Defendant breached policy on 'treatment of persons close to the clinician,' tribunal said
The Ontario Physicians and Surgeons Discipline Tribunal (OPSDT) has found a male doctor guilty of professional misconduct after providing treatment and prescribing medication to a female colleague with whom he had a sexual relationship.
In College of Physicians and Surgeons of Ontario v. Bahrgard Nikoo, 2022 ONPSDT 15, the defendant, Bahrgard Nikoo, and X were both physicians. X was a junior colleague of the defendant at hospitals A and B. In 2016, they entered into a sexual relationship. X had difficulty rejecting the defendant’s advances as she feared for her job security and reputation should the situation come to light. Their relationship ended in 2018.
After a trip abroad, X began feeling unwell, and a doctor advised her to come to hospital A for a medical procedure. Although X had another attending physician when hospital A admitted her, the defendant was always present. X then requested that the defendant perform the medical procedure. X’s treatment was eventually transferred to another doctor, who later discharged her with a prescription for opioid pain relievers.
The defendant advised X that her medication was insufficient to tide her over and prescribed a higher dose of the same opioid medicine. Their relationship resumed in 2020. After a few months, X filed a disciplinary complaint against the defendant.
The defendant entered a plea of no contest. He and the College of Physicians and Surgeons of Ontario (CPSO) jointly proposed the penalty of reprimand, 12-month suspension of his certificate of registration, and costs of $6,000.
In its decision, the OPSDT found that the defendant committed professional misconduct and upheld the proposed penalty.
According to OPSDT, the defendant’s conduct involving X was inappropriate, unprofessional, and inconsistent with expectations set out in CPSO policies, including those that address maintaining appropriate boundaries and physician behaviour in the professional environment.
“Among other things, physician responsibilities to other health care professionals include ensuring a healthy work environment by working respectfully with other members of the health care team and fostering a culture of respect within their workplace,” the OPSDT said.
The defendant’s conduct toward X also violated hospital workplace policies, including expectations relating to sexual harassment, discrimination, and disruptive behaviour, the OPSDT added.
Moreover, the OPSDT ruled that the defendant breached the CPSO policy on the “treatment of persons close to the physician.”
“To ensure that a physician’s ability to maintain the necessary amount of emotional and clinical objectivity is not compromised thereby potentially impacting the quality of care, the policy prohibits physicians from providing treatment to persons who have a personal or close relationship with them,” the OPSDT said.
The OPSDT said that the only exception to this rule is treating a minor condition or in an emergency when another qualified health care professional is not readily available.
“That was not the case here,” the OPSDT said. “In treating X with whom he had a prior sexual relationship outside the limited circumstances permitted by the CPSO policy, the [defendant] violated that policy.”
The OPSDT also determined that the defendant’s opioid prescription to X was “problematic in other respects.”
“After completing the procedure and in the absence of an ongoing therapeutic relationship with X, it was inappropriate for the [defendant] to prescribe for X,” the OPSDT said. “It was particularly inappropriate for him to prescribe a higher dose of opioids to X, particularly as her treating physician had been tapering the dose.”
The OPSDT found that the proposed penalty is “not contrary to the public interest” since the misconduct involved in this case was deemed serious.
“The [defendant] undermined X’s confidence in her critical care abilities and the security of her job and misused his position of power over her to make sexual advances toward her, which she had difficulty rejecting due to his role,” OPSDT said.