THE FOLLOWING INFORMATION WAS OBTAINED FROM THE PHYSICIAN REGISTER SECTION OF THE WEBSITE OF THE COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO (WWW.CPSO.ON.CA) AS OF THE DATE AND TIME NOTED BELOW
20/06/25 05:06:52 AM

General Information

Former Name: No Former Name
Medical School: Schulich School of Medicine and Dentistry, Western University, 1991
Gender: Woman
Languages Spoken: ENGLISH, FRENCH

Practice Information

Primary Business Location: Address not Available
Business Email: No Information Available
Phone: No Information Available
Fax: No Information Available

Specialties

No Specialty Reported

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: Judi Dianne Marcin Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 23 Sep 2016

General Information

Former Name: No Former Name
Gender: Woman
Languages Spoken: ENGLISH, FRENCH
Medical School: Schulich School of Medicine and Dentistry, Western University, 1991

Practice Information

Primary Business Location: Address not Available
Business Email: No Information Available
Phone: No Information Available
Fax: No Information Available

Specialties

No Specialty Reported

Hospital Privileges

No information available

Professional Corporation Information

Corporation Name: Judi Dianne Marcin Medicine Professional Corporation
Certificate of Authorization Status: Inactive End Date: 23 Sep 2016

Practice Conditions

This physician is inactive (Expired, Resigned, Suspended, Revoked, or Deceased) and is not permitted to practise medicine.
This physician is inactive (Expired, Resigned, Suspended, Revoked, or Deceased) and is not permitted to practise medicine.

Current Tribunal Proceedings

No information available

Past Tribunal Proceedings (2)

Date of Decision: 25 Jul 2018
Summary of Decision:
On July 25, 2018 the Discipline Committee found that Judi Dianne Marcin committed an act of professional misconduct in that: she has been found guilty of an offence relevant to her suitability to practice; she has engaged in conduct or 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; she has engaged in conduct unbecoming a physician; she has failed to maintain the standard of practice of the profession; and she contravened a term, condition or limitation on her certificate of registration. The Committee also found that Judi Dianne Marcin is incompetent.

Dr. Marcin was a family physician and psychotherapist practising in Woodstock. The alleged misconduct occurred prior to July 7, 2016, when Dr. Marcin ceased to be a member of the College (the Discipline Committee ordered revocation of Dr. Marcin’s certificate of registration in a 2016 hearing).

April 2014 Undertaking (Graduated Work Hours on Return to Practice)

In April 2014, Dr. Marcin signed an undertaking to the College which set out, among other matters, that she would resume her clinical practice gradually following a period when she had not been practising. It specified the maximum hours per day and the weekdays each week that she could work.

The College’s compliance monitor’s billing analysis showed that the number of hours that Dr. Marcin spent just in providing direct psychotherapy treatment exceeded the maximum she had agreed to for all clinical activity, starting in the third week following her return to practice and continuing on in the great majority of subsequent weeks. In weeks nine to 23, for example, Dr. Marcin exceeded the 30 hours permitted in every week but one. When her maximum was then increased to 40 hours per week, Dr. Marcin exceeded this limit in 68 of the next 79 weeks. In reviewing Dr. Marcin’s appointment logs, the compliance monitor noted that Dr. Marcin had patients scheduled on the Tuesdays of weeks three and four following her return to practice. Dr.Marcin submitted claims for services on both Tuesdays and the second Thursday of weeks three and four, weekdays not permitted at that time by her undertaking. The Committee accepted the evidence of the billing analysis, in Dr. Marcin’s appointment logs and OHIP billings, the Committee found that Dr. Marcin exceeded the number of work hours permitted and worked on prohibited days of the week.

The Committee found that Dr. Marcin breached her April 2014 undertaking and contravened a term, condition or limitation on her certificate of registration. The Committee also found that Dr. Marcin engaged in disgraceful, dishonourable and unprofessional, by breaching the terms of her April 2014 undertaking and contravening a term, condition or limitation on her certificate of registration.

April 2015 Undertaking (Practice Restricted to Psychotherapy) and Registrar’s Investigation

In her April 2015 undertaking to the College, Dr. Marcin committed to immediately cease practising family medicine and to restrict her practice to psychotherapy. She consented to this restriction being a term, condition, or limitation on her certificate. Dr. Marcin acknowledged in the undertaking that she had agreed in a prior undertaking to abide by the recommendations of her clinical supervisor and that her supervisor had recommended on March 5, 2015 that she cease to practise family medicine.

A Registrar’s investigation was commenced after the College received a phone call from a pharmacist in February 2016. An expert in family medicine and psychotherapy retained by the College reviewed office charts and pharmacy information.

The Committee accepted the expert’s opinion that Dr. Marcin practised family medicine outside the scope of psychotherapy after April 16, 2015. Dr. Marcin provided care that was family medicine outside the scope of psychotherapy to 29 of the 30 patients whose office charts were reviewed and five of the eight patients with only pharmacy records. Examples of the conditions that were not within the scope of psychotherapy included many acute and chronic conditions typical of family medicine. The Committee noted from the expert’s report that within just five days of signing her undertaking, Dr. Marcin had prescribed medications to four patients for conditions that are in the scope of family medicine outside psychotherapy. Also, Dr. Marcin wrote letters to third parties on behalf of two patients, in which she identified herself as their primary or primary care physician and opined on matters that were not related to psychotherapy.

The Committee found that Dr. Marcin practised family medicine outside the scope of psychotherapy after her April 2015 undertaking to the College and therefore, breached the terms of her undertaking and contravened a term, condition or limitation on her certificate of registration.

