(1 of 2)
As from December 13, 2024, the following is imposed as a term, condition and limitation on the certificate of registration held by Dr. Linda Ann Robinson in accordance with an undertaking and consent given by Dr. Robinson to the College of Physicians and Surgeons of Ontario:
Dr. Robinson has voluntarily ceased to practise medicine in Ontario as of March 15, 2025.
(2 of 2)
Effective August 19, 2019, Dr. Robinson has completed the requirements of the Undertaking effective September 11, 2017:
A. Clinical Supervision
B. Professional Education
C. Reassessment of Practice
However, Dr. Robinson will continue not to engage in any of the following area of practice: Epidural Steroid Injections. This restriction will remain in effect until further notice from the College.
As from September 11, 2017, the following is imposed as terms, conditions and limitations on the certificate of registration held by Dr. Linda Ann Robinson in accordance with an undertaking and consent given by Dr. Robinson to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. LINDA ANN ROBINSON
("Dr. Robinson")
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;
"ICR Committee" means the Inquiries, Complaints and Reports Committee of the College.
"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. Robinson, certificate of registration number 33705, am a member of the College.
(3) I, Dr. Robinson, acknowledge that the College conducted an investigation bearing File Number 7215990 (the "Investigation") into whether I failed to maintain the standard of practice of the profession and/or am incompetent.
(4) I, Dr. Robinson, acknowledge that, if an original copy of this Undertaking as signed by me is accepted by the Inquiries, Complaints and Reports Committee, the College will also deliver a caution in person.
B. UNDERTAKING
(5) I, Dr. Robinson, undertake to abide by the provisions of this Undertaking, effective upon the date this Undertaking is approved by the ICR Committee ("Effective Date").
(6) I, Dr. Robinson, shall keep a log of all prescriptions for medical marijuana, which will include at least the following information (the "Prescribing Log") as set out in Schedule "A" to this Undertaking:
(i) the date of the appointment;
(ii) the name of the patient and chart/file number;
(iii) the name of the medication prescribed, dose to be dispensed and frequency;
(iv) the clinical indication;
(v) whether the prescription is for a new medication and/or different dose or frequency than currently prescribed to the patient (Y/N);
(vi) Dr. Robinson's signature;
(vii) the date of the Clinical Supervisor's review (if applicable, as set out below); and
(viii) the Clinical Supervisor's signature (if applicable, as set out below).
(7) I, Dr. Robinson, undertake to keep a copy of all prescriptions I write for medical marijuana in the corresponding patient chart.
(8) Clinical Supervision
(a) I, Dr. Robinson, undertake to practise under the guidance of a clinical supervisor(s) acceptable to the College (the "Clinical Supervisor(s)"), for a minimum of four (4) months on the terms set out below (the "Clinical Supervision").
(b) I, Dr. Robinson, undertake to meet with my Clinical Supervisor(s) at least once every month to discuss the Clinical Supervisor(s)'s review of:
i. 15 charts for patients to whom I have prescribed medical marijuana, or if there are not 15 patients listed in the Prescribing Log since the Clinical Supervisor(s)'s prior review, then the charts of all patients listed in the Prescribing Log since the Clinical Supervisor's prior review; and
ii. the chart of every patient to whom I have initiated a new prescription for medical marijuana since the Clinical Supervisor(s)'s prior review.
(c) I, Dr. Robinson, acknowledge that the Clinical Supervisor(s) must sign and date the Prescribing Log to confirm the charts that the Clinical Supervisor(s) have reviewed and discussed with me.
(d) I, Dr. Robinson, acknowledge that the Clinical Supervisor(s) will provide a report to the College at least once every month.
(e) I, Dr. Robinson, acknowledge that after a minimum of four (4) months if the Clinical Supervisor(s) is satisfied that I have the necessary knowledge, skills and judgment to practice without supervision, the Clinical Supervisor(s) may recommend to the College that the Clinical Supervision cease.
(f) I, Dr. Robinson, acknowledge and undertake that the Clinical Supervision will only cease upon recommendation of the Clinical Supervisor(s) and approval by the College.
(g) I, Dr. Robinson, acknowledge that I have reviewed the Clinical Supervisor(s)'s undertaking, attached hereto as Schedule "B", and understand what is required of the Clinical Supervisor(s). In addition to what is set out above, the Clinical Supervisor(s) will, at a minimum:
(i) Facilitate the education program set out in the Individualized Education Plan ("IEP") attached as Schedule "C";
(ii) Discuss any concerns with me arising from chart reviews and observations;
(iii) Make recommendations to me for practice improvements and ongoing professional development and inquire into my compliance with the recommendations; and
(iv) 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.
(h) I, Dr. Robinson, undertake that all meetings with my Clinical Supervisor(s) will take place at my Practice Location, or another location approved by the College;
(i) I, Dr. Robinson, acknowledge that all charts reviewed shall be independently selected by the Clinical Supervisor(s) based on the educational needs identified in the IEP set out at Schedule "B" to my Undertaking, as well as the areas of concern identified in the report of the medical inspector received July 7, 2017, and concerns that may arise during the period of Clinical Supervision.
(j) I, Dr. Robinson, undertake to cooperate fully with the Clinical Supervision of my practice, conducted under the terms of this Undertaking and Schedule "B" 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.
(k) I, Dr. Robinson, undertake to ensure that Schedule "B" to this Undertaking, is signed and delivered to the College within fourteen (14) days of the Effective Date.
