As from December 12, 2024, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Thomas Eliot Johnson in accordance with an undertaking and consent given by Dr. Johnson to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
(“Undertaking”)
of
DR. THOMAS ELIOT JOHNSON
(“Dr. Johnson”)
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 Tribunal” means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
“IEP” means Individualized Education Plan;
“NMS” means the Drug Program Services Branch, the Narcotics Monitoring System implemented under the Narcotics Safety and Awareness Act, 2010;
“OHIP” means the Ontario Health Insurance Plan;
“Ontario Physicians and Surgeons Discipline Tribunal” means the Discipline Committee established under the Code;
“Public Register” means the College’s register that is available to the public; “QAC” means the Quality Assurance Committee of the College.
(2) I, Dr. Johnson, certificate of registration number 30931, am a member of the College.
(3) I, Dr. Johnson, acknowledge that concerns have been identified with respect to my knowledge, skill and judgment. I am aware of the College’s concern about protecting the public.
B. UNDERTAKING
(4) I, Dr. Johnson, undertake to abide by the provisions of this Undertaking, effective immediately.
(5) Clinical Supervision
(a) I, Dr. Johnson, undertake to practise under the guidance of a clinical supervisor or supervisors acceptable to the College (the “Clinical Supervisor” or “Clinical Supervisors”), for at least six (6) months (“Clinical Supervision”). Clinical Supervision shall cease only upon approval from the College.
(b) I, Dr. Johnson, undertake to remain free of any conflict of interest with the Clinical Supervisor.
(c) I, Dr. Johnson, 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 IEP attached as Appendix “B”;
(ii) Review the materials provided by the College and have an orientation session with me, including to discuss the objectives for the Clinical Supervision;
(iii) Meet with me at my Practice Location, or another location approved by the College, once every two (2) weeks;
(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) Discuss any concerns arising from the chart reviews;
(vii) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(viii) 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;
(ix) Submit written reports to the College at least once every month for the first three (3) months, or until the College has approved a reduction in the level of supervision, and once at the end of Clinical Supervision, or more frequently if the Clinical Supervisor has concerns about my standard of practice; and
(x) Remain free of any conflict of interest with me.
(d) I, Dr. Johnson, acknowledge that the charts reviewed shall be selected by the Clinical Supervisor based on the educational needs identified in the IEP set out at Appendix “B” to my Undertaking and concerns that may arise during the period of Clinical Supervision.
(e) I, Dr. Johnson, undertake to cooperate fully with the Clinical Supervision of my practice described in section (5) of this Undertaking and Appendix “A” attached, and undertake to abide by the recommendations of my Clinical Supervisor, including but not limited to recommended practice improvements and ongoing professional development.
(f) I, Dr. Johnson, 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.
(g) I, Dr. Johnson, 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.
(h) I, Dr. Johnson, undertake that if I am unable to obtain a Clinical Supervisor as set out in sections (5)(f) and (5)(g) above, I will cease practising medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.
(i) I, Dr. Johnson, acknowledge that if I am required to cease practise as a result of section (5)(h) above this will constitute a term, condition or limitation on my certificate of registration and said term, condition or limitation will be included on the public register.
(6) Professional Education
(a) I, Dr. Johnson, undertake to participate in and successfully complete the following professional education (the “Professional Education”):
(i) University of Toronto’s Medical Record-Keeping Workshop;
(ii) Review, reflection and discussion with my Clinical Supervisor of the following policies and resources:
1. Diabetes Canada Clinical Practice Guidelines, Diabetes Canada;
2. Sample Diabetes Patient Care Flow Sheet for Adults. Can J Diabetes. 2018;42:S309–S310;
3. Ross DS. Diagnosis of and screening for hypothyroidism in nonpregnant adults. In: Mulder JE, ed. UpToDate. UpToDate; 2024;
4. Ross DS. Treatment of primary hypothyroidism in adults. In: Mulder JE, ed. UpToDate. UpToDate; 2024;
5. Ross DS. Subclinical hypothyroidism in nonpregnant adults. In: Mulder JE, ed. UpToDate. UpToDate; 2024;
6. Patten SB. Updated CANMAT Guidelines for Treatment of Major Depressive Disorder. The Canadian Journal of Psychiatry. 2016;61(9):504-505;
7. Mental Status Exam, The Hub – Psychiatry, University of Toronto;
8. Patient Health Questionnaire-9, Centre For Addiction And Mental Health;
9. Generalized Anxiety Disorder (GAD–7) Scale, Centre For Addiction And Mental Health;
10. Asthma Guidelines, Asthma Canada;
11. Gandhi RT, Meyerowitz EA. COVID-19: Epidemiology, virology, and prevention. In: Bloom A, ed. UpToDate. UpToDate; 2024;
12. COVID-19 Treatment, Ontario Health;
13. Popp M, et al. Ivermectin for preventing and treating COVID‐19.
Cochrane Database of Systematic Reviews. 2022;6:CD015017;