Failed to Maintain the Standard of Practice of the Profession and Incompetence – Family Medicine

The expert found no proper history or examination in 28 of the 29 office charts of patients who Dr. Marcin was treating for family medicine conditions outside the scope of psychotherapy. In the expert’s opinion, in this pervasive lack of documentation, Dr. Marcin failed to maintain the standard of practice of the profession and showed a lack of judgment.

The expert opined that Dr. Marcin also failed to meet the standard of practice of the profession in her prescribing of lansoprazole, a type of medication used in the treatment of heartburn, reflux and stomach ulcers, by prescribing it at unnecessarily high doses, higher than recommended, without justification in three of four patients. The Committee accepted the expert’s opinion. The patients were thereby exposed to an increased risk of significant side effects. Relevant history and examination were absent from all four patient charts

Further, the expert opined about a concern conveyed in writing by a pharmacist to Dr. Marcin about her prescribing for Patient X, specifically what the pharmacist viewed as a complex regimen of multiple medications in a patient who had difficulty with remembering and concentrating. The expert indicated that the absence of any response by Dr. Marcin or change in her prescribing demonstrated a lack of judgment and was a failure to meet the standard of practice. It is a professional expectation that physicians communicate and collaborate respectfully with others involved in the provision of health care in order that patients receive safe and effective care. The Committee found that Dr. Marcin did not meet this expectation in her conduct relating to the concerns of Patient X’s pharmacist.

The Committee found that Dr. Marcin failed to maintain the standard of practice of the profession in family medicine by her pervasive failure to adequately document clinical evaluations, her improper prescribing of lansoprazole and her failure to communicate and collaborate appropriately with another health care professional.

The Committee found that Dr. Marcin showed a consistent lack of judgment and consistently failed to maintain the standard of practice in her family medicine practice, exposing her patients to the risk of harm or injury. The Committee was struck by the pervasiveness, magnitude, and persisting nature of these deficiencies. Also, in Dr. Marcin’s seriously flawed judgment, she thought it was acceptable to continue to practise family medicine almost immediately after signing the undertaking that she would cease doing so. The Committee found that Dr. Marcin’s lack of judgement is such that she is incompetent in family medicine.

Failed to Maintain the Standard of Practice of the Profession and Incompetence – Prescribing Antidepressants

The expert reviewed 30 office charts and the pharmacy records for eight additional patients. The expert identified concerns with Dr. Marcin’s prescribing of antidepressants in eight patients in total, six from among the office charts and two for whom there were only pharmacy records. Specifically, she observed that Dr. Marcin had prescribed antidepressants at very high doses and/or in combinations in these patients that exposed them to increased risk of side effects including the potentially fatal serotonin syndrome. The Committee found that Dr. Marcin failed to maintain the standard of practice of the profession and displayed a lack of judgment in her prescribing of antidepressants.

The Committee stated that the deficiencies in Dr. Marcin’s antidepressant prescribing were not isolated. Deficiencies were identified in eight of the 38 patients reviewed. Although the Committee heard no evidence of actual harm to patient, Dr. Marcin exposed her patients to increased risk, including serious and potentially fatal side effects. The Committee found that Dr. Marcin’s lack of judgment such that she is incompetent in her prescribing of antidepressants.

Disgraceful, Dishonourable or Unprofessional Conduct

The Committee stated that Dr. Marcin demonstrated serious and persistent disregard of her professional obligations by resuming family practice almost immediately after giving her undertaking to the College to cease that practice. Further, Dr. Marcin ignored her practice restriction and misrepresented herself in letters to third parties on behalf of two patients on matters not related to psychotherapy. The Committee found serious deficiencies in Dr. Marcin’s clinical care, deficiencies which have involved a significant number of patients over an extended period of time and that have exposed patients to unnecessary risk of harm. Dr. Marcin’s conduct falls far outside the legitimate exercise of professional judgment or errors in judgment and clearly reflects a serious and persistent disregard for professional values and obligations. The Committee found that Dr. Marcin’s conduct as outlined constituted disgraceful, dishonourable or unprofessional conduct.

Disgraceful, Dishonourable or Unprofessional Conduct and Failling to Maintain the Standard of Practice of the Profession – Providing Care to Family Members

Patients Z and Y were two of Dr. Marcin’s family members. There were no office charts for either. Based on a review of the pharmacy records, the expert concluded that Dr. Marcin was practising family medicine in prescribing multiple medications for her two family members over an extended period of time for a ‘multitude of conditions’ that were not minor and that did not involve emergencies. Moreover, many were chronic conditions that required ongoing care. The College's policy prohibits more than incidental or emergency treatment of family members or others with whom the physician has a close, personal relationship. Dr. Marcin’s care for her two family members met none of the criteria for an exception to the policy.

The Committee found that Dr. Marcin provided ongoing care for family members was contrary to College policy. Also, her violation of the policy was compounded by the fact that she provided care within a scope of practice from which she was prohibited, and she maintained no proper clinical records. The Committee found that by so doing, Dr. Marcin engaged in disgraceful, dishonourable or unprofessional conduct The Committee found that Dr. Marcin failed to maintain the standard of practice of the profession in her prescribing for her two family members, failing to keep proper records of their care, and willfully contravening College policy on providing care for family members.

