after admitting guilt for assaulting female patients.”

McPhedran was on the provincial task force that recommended the college include findings of guilt related to disciplinary decisions and court decisions in 1991 and again 10 years later.

Medical secrecy has been investigated by the Star since 1997. The province pushed for more transparency after a 2007 Star series revealed how little information is available to the public, including negligence by doctors and infection rates at hospitals. In 2009, health professionals were required to report findings of guilt to their respective colleges by the Health Systems Improvement Act. But the law did not require this information to be provided to the public, said Clarke.

“The decision to add information to the college’s public register about criminal findings against doctors and bail conditions that affect their practice is the completion of another step in our plan to increase transparency,” she said.

The college began to look at improving public access to information about physicians in 2012, such as including findings of professional misconduct in the public register.

The college’s latest efforts at transparency were included in a report to the health minister on transparency on Dec. 1. Hoskins asked all regulatory colleges to submit these reports after another Star investigation showed patients were contracting life-threatening infections at four Toronto pain and colonoscopy clinics.

Medical malpractice lawyer Amani Oakley welcomes the college posting criminal findings of guilt but says patients deserve to know about all criminal convictions.

“If there’s a criminal conviction today, I have no idea why that wouldn’t be relevant,” said Oakley.

The college says criminal findings prior to this date would be included in disciplinary decisions in the public register.