On April 28, 2016, the Discipline Committee of the College of Physicians and Surgeons of Ontario found that Dr. Creighton Hui committed an act of professional misconduct in that the governing body of a health profession in a jurisdiction other than Ontario has found that Dr. Hui committed an act of professional misconduct that would, in the opinion of the Committee, be an act of professional misconduct as defined under Ontario legislation.
BACKGROUND
Dr. Creighton Hui has practised emergency medicine at a hospital in Ontario since February 2012. Prior to that, Dr. Hui lived in Manitoba for a fellowship in emergency medicine.
In August 2010, Dr. Hui began seeing patients at Clinic A in Manitoba and providing house calls.
Between April 2011 and January 2012, Dr. Hui entered into an arrangement with a nurse practitioner from Clinic; the nurse practitioner would make house call visits to patients which would be billed to Manitoba Health in Dr. Hui’s name.
The nurse practitioner proposed that Dr. Hui could attend house call visits via live video stream. While Dr. Hui did attend some house call visits by live video stream, he did not attend all of them.
For these visits described above, the nurse practitioner would enter Dr. Hui’s user identifier and password in the electronic medical record. It was therefore unclear from the medical record that Dr. Hui had not personally attended the patient or made the entry.
To facilitate this arrangement, Dr. Hui gave the nurse practitioner his password for the electronic medical record system so that the nurse practitioner could sign on and make chart entries under Dr. Hui’s name.
This was done in spite of the fact that the nurse practitioner had his own user identifier and password, could have made entries under his own name, and could have written prescriptions under his own name.
Between April 2011 and January 2012, Manitoba Health was billed approximately $201,223.00 for house call services provided by the nurse practitioner and billed in the name of Dr. Hui. Dr. Hui ultimately voluntarily repaid the entire $201,223.00 to Manitoba Health.
The College of Physicians and Surgeons of Manitoba (the “CPSM”) commenced an investigation of Dr. Hui in February 2012. During the investigation, Dr. Hui made a number of statements to the CPSM that he subsequently admitted were not true, for example that he supervised all patient visits by the nurse practitioner via live video link as well as that he subsequently reviewed all of the nurse practitioner’s chart entries.
Dr. Hui subsequently admitted that he was not always present on the video link system; that he believed he should have been present on the video link system to comply with Manitoba Health’s fee guideline; that he did not always review the nurse practitioner’s chart entries; and that he never left the hospital when he may have been required on an urgent basis.
An Inquiry Panel of the CPSM held proceedings regarding Dr. Hui’s conduct and found that Dr. Hui had committed acts of professional misconduct. Because Dr. Hui was not licensed to practice in Manitoba at the time of the hearing, the penalty ordered by the CPSM Inquiry Panel was a reprimand, a fine of $10,000 in lieu of a period of suspension, costs of $28,160.25 payable to the CPSM, and publication of Dr. Hui’s name and the Inquiry Panel’s decision.
Dr. Hui cooperated with the Ontario College’s investigation into his conduct in Manitoba.
PENALTY AND COSTS
Having stated the findings in paragraph 1 of its written order of April 28, 2016, on the matter of penalty and costs, the Committee ordered and directed that:
2. The Discipline Committee ordered Dr. Hui to attend before the panel to be reprimanded.
3. The Discipline Committee directed the Registrar to suspend Dr. Hui’s certificate of registration for a period of five (5) months, commencing from May 29, 2016 at 12:01 a.m.
4. The Discipline Committee directed the Registrar to place the following terms, conditions and limitations on Dr. Hui’s certificate of registration:
a. Dr. Hui will participate in and successfully complete, within 6 months of the date of this Order, individualized instruction in medical ethics with an instructor approved by the College, with a report or reports to be provided to the College regarding Dr. Hui’s progress and compliance;
b. For a period of one year after he resumes practice following the suspension of his
certificate of registration described in paragraph 3, Dr. Hui will, at his own expense, retain a practice monitor approved by the College who will sign an undertaking in the form attached hereto as Schedule “A” (the “Practice Monitor”) to review Dr. Hui’s Ontario Health Insurance Plan (“OHIP”) billings and the corresponding patient records to ensure his compliance with the Health Insurance Act, as follows:
i. In respect of Dr. Hui’s Emergency Medicine practice, the Practice Monitor will review once every month Dr. Hui’s ER triage records and the associated billings submitted to OHIP for a minimum of ten percent (10%) of Dr. Hui’s patient encounters;
ii. In respect of any house call practice of Dr. Hui during the one-year period of monitoring, Dr. Hui will notify the College if he resumes providing house calls, in which case the Practice Monitor will review once every month Dr. Hui’s patient records and the associated billings submitted to OHIP for a minimum of twenty-five percent (25%) of Dr. Hui’s patient encounters or, if Dr. Hui’s house call practice volume is greater than a volume of approximately 30-50 patients per month, a reasonable number or percentage of patient records to be determined by the College based on the volume of Dr. Hui’s house call practice when resumed;
iii. In respect of any other practice of Dr. Hui during the one-year period of monitoring, Dr. Hui will notify the College prior to commencing such practice and the Practice Monitor will review once every month a reasonable number or percentage of Dr. Hui’s patient records and associated billings submitted to OHIP in respect of this practice, with the number or percentage of patient records to be determined by the College based on the volume of this practice once known;
iv. The Practice Monitor will be solely responsible for randomly selecting the patient records to be reviewed in accordance with paragraph 4b of this Order;
v. Dr. Hui shall provide his Practice Monitor with his monthly OHIP reconciliation from all Practice Locations, as defined below, and the Practice Monitor shall review the reconciliation;
c. If a Practice Monitor who has given an undertaking in Schedule “A” to this Order is unable or unwilling to continue to fulfill its terms, Dr. Hui 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;
d. If Dr. Hui is unable to obtain a Practice Monitor in accordance with the terms of this Order, he shall cease to remit billings to OHIP until such time as he has done so;
e. Dr. Hui shall consent to the disclosure by his Practice Monitor to the College, and by the College to his Practice Monitor, of all information the Practice Monitor or the College deems necessary or desirable in order to fulfill the Practice Monitor’s undertaking and to monitor Dr. Hui’s compliance with this Order;
f. For a period of one year after he resumes practice following the suspension of his certificate of registration described in paragraph 3, Dr. Hui shall inform the College of each and every location where he practices including, but not limited to hospitals, clinics, and offices, in any jurisdiction (collectively, his “Practice Location(s)”), within fifteen (15) days of this Order, and shall inform the College of any and all new Practice Locations within 15 days of commencing practice at that location, for the purposes of monitoring his compliance with this Order;
g. For a period of one year after he resumes practice following the suspension of his certificate of registration described in paragraph 3, Dr. Hui shall submit to, and not interfere with, unannounced inspections of his Practice Location(s) and patient records by
a College representative for the purposes of monitoring his compliance with this Order;
h. Dr. Hui shall provide consent to the College to make appropriate enquiries of OHIP, for a period of one year after he resumes practice following the suspension of his certificate of registration described in paragraph 3, for the purpose of monitoring his compliance with the terms of this Order; and
i. Dr. Hui shall be responsible for any and all costs associated with implementing the terms of this Order.
5. The Discipline Committee ordered Dr. Hui to pay to the College costs in the amount of $5,000, within thirty (30) days of the date of this Order.
Terms and conditions imposed on certificate by: Discipline Committee