Guilty of an Offence relevant to Suitability to Practise, Conduct Unbecoming a Physician, Disgraceful, Dishonourable or Unprofessional Conduct - 2016 Conviction for Failing to Comply with a Probation Order

The Committee found that Dr. Marcin has been found guilty of an offence relevant to her suitability to practice. Dr. Marcin was convicted on May 19, 2016 of failing to comply with the terms of a probation order, by failing to pay restitution in the amount of $100,356.60, related to a prior conviction in 2012 of defrauding OHIP. This offence was viewed as a serious one by the court, which sentenced her to 21 days in jail, 12 months’ probation and payment of the balance of the restitution, $97,856.60. Dr. Marcin’s conduct in failing to comply with the court’s order to make restitution for her OHIP fraud reflects a serious disregard of professional values and obligations. The Committee found that Dr. Marcin’s conduct in this regard also constituted conduct unbecoming a physician, as it reflects negatively on the reputation of the profession as a whole. Further, it constitutes conduct or an act or omission that is relevant to the practice of medicine and would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

Disgraceful, Dishonourable or Unprofessional Conduct - Patient A

Dr. Marcin provided psychotherapy services to Patient A between 2012 and 2016. The Committee found that Dr. Marcin asked her about her financial situation when she first became her patient, shortly after Patient A’s husband had died. Patient A was seeking help for stress and depression. Dr. Marcin asked Patient A for money to pay a bill and Patient A gave her $1,000.00. In February 2016, Dr. Marcin again told Patient A that she needed money and asked for $40,000.00. Patient A cashed in some of her savings and gave Dr. Marcin $32,000.00 as a loan. Dr. Marcin wrote out a receipt and repayment schedule when Patient A insisted. Later, when Dr. Marcin came to Patient A’s house, Patient A asked Dr. Marcin about repayment of the loan. In response, Dr. Marcin told her she needed more money and asked Patient A for $125,000.00. Dr. Marcin said to her, “You’re mean” when she refused. Patient A testified that she has never received any repayment, despite retaining a lawyer who wrote to Dr. Marcin.

The Committee found that Patient A was a vulnerable patient, whom Dr. Marcin took advantage of almost from the time she first became her patient. Dr. Marcin took little account of Patient A’s interests, allowed her own personal needs to dominate their relationship, and repeatedly grossly violated professional boundaries. Dr. Marcin’s telling Patient A that she was ‘mean’ when Patient A refused to give her even more money was a further reflection of Dr. Marcin’s profound disregard for even basic professional values and obligations.

Disposition

On July 27, 2018, the Discipline Committee ordered that:

- the Registrar revoke Judi Dianne Marcin’s certificate of registration effective immediately.

- Judi Dianne Marcin appear before the panel to be reprimanded.

- Judi Dianne Marcin pay to the College its costs of this proceeding in the amount of $30,540.00 within thirty (30) days from the date this Order becomes final.
 
Reasons for Decision: Download Full Decision (PDF)
Hearing Date(s): Hearing: July 24-25, 2018; Penalty Hearing: July 27, 2018
Date of Decision: 30 Mar 2016
Summary of Decision:
On March 30, 2016, the Discipline Committee of the College of Physicians and Surgeons of Ontario found that Dr. Judi Dianne Marcin committed an act of professional misconduct in that she has been found guilty of an offence relevant to her suitability to practice; engaged in conduct which would reasonably be regard by members as disgraceful, dishonourable or unprofessional; failed to maintain the standard of practice of the profession; contravened terms, conditions, or limitations on her certificate of registration; and engaged in conduct unbecoming a physician.

The Committee also found that Dr. Marcin is incompetent as defined by the Code.

CRIMINAL CONVICTION
 
On March 22, 2012, Dr. Marcin was convicted of defrauding the Ministry of Health and Long-Term Care of $100,356.60 contrary to s. 380(1)(a) of the Criminal Code. Dr. Marcin received a suspended sentence and 18 months’ probation. She was ordered to perform 100 hours of community service and to make $100,356.60 in restitution.
 
DR. MARCIN AND PATIENT A
 
In 2002, Patient A began seeing Dr. Marcin after he was referred to her by a counsellor at a residential treatment center where he had been receiving treatment for addiction. Dr. Marcin was Patient A’s psychotherapist as well as his family doctor.

In approximately March 2010, Patient A told Dr. Marcin that he had developed romantic feelings her. Dr. Marcin explained to him that his romantic feelings were not for her personally but for an ideal of someone like her.

Between April 2010 and June 2010, records demonstrate that 17 separate phone calls took place between Dr. Marcin and Patient A outside office hours while Dr. Marcin was still providing care to Patient A.

In the summer of 2010, Dr. Marcin told Patient A that she would be vacationing in an area in Ontario.

Patient A concocted a story about his substance abuse sponsor heading to a retreat in the same area and explained that, if Dr. Marcin could give him a ride, Patient A would then be able to meet his sponsor at that retreat. Dr. Marcin agreed.

Once at Hotel Z, Patient A revealed to Dr. Marcin that he had invented the entire story to be alone with her in an attempt to initiate a romantic relationship.

Dr. Marcin expressed her disappointment with Patient A for misleading her, telling him that she was hurt that he had lied to her, and that she had to fire him as her patient.

Nevertheless, Dr. Marcin allowed Patient A to sleep on her hotel room floor at Hotel Z for the duration of the multi-day vacation.

On the dates in August 2010 in which Dr. Marcin allowed Patient A to stay with her in her room at Hotel Z, several other vacant rooms were available at Hotel Z. There were also approximately 20 other hotels in the surrounding area.

On the drive home from Hotel Z in August 2010, Dr. Marcin told Patient A he should no longer see her as his doctor. However, Dr. Marcin continued to fill his prescriptions after this date.

Phone records demonstrate that Dr. Marcin and Patient A spoke on the phone and texted multiple times between August 2010 and February 2011.

In his letters, Patient A had indicated that he and Dr. Marcin could write emails while logged into the Gmail account but leave them in the draft folder as a way of communicating without actually having to send an email. Dr. Marcin accessed the shared Gmail account on or after May 18, 2010 and composed and/or read emails in the drafts folder of the account.