14. Rowe T. A Word About Bioidenticals. J Obstet Gynaecol Can.
2016;38(8):697-699;
15. Jackson LM, Parker RM, Mattison DR, editors. The Clinical Utility of Compounded Bioidentical Hormone Therapy: A Review of Safety, Effectiveness, and Use. Washington (DC): National Academies Press (US); 2020 Jul 1. 8, The Use of Compounded Bioidentical Hormone Therapy;
16. McChesney C, Singer A, Duquette D, Forouhi NG, Levinson W. Do not routinely test for vitamin D. BMJ. 2022;378:e070270. Published 2022 Jul 18;
17. Nutrition for healthy term infants: Recommendations from birth to six months, Government of Canada;
18. Vitamin D, Osteoporosis Canada;
19. Consent to Treatment, College of Physicians and Surgeons of Ontario;
20. Complementary / Alternative Medicine, College of Physicians and Surgeons of Ontario;
21. Virtual Care, College of Physicians and Surgeons of Ontario;
22. Family Medicine Recommendations, Choosing Wisely Canada;
23. Canadian Task Force on Preventative Health Care;
24. Screening Programs, Cancer Care Ontario;
25. Publicly Funded Immunization Schedules, Ministry of Health and Long Term Care;
26. National Advisory Committee on Immunization (NACI): Statements and publications, Government of Canada;
27. Medical Records Documentation, College of Physicians and Surgeons of Ontario; and
28. Advertising, College of Physicians and Surgeons of Ontario; and
(iii) any additional professional education recommended by my Clinical Supervisor.
(b) I, Dr. Johnson, 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. Johnson, undertake to complete this requirement within three (3) months or, if no satisfactory program is available by that time, by the first possible opportunity thereafter.
(d) I, Dr. Johnson, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. Johnson, acknowledge that if any of the programs listed above become unavailable, substitution requests will be reviewed by the College and the College will determine in its sole discretion whether substitution is appropriate.
(7) Reassessment of Practice
(a) I, Dr. Johnson, undertake that, approximately six (6) months after the completion of the Clinical Supervision and the Professional Education set out above and in Appendix “A” and Appendix “B” attached, I will submit to a reassessment of my practice (the “Reassessment”) by an assessor or assessors selected by the College (the “Assessor” or “Assessors”). I acknowledge that the Reassessment may include a chart review of a minimum of fifteen (15) charts, direct observation of my care, interviews with me, colleagues and co-workers, feedback from patients, and any other tools deemed necessary by the College.
(b) I, Dr. Johnson, undertake to co-operate fully with the Reassessment conducted under section (7) of this Undertaking.
(c) I, Dr. Johnson, acknowledge and provide consent that my Clinical Supervisor may receive and review the findings of the Assessor, and may discuss with the Assessor any issues or concerns arising from the Reassessment.
(d) I, Dr. Johnson, acknowledge that the results of the Reassessment will be provided to me and reported to the College and the Reassessment may form the basis of further action by the College.
(8) Monitoring
(a) I, Dr. Johnson, undertake to inform the College of each and every location at which I practice, delegate, or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Out-of-Hospital Premises and Independent Health Facilities with which I am affiliated, in any jurisdiction (collectively my “Practice Location” of “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. Johnson, 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. ACKNOWLEDGEMENT
(9) I, Dr. Johnson, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Johnson, 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. Johnson, 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. Johnson, 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. Johnson, 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 any one or more of the following: consideration by the QAC, an investigation by the College, or further action by the College, including a referral of specified allegations to the Discipline Tribunal.
(14) I, Dr. Johnson, 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. Johnson, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Johnson, 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:
Concerns have been identified with respect to Dr. Johnson’s knowledge, skill and judgment. As a result:
Dr. Johnson will practise under the guidance of a Clinical Supervisor acceptable to the College for 6 months.
Dr. Johnson will engage in professional education, including in the current standards of practice for the assessment, management and follow-up of conditions commonly encountered in family medicine, medical record-keeping, preventative screening and immunization.
Dr. Johnson’s practice will be reassessed by an assessor selected by the College within 6 months of the end of the period of Clinical Supervision and completion of the Professional Education.
(c) I, Dr. Johnson, acknowledge that this Undertaking remains in effect until the College determines its terms are satisfied.
D. CONSENT
(16) I, Dr. Johnson, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS 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.
(17) I, Dr. Johnson, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Appendix “C” and Appendix “D”, respectively.
(18) I, Dr. Johnson, give my irrevocable consent to the College to provide the following information to any person who facilitates my completion of the Professional Education and to all Clinical Supervisors and Assessors:
(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.
(19) I, Dr. Johnson, give my irrevocable consent to the College to provide all Chiefs of Staff with any information arising from the monitoring of my compliance with this Undertaking.
(20) I, Dr. Johnson, give my irrevocable consent to all Clinical Supervisors, Chiefs of Staff, Assessors, and any persons who facilitate my completion of the Professional Education, to disclose to the College, and to one another, any information:
(a) relevant to this Undertaking;
(b) relevant to the provisions of the Clinical Supervisor’s undertaking set out at Appendix “A”;
(c) relevant to the Reassessment;
(d) relevant for the purposes of monitoring my compliance with this Undertaking; and
(e) 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.
Terms and conditions imposed on certificate by: Member