(1 of 2)
As from February 4, 2020, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Heung-Wing Li in accordance with an undertaking and consent given by Dr. Li to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. HEUNG-WING LI
("Dr. Li")
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 Discipline Committee of the College;
"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. Li, certificate of registration number 32486, am a member of the College. I acknowledge that I was the subject of an Order of the Discipline Committee dated October 2, 2006, as clarified on April 17, 2007 and as modified by the Divisional Court on July 28, 2008 (the "Discipline Order"), by which, if I wish to re-enter the general practice of medicine, I am required to successfully complete an approved re-entry program including education, training and supervision. As a result, on November 6, 2008, I entered into an undertaking regarding the terms of a re-entry program (my "2008 Re-entry Undertaking"). Pursuant to the 2008 Re-entry Undertaking, I practiced under clinical supervision and underwent a series of assessments of my practice.
(3) I, Dr. Li, acknowledge that I did not successfully complete an approved re-entry program, and that the College received information regarding my standard of practice through an assessment conducted as part of my re-entry program. As a result, I entered into an undertaking on November 24, 2017 (my "2017 Re-entry Undertaking"), which replaced my 2008 Re-entry Undertaking to establish a new framework for my continued participation in a re-entry program.
(4) I, Dr. Li, acknowledge that College considered a reassessment report arising out of my 2017 Re-entry Undertaking which raised concerns about my standard of practice.
(5) I, Dr. Li, acknowledge that I shall have clinical encounters with male patients only, in compliance with the Discipline Order.
B. UNDERTAKING
(6) I, Dr. Li, undertake to abide by the provisions of this Undertaking, effective immediately.
(7) Practice Restriction
(a) I, Dr. Li, undertake to continue to abide by the following restriction from my 2017 Re-entry Undertaking: I shall have clinical interactions with no more than five (5) patients per hour, to a maximum of eight (8) hours per day, except that on one (1) day each week I may have clinical interactions to a maximum of ten (10) hours.
(8) Clinical Supervision
(a) I, Dr. Li, undertake to practice medicine under the guidance of a clinical supervisor or clinical supervisors acceptable to the College (the "Clinical Supervisor" or "Clinical Supervisors"), for at least three (3) months ("Clinical Supervision").
(b) I, Dr. Li, 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," with a view to preparing me to engage in independent unsupervised practice;
(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 month;
(iv) Review at least fifteen (15) of my patient charts at every meeting;
(v) Discuss any concerns arising from the chart reviews;
(vi) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations;
(vii) 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
(viii) Submit written reports to the College after three months, or more frequently if the Clinical Supervisor has concerns about my standard of practice.
(c) I, Dr. Li, 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 report of the assessor received June 10, 2019 and addendums dated August 1 and 19, 2019, and concerns that may arise during the period of Clinical Supervision.
(d) I, Dr. Li, 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. Li, 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. Li, 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. Li, undertake that if I am unable to obtain a Clinical Supervisor on the provisions set out under sections (8)(e) and/or (f) above, I will cease practicing medicine until such time as I have obtained a Clinical Supervisor acceptable to the College.
(h) I, Dr. Li, acknowledge that if I am required to cease to engage in the general of medicine as a result of section (8)(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.
(9) Professional Education
(a) I, Dr. Li, 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) Courses:
1. Successful Patient Interactions, Saegis;
2. PROBE: Ethics & Boundaries Program, by receiving a passing evaluation or grade, without any condition or qualification. I, Dr. Li, undertake to abide by any recommendations of the PROBE program;
(ii) Review and discussion with Clinical Supervisor:
1. Canadian Immunization Guide;
2. The Practice Guide, CPSO;
3. Medical Records, CPSO;
4. Infection Prevention and Control for Clinical Office Practice Document, Provincial Infectious Diseases Advisory Committee (PIDAC);
(iii) Review, reflection, and written summary of:
1. Choosing Wisely Canada - Family Medicine;
(iv) any additional professional education recommended by my Clinical Supervisor.
(b) I, Dr. Li, 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. Li, undertake to complete the courses by the earliest available date and to complete the review, written summary and discussion listed above within three (3) months of signing this Undertaking.
(d) I, Dr. Li, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(10) Reassessment of Practice
(a) I, Dr. Li, undertake that, approximately twelve (12) months after the completion of the Clinical Supervision set out in section (8)above and Appendix "A" to this Undertaking, and the completion of the Professional Education set out in section (9) above, 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. Li, undertake to co-operate fully with the Reassessment, conducted under the term of this Undertaking.