The College-retained information systems expert recovered 12 emails and email fragments written between October 2010 and January 2011 which had been deleted from Dr. Marcin’s computer.

On December 18, 2012, the College received Dr. Marcin’s original patient chart for Patient A, containing a letter from Dr. Marcin to Patient A bearing a date in November 2010 purporting to formally terminate her doctor-patient relationship with Patient A. However, the information systems expert determined that the document entitled “letter of termination [Patient A] nov 2010.wps”, bearing a date in November 2010, was in fact created by Dr. Marcin on December 5, 2012.

OHIP BILLING RE PATIENT A

Among other billing and record-keeping issues, between 2009 and 2011, Dr. Marcin billed for OHIP 93 times for individual psychotherapy for Patient A for which there are no corresponding patient notes. This includes billing for services in August 2010 while she was with Patient A at Hotel Z.

Patient A told the College he did not receive psychotherapy on weekends. In 2010, Dr. Marcin billed OHIP 36 times for individual psychotherapy for Patient A on Saturdays.

FAILING TO MAINTAIN THE STANDARD OF PRACTICE, INCOMPETENCE, AND DISGRACEFUL, DISHONOURABLE AND UNPROFESSIONAL CONDUCT RE PRESCRIBING
 
On February 11, 2013, the Inquiries, Complaints and Reports Committee (“ICRC”) imposed terms on Dr. Marcin’s certificate of registration, ordering that she retain a Health Monitor. On October 21, 2013, the ICRC gave notice of its intention to vary that Order based on information that Dr. Marcin may be in breach of it.

On November 11, 2013, Dr. Marcin entered into an undertaking with the College, in which she agreed to cease to practise medicine in all jurisdictions. Prior to entering into this November 11 Undertaking, Dr. Marcin issued 8 patients multiple prescriptions for narcotics between November 1 and November 11, 2013.

The College expert found that Dr. Marcin’s November 1 to 11, 2013 prescribing of Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines/Other Targeted Substances, and all other Monitored Drugs failed to maintain the standard of practice of the profession in seven of the charts she reviewed.

The assessor concluded that Dr. Marcin exposed all of the reviewed patients to harm or injury by prescribing high doses of opioid/benzodiazepines at times in combination with other medications.

The assessor concluded that Dr. Marcin showed a disregard for pharmacists who had expressed concern to Dr. Marcin regarding the risk of prescribing high doses opioids and/or benzodiazepines and in some patients a high dose of SSRI’s in conjunction with these drugs, significantly increasing the risk of Serotonin Syndrome.

Dr. Marcin issued multiple prescriptions for narcotics for eight patients in the two weeks prior to signing an undertaking with the College in which she agreed to cease to practice medicine in all jurisdictions.

The College expert concluded that Dr. Marcin displayed a lack of knowledge, skill, and judgment, and she exposed all of the patients reviewed to harm or injury. Dr. Marcin exhibited a total disregard for well-accepted guidelines for routine addiction management. By issuing multiple prescriptions, Dr. Marcin increased the risk of overdose, abuse, and diversion of drugs.

Breaches of undertakings made to the College
 
The Committee found that Dr. Marcin contravened a term, condition, or limitation on her certificate of registration in respect of her March 26, 2014 undertaking involved prescribing narcotics and other monitored drugs when she was expressly prohibited from doing so.

The Committee also found that Dr. Marcin contravened a term, condition, or limitation on her certificate of registration in respect of her December 17, 2014 undertaking.

Dr. Marcin’s breach of her December 17, 2014 undertaking involved a failure to fulfil the terms of a monitoring and rehabilitation plan. Dr. Marcin had not completed a CPD Plan and had not completed the Psychotherapy Certificate Program as she had untaken to do. While the Committee believed that Dr. Marcin has made some effort to comply with the monitoring terms, it is clear from the totality of the record that she repeatedly failed to comply. The College monitor repeatedly reminded Dr. Marcin of the terms of her undertaking throughout the monitoring.

PENALTY
 
On July 7, 2016, the Discipline Committee ordered and directed that:
 
1. The Registrar revoke Dr. Marcin’s certificate of registration effective immediately;

2. Dr. Marcin appear before the panel to be reprimanded; and

3. Dr. Marcin pay costs to the College in the amount of $10,000.00 within thirty (30) days of the date this Order becomes final.
 
Reasons for Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): January 13, February 29, 2016

Other Notifications (1)

Source: Other
Effective Date: 25 Jan 2016
Summary:
FINDINGS OF GUILT
Judi Diane Marcin was found guilty of the following offence:

1. Failing to comply with probation order requiring restitution payment to the Court, contrary to Section 733.1(1) of the Criminal Code of Canada.

DATE: September 20, 2016
SENTENCE: 21 days in jail; 12 months’ probation; Victim Surcharge of $100.

Current Tribunal Proceedings

No information available

Past Tribunal Proceedings (2)

Date of Decision: 25 Jul 2018
Summary of Decision:
On July 25, 2018 the Discipline Committee found that Judi Dianne Marcin committed an act of professional misconduct in that: she has been found guilty of an offence relevant to her suitability to practice; she has engaged in conduct or 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; she has engaged in conduct unbecoming a physician; she has failed to maintain the standard of practice of the profession; and she contravened a term, condition or limitation on her certificate of registration. The Committee also found that Judi Dianne Marcin is incompetent.

Dr. Marcin was a family physician and psychotherapist practising in Woodstock. The alleged misconduct occurred prior to July 7, 2016, when Dr. Marcin ceased to be a member of the College (the Discipline Committee ordered revocation of Dr. Marcin’s certificate of registration in a 2016 hearing).

