On November 16, 2016, the Discipline Committee of the College of Physicians and Surgeons of Ontario found that Dr. Murray Bruce Wilson has committed an act of professional misconduct in that he has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable, or unprofessional.
Dr. Wilson is a family physician who has practised in Bradford, Ontario since 1985. Patient A was Dr. Wilson’s patient beginning when she was a young child.
In December 2004, when she was in her teens, Patient A attended at Dr. Wilson’s office because she was experiencing pain after having had intercourse earlier that day (dyspareunia). Her medical record indicates that on that day she was also complaining of dysmenorrhea and menorrhagia, as well as lower back pain of two months’ duration, which was aggravated by bending. At a previous appointment, Dr Wilson had performed a breast examination and identified a lump that should be monitored.
At the December 2004 appointment, Dr. Wilson performed a clinically-indicated physical examination on Patient A, which included an examination of the chest, breasts, cardiovascular system, abdomen, and pelvis. Dr. Wilson took a vaginal swab, provided Patient A with a requisition for a urine test, and ordered a pelvic ultrasound. Dr. Wilson documented the examination in the patient chart.
Dr. Wilson also assessed Patient A’s lower back at the appointment, which included asking that she stand and bend to 90 degrees. This assessment was clinically indicated and documented in the patient chart. Dr. Wilson noted in the chart that his impression was that Patient A had a lumbar strain.
Patient A was confused and distressed by this appointment as a result of Dr. Wilson’s conduct during the appointment, which included the following:
- Dr. Wilson did not provide Patient A with a gown, but only with a drape, which was inadequate for the examinations performed. Patient A found it hard to cover herself sufficiently throughout the appointment. This left her feeling exposed and vulnerable.
- Dr. Wilson did not adequately explain the pelvic and breast examinations that he - conducted to Patient A to obtain her informed consent. Patient A did not understand the purpose and steps involved.
- Although Dr. Wilson asked Patient A for sexual information relevant to the pain she was experiencing after intercourse, he did not explain the clinical basis for his questions. He asked her whether it hurt and how it felt when her boyfriend “went deep,” and repeated the word “deep” several times. Patient A felt very uncomfortable.
- Dr. Wilson directed Patient A to bend over with her back to him, without explaining the clinical reason or seeking her consent. Patient A bent over as directed, but had only the drape to hold in place at her front, while her back (which was towards Dr. Wilson) was fully exposed, including her buttocks. Patient A did not understand the purpose of this examination and felt shocked and violated.
As a result, Patient A experienced great discomfort during the appointment. She returned to see Dr. Wilson on several more occasions but was not comfortable with him. The experience made her more reluctant to seek medical care in general. In 2013, Patient A considered the continued impact of her experience with Dr. Wilson. Subsequently, Patient A decided to report her experience to the College.
Dr. Wilson is subject to an undertaking to the College into which he entered on January 13, 2012. It requires Dr. Wilson to have a practice monitor who is a regulated health professional acceptable to the College, who must carefully observe all of his examinations of female patients and remain in the examination or consulting room at all times during all professional encounters with female patients. The practice monitor is required to report on at least a monthly basis to the College. Dr. Wilson is required to post a sign regarding this restriction in his waiting room and all examination rooms, and there are various provisions to permit compliance monitoring.
Dr. Wilson entered into this undertaking at the College’s request after the College received complaints about female patients’ experiences in Dr. Wilson’s office, including two instances in which Dr. Wilson moved the patient’s clothing aside and commenced an examination without adequate explanation or consent.
In 2011, Dr. Wilson voluntarily completed a course offered by the University of Western Ontario on Understanding Boundary Issues and Managing the Risks Inherent in the Doctor-Patient Relationship.
Dr. Wilson’s practice monitor has advised that she has not had concerns regarding his respect for female patients’ boundaries and privacy.
The College has not received any complaints regarding conduct by Dr. Wilson towards female patients that has taken place since he entered into the 2012 undertaking.
PENALTY
On November 16, 2016, the Discipline Committee ordered and directed that:
- the Registrar suspend Dr. Wilson’s certificate of registration for period of four (4) months, to commence at 12:01 a.m. on November 17, 2016.
- the Registrar impose the terms of Dr. Wilson’s undertaking with the College dated January 13, 2012 as terms, conditions and limitations on Dr. Wilson’s certificate of registration.
- Dr. Wilson appear before the panel to be reprimanded.
- Dr. Wilson pay to the College its costs of this proceeding in the amount of $5,000.00 within thirty (30) days from the date of this Order.
Terms and conditions imposed on certificate by: Discipline Committee