A Val Caron family doctor will be suspended for three months starting Dec. 16 and have to take an ethics and boundaries program following a discipline hearing in Toronto late last month.
A College of Physicians and Surgeons of Ontario (CPSO) discipline committee ruled that Dr. Paul Malette acted in a way that could be considered as disgraceful, dishonourable or unprofessional.
Dr. Malette, 63, has been a doctor since 1985 and works out of the Val Caron clinic of the City of Lakes Family Health.
The finding stemmed from an agreed statement of facts and an admission by Malette to the discipline committee.
The hearing was held after a long-time female patient of Malette’s filed a complaint.
According to the agreed statement of facts, Malette began hugging the patient starting about 2005 at the end of every appointment in his examination room. During some hugs, Malette’s cheek and/or lips made contact with the patient’s cheek, giving her the impression he was trying to kiss her.
The hugs, however, were unwelcomed and they made the patient feel extremely uncomfortable.
In September of 2008, the college revised its policy on Maintaining Appropriate Boundaries and Preventing Sexual Abuse to include the guideline that doctors avoid physical contact with patients except when required to perform medically necessary examinations.
Malette’s routine of hugging the patient, as a result, did not comply with the guideline from that point on.
When the patient complained to Malette in 2009 that she had a loss of libido and sensation in her genital area, and then complained of numbness in the genitals inhibiting sexual functioning, Malette examined her genital area. He did a bimanual examination, a Pap test, and palpation of her vulva and clitoris.
While palpating her genitals, Malette asked the patient to compare the loss of sensation she was experiencing during the examination with the loss of sensation she experienced during sex with her husband.
The question upset the patient.
Malette did not adequately explain the examination and the purpose of his question to the patient before the examination, the college said. The inadequate explanation alarmed the patient.
Malette then hugged the patient at the end of her appointment.
Although the woman remained a patient of Malette’s for several years, she did not return to him for another pelvic examination. Her next Pap test was conducted six years later with a female registered practical nurse.
In addition to the three-month suspension, Malette has to complete and pass the PROBE Ethics & Boundaries Program offered by the Centre for Personalized Education for Professionals within six months.
Malette must also not conduct any pelvic, genital and/or rectal examination of any patient, of any age, in any jurisdiction, unless the examination takes place in the continuous presence and under the continuous observation of a monitor who is a regulated health professional acceptable to the CPSO.
The supervising practice monitor must be present when such examinations occur either at the Val Caron clinic or at Health Sciences North, where Malette has privileges.
As well, Malette shall inform his patients of the indication for any such examinations he may perform and shall document the discussion on the patient chart, and that the supervising practice monitors shall maintain logs of all such examinations Malette conducts to be made available to the CPSO upon request.
Malette must also ensure that the original logs are submitted to the college monthly.
A clearly visible sign must also be posted in all waiting, examination and consulting rooms in Malette’s office-based practice that states “Dr. Malette must not conduct pelvic, genital and/or rectal examinations of any kind unless in the continuous observation of a practice monitor acceptable to the College of Physicians and Surgeons of Ontario. Dr. Malette must not be alone with patients during pelvic, genital and/or rectal examinations. Further information may be found on the College website at www.cpso.on.ca.”
Malette also shall submit to and not interfere with unannounced inspections of his practice locations and to the inspection of patient records by the college and to any other activity the college deems necessary to monitor his compliance with the provisions of the order.
Malette was also ordered to pay costs of $10,370.
In July 2018, the City of Lakes Family Health Team said in a statement it was aware of the allegations against Malette, one of its affiliated physicians.
“The safety and well-being of our patients is paramount to all members of our Family Health Team,” it said. “Dr. Malette has denied the allegations and is complying with all clinical conditions and requirements of the (College of Physicians and Surgeons of Ontario).”
Mallete, who was headed to a discipline committee hearing at the time, was alleged to have “sexually abused Patient A and engaged in disgraceful, dishonourable or unprofessional conduct towards Patient A,” the college said in a summary of allegations against the doctor.
The college said Malette allegedly tried “kissing and/or attempting to kiss her, by touching her body, including her genital area, in a manner that was sexual and/or inappropriate, by breaching boundaries, and by making inappropriate remarks and remarks of a sexual nature towards Patient A.”