April 2014 Undertaking (Graduated Work Hours on Return to Practice)

In April 2014, Dr. Marcin signed an undertaking to the College which set out, among other matters, that she would resume her clinical practice gradually following a period when she had not been practising. It specified the maximum hours per day and the weekdays each week that she could work.

The College’s compliance monitor’s billing analysis showed that the number of hours that Dr. Marcin spent just in providing direct psychotherapy treatment exceeded the maximum she had agreed to for all clinical activity, starting in the third week following her return to practice and continuing on in the great majority of subsequent weeks. In weeks nine to 23, for example, Dr. Marcin exceeded the 30 hours permitted in every week but one. When her maximum was then increased to 40 hours per week, Dr. Marcin exceeded this limit in 68 of the next 79 weeks. In reviewing Dr. Marcin’s appointment logs, the compliance monitor noted that Dr. Marcin had patients scheduled on the Tuesdays of weeks three and four following her return to practice. Dr.Marcin submitted claims for services on both Tuesdays and the second Thursday of weeks three and four, weekdays not permitted at that time by her undertaking. The Committee accepted the evidence of the billing analysis, in Dr. Marcin’s appointment logs and OHIP billings, the Committee found that Dr. Marcin exceeded the number of work hours permitted and worked on prohibited days of the week.

The Committee found that Dr. Marcin breached her April 2014 undertaking and contravened a term, condition or limitation on her certificate of registration. The Committee also found that Dr. Marcin engaged in disgraceful, dishonourable and unprofessional, by breaching the terms of her April 2014 undertaking and contravening a term, condition or limitation on her certificate of registration.

April 2015 Undertaking (Practice Restricted to Psychotherapy) and Registrar’s Investigation

In her April 2015 undertaking to the College, Dr. Marcin committed to immediately cease practising family medicine and to restrict her practice to psychotherapy. She consented to this restriction being a term, condition, or limitation on her certificate. Dr. Marcin acknowledged in the undertaking that she had agreed in a prior undertaking to abide by the recommendations of her clinical supervisor and that her supervisor had recommended on March 5, 2015 that she cease to practise family medicine.

A Registrar’s investigation was commenced after the College received a phone call from a pharmacist in February 2016. An expert in family medicine and psychotherapy retained by the College reviewed office charts and pharmacy information.

The Committee accepted the expert’s opinion that Dr. Marcin practised family medicine outside the scope of psychotherapy after April 16, 2015. Dr. Marcin provided care that was family medicine outside the scope of psychotherapy to 29 of the 30 patients whose office charts were reviewed and five of the eight patients with only pharmacy records. Examples of the conditions that were not within the scope of psychotherapy included many acute and chronic conditions typical of family medicine. The Committee noted from the expert’s report that within just five days of signing her undertaking, Dr. Marcin had prescribed medications to four patients for conditions that are in the scope of family medicine outside psychotherapy. Also, Dr. Marcin wrote letters to third parties on behalf of two patients, in which she identified herself as their primary or primary care physician and opined on matters that were not related to psychotherapy.

The Committee found that Dr. Marcin practised family medicine outside the scope of psychotherapy after her April 2015 undertaking to the College and therefore, breached the terms of her undertaking and contravened a term, condition or limitation on her certificate of registration.

Failed to Maintain the Standard of Practice of the Profession and Incompetence – Family Medicine

The expert found no proper history or examination in 28 of the 29 office charts of patients who Dr. Marcin was treating for family medicine conditions outside the scope of psychotherapy. In the expert’s opinion, in this pervasive lack of documentation, Dr. Marcin failed to maintain the standard of practice of the profession and showed a lack of judgment.

The expert opined that Dr. Marcin also failed to meet the standard of practice of the profession in her prescribing of lansoprazole, a type of medication used in the treatment of heartburn, reflux and stomach ulcers, by prescribing it at unnecessarily high doses, higher than recommended, without justification in three of four patients. The Committee accepted the expert’s opinion. The patients were thereby exposed to an increased risk of significant side effects. Relevant history and examination were absent from all four patient charts

Further, the expert opined about a concern conveyed in writing by a pharmacist to Dr. Marcin about her prescribing for Patient X, specifically what the pharmacist viewed as a complex regimen of multiple medications in a patient who had difficulty with remembering and concentrating. The expert indicated that the absence of any response by Dr. Marcin or change in her prescribing demonstrated a lack of judgment and was a failure to meet the standard of practice. It is a professional expectation that physicians communicate and collaborate respectfully with others involved in the provision of health care in order that patients receive safe and effective care. The Committee found that Dr. Marcin did not meet this expectation in her conduct relating to the concerns of Patient X’s pharmacist.

The Committee found that Dr. Marcin failed to maintain the standard of practice of the profession in family medicine by her pervasive failure to adequately document clinical evaluations, her improper prescribing of lansoprazole and her failure to communicate and collaborate appropriately with another health care professional.

The Committee found that Dr. Marcin showed a consistent lack of judgment and consistently failed to maintain the standard of practice in her family medicine practice, exposing her patients to the risk of harm or injury. The Committee was struck by the pervasiveness, magnitude, and persisting nature of these deficiencies. Also, in Dr. Marcin’s seriously flawed judgment, she thought it was acceptable to continue to practise family medicine almost immediately after signing the undertaking that she would cease doing so. The Committee found that Dr. Marcin’s lack of judgement is such that she is incompetent in family medicine.

