As from March 7, 2017, the following is imposed as a term, condition and
limitation on the certificate of registration held by Dr.Howard Elliot Mandel,
in accordance with an undertaking and consent given by Dr. Mandel to the
College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. HOWARD ELLIOT MANDEL
("Dr. Mandel")
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;
"Discipline Committee" means the Discipline 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. Mandel, certificate of registration number 27426, am a member of
the College. Further to a reassessment of my practice, the College has
received information regarding my standard of practice.
B. UNDERTAKING
(3) I, Dr. Mandel, undertake to abide by the provisions of this Undertaking,
effective immediately.
(4) Practice Restrictions
(a) I, Dr. Mandel, undertake that I will:
(i) restrict my practice to a maximum of 5 patient encounters per
hour, up to a maximum of 40 patient encounters per day.
(5) Clinical Supervision
(a) I, Dr. Mandel, undertake to practise under the guidance of a
clinical supervisor(s) acceptable to the College (the "Clinical
Supervisor(s)"), for six (6) months ("Clinical Supervision").
(b) I, Dr. Mandel, acknowledge that I have reviewed the Clinical
Supervisor(s)'s undertaking, attached hereto as Appendix "A", and
understand what is required of the Clinical Supervisor(s). The
Clinical Supervisor(s) will, at minimum:
(i) Facilitate the education program set out in the
Individualized Education Plan
("IEP") attached as Appendix "B";
(ii) Meet with me at my Practice Location, or another location
approved by the College, once every month;
(iii) Review at least twenty (20) of my patient charts at every
meeting;
(iv) Discuss any concerns arising from the chart reviews;
(v) Make recommendations to me for practice improvements and
ongoing professional development and inquire into my
compliance with the
recommendations;
(vi) Perform any other duties, such as reviewing other documents
or conducting interviews with staff or colleagues, that the
Clinical Supervisor(s) deem necessary to my Clinical
Supervision; and
(vii) Submit written reports to the College at least once every
month, or more frequently if the Clinical Supervisor(s) has
concerns about my standard of practice.
(c) I, Dr. Mandel, acknowledge that the charts reviewed shall be
selected by the Clinical Supervisor(s) based on the educational
needs identified in the IEP set out at Appendix "B" to my
Undertaking, as well as the areas of concern identified in the
report(s) of the assessor, dated March 9, 2016, and concerns that
may arise during the period of Clinical Supervision.
(d) I, Dr. Mandel, undertake to cooperate fully with the Clinical
Supervision of my practice, conducted under the term of this
Undertaking and Appendix "A" attached, and to abide by the
recommendations of my Clinical Supervisor(s), including but not
limited to, any recommended practice improvements and ongoing
professional development.
(e) I, Dr. Mandel, 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. Mandel, 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. Mandel, agree 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. Mandel, agree 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.
(6) Professional Education
(a) I, Dr. Mandel, 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) Medical record-keeping; and
(ii) any additional professional education recommended by my
Clinical Supervisor(s).
(b) I, Dr. Mandel, 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. Mandel, acknowledge that a report or reports may be provided
to the College regarding my progress and compliance with the
Professional Education.
(d) I, Dr. Mandel, undertake to complete this requirement within three
(3) months of executing this undertaking or, if no satisfactory
program is available by that time, by the first possible
opportunity thereafter.
(7) Reassessment of Practice
(a) I, Dr. Mandel, undertake that, approximately six (6) months after
the completion of the Clinical Supervision set out in section (6)
above and Appendix "A" attached, I will submit to a Reassessment of
my practice ("the Reassessment") by an assessor or assessors
selected by the College (the "Assessor(s)"). I acknowledge and
agree that the Reassessment may include a chart review, direct
observation of my care, interviews with colleagues and co-workers,
feedback from patients and any other tools deemed necessary by the
College.
(b) I, Dr. Mandel, undertake to co-operate fully with the Reassessment,
conducted under the term of this Undertaking, and to abide by those
recommendations of the Assessor(s) that are approved by the ICR
Committee.
(c) I, Dr. Mandel, acknowledge and agree that my Clinical Supervisor(s)
may receive and review the findings of the Assessor(s), and may
discuss with the Assessor(s) any issues or concerns arising from
the Reassessment. I also acknowledge that the results of the
Reassessment will be provided to me and reported to the College and
the report may form the basis of further action by the College.
(d) I, Dr. Mandel, understand and agree that if I am of the view that
any of the Assessor(s)'s recommendations are unreasonable, I will
have thirty (30) days following my receipt of the recommendations
within which to provide the College with my submissions in this
regard. I further understand and agree that thereafter, the ICR
Committee will consider my submissions and make a determination
regarding whether or not the recommendations, or any of them, are
reasonable and if so, whether they, or any of them, constitute
limitations or restrictions on my practice, and that decision will
be provided to me.
(e) I, Dr. Mandel, undertake that, following the decision referenced in
section (8)(d) above, I will abide by those recommendations of the
Assessor(s) that the ICR Committee has determined are reasonable.
(f) I, Dr. Mandel, hereby consent to any of the following being
included on the public register as terms, conditions or limitations
on my certificate of registration, for the purposes of section 23
of the Code:
(i) any recommendations of the Assessor(s) which are terms,
conditions or limitations on my practice; (ii)any
recommendations of the Assessor(s) which the ICR Committee
has identified in its decision referenced in section (8)(d)
as terms, conditions or limitations on my practice.
(8) Monitoring
(a) I, Dr. Mandel, undertake to inform the College of each and every
location where I practise or have privileges, including, but not
limited to, hospital(s), clinic(s) and office(s), in any
jurisdiction (collectively my "Practice Location(s)"), 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. Mandel, undertake and agree that I will submit to, and not
interfere with, unannounced inspections of my Practice Locations
and patient charts by a College representative for the purposes of
monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Mandel, 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. Mandel, acknowledge that I have executed the OHIP consent
form, attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(9) I, Dr. Mandel, acknowledge that all appendices attached to or referred to
in this Undertaking form part of this Undertaking.
(10) I, Dr. Mandel, 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. Mandel, 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. Mandel, 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.
(13) I, Dr. Mandel, acknowledge that this Undertaking constitutes terms,
conditions, and limitations on my certificate of registration for the
purposes of section 23 of the Code.
(14) Public Register
(a) I, Dr. Mandel, acknowledge that, during the time period that this
Undertaking remains in effect, this Undertaking shall be posted on
the Public Register.
(b) I, Dr. Mandel, acknowledge that, in addition to this Undertaking
being posted in accordance with section (15) above, the following
summary shall be posted on the Public Register during the time
period that this Undertaking remains in effect:
Pursuant to a reassessment, the College received information
regarding Dr. Mandel's standard of practice. As a result,
Dr. Mandel voluntarily restricts his practice to a maximum of
5 patient encounters per hour, up to a maximum of 40 patient
encounters per day.
Dr. Mandel must also:
"practise under the guidance of a Clinical Supervisor
acceptable to the College for 6 months.
"engage in professional education in medical
record-keeping.
"have his practice reassessed by an assessor selected
by the College within 6 months of the end of the period
of Clinical Supervision.
D. CONSENT
(15) I, Dr. Mandel, give my irrevocable consent to the College to provide all
Chief(s) 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.
Terms and conditions imposed on certificate by: Member