(l) I, Dr. Robinson, undertake that if a person who has given an undertaking in Schedule "B" to this Undertaking is unable or unwilling to continue to fulfill its provisions, I shall, within fourteen (14) 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.
(m) I, Dr. Robinson, agree that if I am unable to obtain a Clinical Supervisor on the terms set out in sections (8)(k) and/or (l) above, I will cease prescribing medical marijuana until such time as I have obtained a Clinical Supervisor acceptable to the College.
(n) I, Dr. Robinson, agree that if I am required to cease prescribing medical marijuana as a result of section (8)(m) 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. Robinson, undertake to participate in and successfully complete all elements of the detailed IEP, attached hereto as Schedule "C", including but not limited to, the following elements of professional education (the "Professional Education"):
(i) Review and discuss with my Clinical Supervisor(s) the following resources:
1. CPSO Policy "Prescribing Drugs":
http://www.cpso.on.ca/Policies-Publications/Policy/Prescribing-Drugs;
2. the CPSO Policy on Prescribing Marijuana for Medical Purposes
http://www.cpso.on.ca/Policies-Publications/Policy/Marijuana-for-Medical-Purposes and
3. the CPSO Policy on Record Keeping
http://www.cpso.on.ca/Policies-Publications/Policy/Medical-Records
(ii) University of Toronto Medical Record Keeping Course
https://www.cpd.utoronto.ca/recordkeeping/ and
(iii) any additional professional education recommended by my Clinical Supervisor(s).
(b) I, Dr. Robinson, undertake to provide proof to the College of my successful completion of each element of the Professional Education specified above, including proof of registration, attendance and participant assessment reports where available, within one (1) month of completion of each element. I acknowledge that the College will determine, in its sole discretion, whether I have successfully completed each element of the Professional Education.
(c) I, Dr. Robinson, 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. Robinson, undertake that, approximately six (6) months after the Clinical Supervision set out under section 8 of the Undertaking has ceased, I will submit to a reassessment of my practice by an assessor or assessors selected by the College (the "Reassessment").
(b) I, Dr. Robinson, acknowledge and agree that the Reassessment may include a chart review, direct observation of my care, an interview of me, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College.
(c) I, Dr. Robinson, undertake to co-operate fully with the Reassessment, conducted under the terms of this Undertaking
(d) I, Dr. Robinson, 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.
(e) I, Dr. Robinson, acknowledge that the results of the Reassessment will be provided to me and reported to the College and that the Reassessment may form the basis of further action by the College.
(11) Practice Restrictions
(a) I, Dr. Robinson, undertake that I will not engage in any of the following area of practice: Epidural Steroid Injections
(12) Monitoring
(a) I, Dr. Robinson, 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 ten (10) business days of executing this Undertaking. Going forward, I further undertake to inform the College of any and all new Practice Locations within ten (10) business days of commencing practice at that location.
(b) I, Dr. Robinson, undertake and agree that I will submit to, and not interfere with, unannounced inspections of my Practice Location(s) and patient records by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Robinson, give my irrevocable consent to the College to make appropriate enquiries of the Ontario Health Insurance Plan ("OHIP"), the Drug Program Services Branch, the Narcotics Monitoring System ("NMS") implemented under the Narcotics Safety and Awareness Act, 2010 and/or any person or institution who may have relevant information, in order for the College to monitor my compliance with the provisions of this Undertaking.
(d) I, Dr. Robinson, acknowledge that I have executed the OHIP and NMS consent form(s), attached hereto as Schedule "D" and Schedule "E", respectively.
C. ACKNOWLEDGEMENT
(13) I, Dr. Robinson, acknowledge that all schedules attached to or referred to in this Undertaking form part of this Undertaking.
(14) I, Dr. Robinson, acknowledge 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.
(15) I, Dr. Robinson, acknowledge and confirm 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.
(16) I, Dr. Robinson, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief(s) of Staff").
(17) I, Dr. Robinson, 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.
(18) I, Dr. Robinson, acknowledge that this entire Undertaking constitutes terms, conditions, and limitations on my certificate of registration for the purposes of section 23 of the Code.
(19) Public Register
(a) I, Dr. Robinson, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Robinson, acknowledge that, in addition to this Undertaking being posted in accordance with the section above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
The College conducted an investigation into whether Dr. Robinson failed to maintain the standard of practice of the profession and/or was incompetent. As a result of the investigation:
"Dr. Robinson has agreed not to perform epidural steroid injections.
"Dr. Robinson's prescribing of medical marijuana will be supervised by a Clinical Supervisor acceptable to the College for a minimum of four (4) months.
"Dr. Robinson will engage in professional education in the prescribing of medical marijuana and record keeping.
"Following the professional education and period of supervision, Dr. Robinson's prescribing of controlled substances, including narcotics, will be re-assessed by an assessor selected by the College.
D. CONSENT
(20) I, Dr. Robinson, give my irrevocable consent to the College to provide the following information to any person who requires this information fort 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.
(21) I, Dr. Robinson, 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.
(22) I, Dr. Robinson, give my irrevocable consent to any person who facilitates 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 information:
(a) relevant to this Undertaking;
(b) relevant to the provisions of the Clinical Supervisor's undertaking set out at Schedule "B";
(c) relevant to the Reassessment;
(d) relevant for the purposes of monitoring my compliance with this Undertaking; and/or
(e) which comes to his or her attention in the course of providing the Professional Education and which he or she reasonably believes indicates a potential risk of harm to my patients.
Terms and conditions imposed on certificate by: Member