Failed to Maintain the Standard of Practice of the Profession and Incompetence – Prescribing Antidepressants

The expert reviewed 30 office charts and the pharmacy records for eight additional patients. The expert identified concerns with Dr. Marcin’s prescribing of antidepressants in eight patients in total, six from among the office charts and two for whom there were only pharmacy records. Specifically, she observed that Dr. Marcin had prescribed antidepressants at very high doses and/or in combinations in these patients that exposed them to increased risk of side effects including the potentially fatal serotonin syndrome. The Committee found that Dr. Marcin failed to maintain the standard of practice of the profession and displayed a lack of judgment in her prescribing of antidepressants.

The Committee stated that the deficiencies in Dr. Marcin’s antidepressant prescribing were not isolated. Deficiencies were identified in eight of the 38 patients reviewed. Although the Committee heard no evidence of actual harm to patient, Dr. Marcin exposed her patients to increased risk, including serious and potentially fatal side effects. The Committee found that Dr. Marcin’s lack of judgment such that she is incompetent in her prescribing of antidepressants.

Disgraceful, Dishonourable or Unprofessional Conduct

The Committee stated that Dr. Marcin demonstrated serious and persistent disregard of her professional obligations by resuming family practice almost immediately after giving her undertaking to the College to cease that practice. Further, Dr. Marcin ignored her practice restriction and misrepresented herself in letters to third parties on behalf of two patients on matters not related to psychotherapy. The Committee found serious deficiencies in Dr. Marcin’s clinical care, deficiencies which have involved a significant number of patients over an extended period of time and that have exposed patients to unnecessary risk of harm. Dr. Marcin’s conduct falls far outside the legitimate exercise of professional judgment or errors in judgment and clearly reflects a serious and persistent disregard for professional values and obligations. The Committee found that Dr. Marcin’s conduct as outlined constituted disgraceful, dishonourable or unprofessional conduct.

Disgraceful, Dishonourable or Unprofessional Conduct and Failling to Maintain the Standard of Practice of the Profession – Providing Care to Family Members

Patients Z and Y were two of Dr. Marcin’s family members. There were no office charts for either. Based on a review of the pharmacy records, the expert concluded that Dr. Marcin was practising family medicine in prescribing multiple medications for her two family members over an extended period of time for a ‘multitude of conditions’ that were not minor and that did not involve emergencies. Moreover, many were chronic conditions that required ongoing care. The College's policy prohibits more than incidental or emergency treatment of family members or others with whom the physician has a close, personal relationship. Dr. Marcin’s care for her two family members met none of the criteria for an exception to the policy.

The Committee found that Dr. Marcin provided ongoing care for family members was contrary to College policy. Also, her violation of the policy was compounded by the fact that she provided care within a scope of practice from which she was prohibited, and she maintained no proper clinical records. The Committee found that by so doing, Dr. Marcin engaged in disgraceful, dishonourable or unprofessional conduct The Committee found that Dr. Marcin failed to maintain the standard of practice of the profession in her prescribing for her two family members, failing to keep proper records of their care, and willfully contravening College policy on providing care for family members.

Guilty of an Offence relevant to Suitability to Practise, Conduct Unbecoming a Physician, Disgraceful, Dishonourable or Unprofessional Conduct - 2016 Conviction for Failing to Comply with a Probation Order

The Committee found that Dr. Marcin has been found guilty of an offence relevant to her suitability to practice. Dr. Marcin was convicted on May 19, 2016 of failing to comply with the terms of a probation order, by failing to pay restitution in the amount of $100,356.60, related to a prior conviction in 2012 of defrauding OHIP. This offence was viewed as a serious one by the court, which sentenced her to 21 days in jail, 12 months’ probation and payment of the balance of the restitution, $97,856.60. Dr. Marcin’s conduct in failing to comply with the court’s order to make restitution for her OHIP fraud reflects a serious disregard of professional values and obligations. The Committee found that Dr. Marcin’s conduct in this regard also constituted conduct unbecoming a physician, as it reflects negatively on the reputation of the profession as a whole. Further, it constitutes conduct or an act or omission that is relevant to the practice of medicine and would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

Disgraceful, Dishonourable or Unprofessional Conduct - Patient A

Dr. Marcin provided psychotherapy services to Patient A between 2012 and 2016. The Committee found that Dr. Marcin asked her about her financial situation when she first became her patient, shortly after Patient A’s husband had died. Patient A was seeking help for stress and depression. Dr. Marcin asked Patient A for money to pay a bill and Patient A gave her $1,000.00. In February 2016, Dr. Marcin again told Patient A that she needed money and asked for $40,000.00. Patient A cashed in some of her savings and gave Dr. Marcin $32,000.00 as a loan. Dr. Marcin wrote out a receipt and repayment schedule when Patient A insisted. Later, when Dr. Marcin came to Patient A’s house, Patient A asked Dr. Marcin about repayment of the loan. In response, Dr. Marcin told her she needed more money and asked Patient A for $125,000.00. Dr. Marcin said to her, “You’re mean” when she refused. Patient A testified that she has never received any repayment, despite retaining a lawyer who wrote to Dr. Marcin.

The Committee found that Patient A was a vulnerable patient, whom Dr. Marcin took advantage of almost from the time she first became her patient. Dr. Marcin took little account of Patient A’s interests, allowed her own personal needs to dominate their relationship, and repeatedly grossly violated professional boundaries. Dr. Marcin’s telling Patient A that she was ‘mean’ when Patient A refused to give her even more money was a further reflection of Dr. Marcin’s profound disregard for even basic professional values and obligations.

Disposition

On July 27, 2018, the Discipline Committee ordered that:

- the Registrar revoke Judi Dianne Marcin’s certificate of registration effective immediately.

- Judi Dianne Marcin appear before the panel to be reprimanded.

- Judi Dianne Marcin pay to the College its costs of this proceeding in the amount of $30,540.00 within thirty (30) days from the date this Order becomes final.
 