(c) I, Dr. Li, acknowledge 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. Li, 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.
(11) Monitoring
(a) I, Dr. Li, 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. Li, undertake to maintain an up-to-date daily log (the "Patient Log") listing every patient seen by me in my general practice each day, including the patient's name, date of birth, OHIP number, date of appointment or visit, and start and end time of appointment or visit. I undertake to maintain the original Patient Log and to send a copy to the College at the end of every calendar month.
(c) I, Dr. Li, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Location(s) and patient records, including the Patient Log and daily appointment book(s), by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(d) I, Dr. Li, 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.
(e) I, Dr. Li, acknowledge that I have executed the OHIP consent form, attached hereto as Appendix "C".
C. ACKNOWLEDGEMENT
(12) I, Dr. Li, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(13) I, Dr. Li, 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.
(14) I, Dr. Li, 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.
(15) I, Dr. Li, 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").
(16) I, Dr. Li, 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.
(17) I, Dr. Li, acknowledge that this Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(18) Public Register
(a) I, Dr. Li, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Li, acknowledge that, in addition to this Undertaking being posted in accordance with section (18)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
Dr. Li engaged in a program to re-enter the general practice of medicine. The College received information which raised concerns about Dr. Li's standard of practice in the course of the re-entry program. As a result:
As of December 3, 2017, Dr. Li will have clinical interactions with no more than five (5) patients per hour, to a maximum of eight (8) hours per day, except that on one (1) day each week he may have clinical interactions to a maximum of ten (10) hours.
Dr. Li will maintain an up-to-date daily log listing every patient seen by him in his general practice each day, including the patient's name, date of birth, OHIP number, date of appointment or visit, and start and end time of appointment or visit.
Dr. Li will practise under the guidance of a Clinical Supervisor acceptable to the College for at least three (3) months.
Dr. Li's practice will be assessed by an assessor selected by the College within 12 months of the end of the Clinical Supervision.
In compliance with an order of the Discipline Committee, Dr. Li will have clinical interactions with male patients only.
D. CONSENT
(19) I, Dr. Li, 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, and/or 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.
(20) I, Dr. Li, 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.
(21) I, Dr. Li, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Clinical Supervisors, Chiefs of Staff and Assessors, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking or my 2008 or 2017 Re-entry Undertakings (collectively my "Undertakings");
(b) any information relevant to the provisions of the Clinical Supervisor's undertaking set out at Appendix "A" to my Undertakings;
(c) any information relevant to the Reassessment or any Assessment conducted under my Undertakings;
(d) any information relevant for the purposes of monitoring my compliance with this Undertaking; and/or
(e) any information which comes to their attention in the course their duties which they reasonably believe indicates a potential risk of harm to my patients.
(2of 2)
As from November 26, 2017, the following is imposed as a term, condition and limitation on the certificate of registration held by Dr. Heung-Wing Li in accordance with an undertaking and consent given by Dr. Li to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. HEUNG-WING LI
("Dr. Li")
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;
"NMS" means the Drug Program Services Branch, the Narcotics Monitoring System implemented under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22, as amended;
"OHIP" means the Ontario Health Insurance Plan;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Li, certificate of registration number 32486, am a member of the College. The College has received information regarding my standard of practice.
(3) I, Dr. Li, acknowledge that the College has received information regarding my standard of practice through an assessment received as part of a process by which I am seeking to re-enter general practice.
B. UNDERTAKING
(4) I, Dr. Li, undertake to abide by the provisions of this Undertaking, effective immediately.
(5) Resignation of Prescribing Privileges
(a) I, Dr. Li, acknowledge that I have executed the Prescribing Resignation Letter to Health Canada, effective December 3, 2017, which is attached hereto as Schedule "A" (the "Resignation Letter").
(b) I, Dr. Li, consent to the College sending the Resignation Letter to Health Canada on my behalf.
(c) I, Dr. Li, undertake that, as of December 3, 2017, I will not issue new prescriptions or renew existing prescriptions for or administer any of the following substances:
(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c.19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(A summary of the above-named drugs [from Appendix I to the Compendium of Pharmaceuticals and Specialties] is attached hereto as Schedule "B"; and the current regulatory lists are attached hereto as Schedule "C")
(v) All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22 as noted in Schedule "D");
and as amended from time to time.