Reasons for Decision: Download Full Decision (PDF)
Hearing Date(s): Hearing: July 24-25, 2018; Penalty Hearing: July 27, 2018
Date of Decision: 30 Mar 2016
Summary of Decision:
On March 30, 2016, the Discipline Committee of the College of Physicians and Surgeons of Ontario found that Dr. Judi Dianne Marcin committed an act of professional misconduct in that she has been found guilty of an offence relevant to her suitability to practice; engaged in conduct which would reasonably be regard by members as disgraceful, dishonourable or unprofessional; failed to maintain the standard of practice of the profession; contravened terms, conditions, or limitations on her certificate of registration; and engaged in conduct unbecoming a physician.

The Committee also found that Dr. Marcin is incompetent as defined by the Code.

CRIMINAL CONVICTION
 
On March 22, 2012, Dr. Marcin was convicted of defrauding the Ministry of Health and Long-Term Care of $100,356.60 contrary to s. 380(1)(a) of the Criminal Code. Dr. Marcin received a suspended sentence and 18 months’ probation. She was ordered to perform 100 hours of community service and to make $100,356.60 in restitution.
 
DR. MARCIN AND PATIENT A
 
In 2002, Patient A began seeing Dr. Marcin after he was referred to her by a counsellor at a residential treatment center where he had been receiving treatment for addiction. Dr. Marcin was Patient A’s psychotherapist as well as his family doctor.

In approximately March 2010, Patient A told Dr. Marcin that he had developed romantic feelings her. Dr. Marcin explained to him that his romantic feelings were not for her personally but for an ideal of someone like her.

Between April 2010 and June 2010, records demonstrate that 17 separate phone calls took place between Dr. Marcin and Patient A outside office hours while Dr. Marcin was still providing care to Patient A.

In the summer of 2010, Dr. Marcin told Patient A that she would be vacationing in an area in Ontario.

Patient A concocted a story about his substance abuse sponsor heading to a retreat in the same area and explained that, if Dr. Marcin could give him a ride, Patient A would then be able to meet his sponsor at that retreat. Dr. Marcin agreed.

Once at Hotel Z, Patient A revealed to Dr. Marcin that he had invented the entire story to be alone with her in an attempt to initiate a romantic relationship.

Dr. Marcin expressed her disappointment with Patient A for misleading her, telling him that she was hurt that he had lied to her, and that she had to fire him as her patient.

Nevertheless, Dr. Marcin allowed Patient A to sleep on her hotel room floor at Hotel Z for the duration of the multi-day vacation.

On the dates in August 2010 in which Dr. Marcin allowed Patient A to stay with her in her room at Hotel Z, several other vacant rooms were available at Hotel Z. There were also approximately 20 other hotels in the surrounding area.

On the drive home from Hotel Z in August 2010, Dr. Marcin told Patient A he should no longer see her as his doctor. However, Dr. Marcin continued to fill his prescriptions after this date.

Phone records demonstrate that Dr. Marcin and Patient A spoke on the phone and texted multiple times between August 2010 and February 2011.

In his letters, Patient A had indicated that he and Dr. Marcin could write emails while logged into the Gmail account but leave them in the draft folder as a way of communicating without actually having to send an email. Dr. Marcin accessed the shared Gmail account on or after May 18, 2010 and composed and/or read emails in the drafts folder of the account.

The College-retained information systems expert recovered 12 emails and email fragments written between October 2010 and January 2011 which had been deleted from Dr. Marcin’s computer.

On December 18, 2012, the College received Dr. Marcin’s original patient chart for Patient A, containing a letter from Dr. Marcin to Patient A bearing a date in November 2010 purporting to formally terminate her doctor-patient relationship with Patient A. However, the information systems expert determined that the document entitled “letter of termination [Patient A] nov 2010.wps”, bearing a date in November 2010, was in fact created by Dr. Marcin on December 5, 2012.

OHIP BILLING RE PATIENT A

Among other billing and record-keeping issues, between 2009 and 2011, Dr. Marcin billed for OHIP 93 times for individual psychotherapy for Patient A for which there are no corresponding patient notes. This includes billing for services in August 2010 while she was with Patient A at Hotel Z.

Patient A told the College he did not receive psychotherapy on weekends. In 2010, Dr. Marcin billed OHIP 36 times for individual psychotherapy for Patient A on Saturdays.

FAILING TO MAINTAIN THE STANDARD OF PRACTICE, INCOMPETENCE, AND DISGRACEFUL, DISHONOURABLE AND UNPROFESSIONAL CONDUCT RE PRESCRIBING
 
On February 11, 2013, the Inquiries, Complaints and Reports Committee (“ICRC”) imposed terms on Dr. Marcin’s certificate of registration, ordering that she retain a Health Monitor. On October 21, 2013, the ICRC gave notice of its intention to vary that Order based on information that Dr. Marcin may be in breach of it.

On November 11, 2013, Dr. Marcin entered into an undertaking with the College, in which she agreed to cease to practise medicine in all jurisdictions. Prior to entering into this November 11 Undertaking, Dr. Marcin issued 8 patients multiple prescriptions for narcotics between November 1 and November 11, 2013.

The College expert found that Dr. Marcin’s November 1 to 11, 2013 prescribing of Narcotic Drugs, Narcotic Preparations, Controlled Drugs, Benzodiazepines/Other Targeted Substances, and all other Monitored Drugs failed to maintain the standard of practice of the profession in seven of the charts she reviewed.

The assessor concluded that Dr. Marcin exposed all of the reviewed patients to harm or injury by prescribing high doses of opioid/benzodiazepines at times in combination with other medications.