(d) I, Dr. Li, undertake to refer all patients to whom I am prescribing any of the substances described in section (5)(c), above, to other physicians for assessment and care by December 3, 2017.
(e) I, Dr. Li, undertake to keep a log of all patients referred to other physicians pursuant to section (5)(d), above (the "Log"). I, Dr. Li, undertake to include in the Log the name of each patient referred, the name of the physician referred to, and the date of referral.
(6) I, Dr. Li, undertake that I will return any supplies of the substances referred to in section (5)(c) above that are presently in my possession, in any place, to a pharmacy in a safe and secure manner, as stipulated in the College's Policy Number 8-12, "Prescribing Drugs."
(7) I, Dr. Li, undertake to inform the College of each and every location that 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.
(8) Posting a Sign
(a) I, Dr. Li, undertake that I shall post a sign in the waiting room(s) and in each examination and consulting room, in all my Practice Locations, in a clearly visible and secure location, in the form set out at Schedule "E." For further clarity, this sign shall state as follows:
IMPORTANT NOTICE
Effective December 3, 2017, Dr. Li has voluntarily agreed not to prescribe or administer any of the following:
-Narcotic Drugs
-Narcotic Preparations
-Controlled Drugs
-Benzodiazepines and Other Targeted Substances
-All other Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
(b) I, Dr. Li, undertake to post a certified translation in any language in which I provide services, of the sign described in section (8)(a) above, in the waiting room(s) and in each examination and consulting room, in all my Practice Locations, in a clearly visible and secure location, in the form set out at Schedule "E."
(c) I, Dr. Li, undertake to provide the certified translation(s) described in section (8)(b), to the College within thirty (30) days of executing this Undertaking.
(d) I, Dr. Li, undertake that if I elect, after the execution of this Undertaking, to provide services in any other language(s), I will notify the College prior to providing any such services.
(e) I, Dr. Li, undertake to provide to the College the certified translation(s) described in section (8)(c) prior to beginning to provide services in the language(s) described in section (8)(d).
C. ACKNOWLEDGEMENT
(9) I, Dr. Li, acknowledge that all schedules attached to or referred to in this Undertaking form part of this Undertaking.
(10) I, Dr. Li, 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. Li, 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. Li, acknowledge that the College will provide this Undertaking to any Chief(s) of Staff, or a colleague(s) with similar responsibilities, at any Practice Location ("Chief(s) of Staff").
(13) I, Dr. Li, 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.
(14) I, Dr. Li, 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. Li, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Li, 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:
The College received information regarding Dr. Li's standard of practice through an assessment conducted as part of the process by which he sought to re-enter general practice. As a result:
Effective December 3, 2017, Dr. Li has voluntarily agreed not to issue new prescriptions or renew existing prescriptions for or administer any of the following substances:
(i) Narcotic Drugs (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(ii) Narcotic Preparations (from the Narcotic Control Regulations made under the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
(iii) Controlled Drugs (from Part G of the Food and Drug Regulations under the Food and Drugs Act, S.C., 1985, c. F-27);
(iv) Benzodiazepines and Other Targeted Substances (from the Benzodiazepines and Other Targeted Substances Regulations made under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
(v) All other Monitored Drugs (as defined under the Narcotics Safety and Awareness Act, 2010, S.O. 2010, c. 22);
and as amended from time to time.
Dr. Li must post a clearly visible sign in the waiting rooms and each examination and consulting room, in all Practice Locations, which states as follows:
IMPORTANT NOTICE
Effective December 3, 2017, Dr. Li has voluntarily agreed not to prescribe or administer any of the following:
-Narcotic Drugs
-Narcotic Preparations
-Controlled Drugs
-Benzodiazepines and Other Targeted Substances
-All other Monitored Drugs
Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca
D. CONSENT
(16) I, Dr. Li, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Location(s) and patient charts by the College and to any other activity the College deems necessary in order to monitor my compliance with the provisions of this Undertaking.
(17) I, Dr. Li, give my irrevocable consent to the College to make appropriate enquiries of OHIP, NMS, and 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.
(18) I, Dr. Li, acknowledge that I have executed the OHIP and NMS consent forms, attached hereto as Schedule "F" and Schedule "G", respectively.
(19) I, Dr. Li, 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 any information arising from the monitoring of my compliance with this Undertaking.
Terms and conditions imposed on certificate