The assessor concluded that Dr. Marcin showed a disregard for pharmacists who had expressed concern to Dr. Marcin regarding the risk of prescribing high doses opioids and/or benzodiazepines and in some patients a high dose of SSRI’s in conjunction with these drugs, significantly increasing the risk of Serotonin Syndrome.

Dr. Marcin issued multiple prescriptions for narcotics for eight patients in the two weeks prior to signing an undertaking with the College in which she agreed to cease to practice medicine in all jurisdictions.

The College expert concluded that Dr. Marcin displayed a lack of knowledge, skill, and judgment, and she exposed all of the patients reviewed to harm or injury. Dr. Marcin exhibited a total disregard for well-accepted guidelines for routine addiction management. By issuing multiple prescriptions, Dr. Marcin increased the risk of overdose, abuse, and diversion of drugs.

Breaches of undertakings made to the College
 
The Committee found that Dr. Marcin contravened a term, condition, or limitation on her certificate of registration in respect of her March 26, 2014 undertaking involved prescribing narcotics and other monitored drugs when she was expressly prohibited from doing so.

The Committee also found that Dr. Marcin contravened a term, condition, or limitation on her certificate of registration in respect of her December 17, 2014 undertaking.

Dr. Marcin’s breach of her December 17, 2014 undertaking involved a failure to fulfil the terms of a monitoring and rehabilitation plan. Dr. Marcin had not completed a CPD Plan and had not completed the Psychotherapy Certificate Program as she had untaken to do. While the Committee believed that Dr. Marcin has made some effort to comply with the monitoring terms, it is clear from the totality of the record that she repeatedly failed to comply. The College monitor repeatedly reminded Dr. Marcin of the terms of her undertaking throughout the monitoring.

PENALTY
 
On July 7, 2016, the Discipline Committee ordered and directed that:
 
1. The Registrar revoke Dr. Marcin’s certificate of registration effective immediately;

2. Dr. Marcin appear before the panel to be reprimanded; and

3. Dr. Marcin pay costs to the College in the amount of $10,000.00 within thirty (30) days of the date this Order becomes final.
 
Reasons for Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): January 13, February 29, 2016

Other Notifications (1)

Source: Other
Effective Date: 25 Jan 2016
Summary:
FINDINGS OF GUILT
Judi Diane Marcin was found guilty of the following offence:

1. Failing to comply with probation order requiring restitution payment to the Court, contrary to Section 733.1(1) of the Criminal Code of Canada.

DATE: September 20, 2016
SENTENCE: 21 days in jail; 12 months’ probation; Victim Surcharge of $100.

Training

Medical School: Schulich School of Medicine and Dentistry, Western University, 1991

Registration History

DETAILS DATE
Revoked: Discipline Committee. Effective: 27 Jul 2018
Revoked: Discipline Committee. Effective: 07 Jul 2016
Terms and conditions amended by Member. Effective: 16 Apr 2015
Terms and conditions amended by Member. Effective: 21 Apr 2014
Terms and conditions amended by Member. Effective: 26 Mar 2014
Terms and conditions amended by Member. Effective: 11 Nov 2013
Transfer of class of registration to: Restricted Certificate Effective: 14 Feb 2013
Arrow_iconTerms and conditions imposed on certificate by: Inquiries, Complaints and Reports Committee Effective: 14 Feb 2013
Expired: Terms and conditions imposed on certificate by Registration Committee Effective: 20 Nov 2003
Subsequent certificate of registration issued: Independent Practice Certificate Effective: 20 Nov 2003
Subsequent certificate of registration issued: Restricted Certificate Effective: 18 Aug 1995
Arrow_iconTerms and conditions imposed on certificate by: Registration Committee Effective: 18 Aug 1995
Expired: Terms and conditions of certificate of registration Effective: 28 Feb 1995
Subsequent certificate of registration issued: Postgraduate Education Certificate Effective: 16 May 1994
Expired: Terms and conditions of certificate of registration Effective: 30 Jun 1993
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1991
DETAILS: Revoked: Discipline Committee.
Date: Effective: 27 Jul 2018
DETAILS: Revoked: Discipline Committee.
Date: Effective: 07 Jul 2016
DETAILS: Terms and conditions amended by Member.
Date: Effective: 16 Apr 2015
DETAILS: Terms and conditions amended by Member.
Date: Effective: 21 Apr 2014
DETAILS: Terms and conditions amended by Member.
Date: Effective: 26 Mar 2014
DETAILS: Terms and conditions amended by Member.
Date: Effective: 11 Nov 2013
DETAILS: Transfer of class of registration to: Restricted Certificate
Date: Effective: 14 Feb 2013
DETAILS: Terms and conditions imposed on certificate by: Inquiries, Complaints and Reports Committee
Date: Effective: 14 Feb 2013
DETAILS: Expired: Terms and conditions imposed on certificate by Registration Committee
Date: Effective: 20 Nov 2003
DETAILS: Subsequent certificate of registration issued: Independent Practice Certificate
Date: Effective: 20 Nov 2003
DETAILS: Subsequent certificate of registration issued: Restricted Certificate
Date: Effective: 18 Aug 1995
DETAILS: Terms and conditions imposed on certificate by: Registration Committee
Date: Effective: 18 Aug 1995
DETAILS: Expired: Terms and conditions of certificate of registration
Date: Effective: 28 Feb 1995
DETAILS: Subsequent certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 16 May 1994
DETAILS: Expired: Terms and conditions of certificate of registration
Date: Effective: 30 Jun 1993
DETAILS: First certificate of registration issued: Postgraduate Education Certificate
Date: Effective: 15 Jun 1991