Discipline Case Summary

The following is a summary of a matter placed before a five-member panel of the Discipline Committee of the College of Physiotherapists of Ontario on February 4, 2002.

In this matter, the panel of the Discipline Committee considered and accepted a Joint Submission on Finding and found Mr. Doig guilty of professional misconduct, on the basis set out in the Joint Submission on Finding, that he sexually abused the complainant.

The Hearing

The College proceeded on the basis of allegations in the notice of hearing that Mr. Doig was guilty of professional misconduct as defined in clause 51 (1)(b.1) (sexual abuse) of the Health Professions Procedural Code and paragraphs 2 (standards of practice), 5 (abusing a patient physically and verbally) and 25 (unprofessional conduct) of the College's Professional Misconduct Regulation (Ontario Regulation 861/93, Professional Misconduct, Physiotherapy Act, 1991).

A Notice of Hearing, Joint Submission of Finding, the patient's chart and a Joint Submission on Order were filed as exhibits with the panel of the Committee.

The panel also received a written impact statement by the complainant and three letters of reference in relation to Mr. Doig. Mr. Doig had been represented by legal counsel but chose to attend at the hearing without counsel. Mr. Doig had signed the Joint Submission of Finding, attesting to the authenticity of the evidence presented.

The Facts

The facts agreed to and set out in the Joint Submission on Finding were as follows:

1. Graham Doig was a duly registered physiotherapist working at Harwood Rehabilitation and Sports Injury Clinic in Ajax, Ontario.
2. Ms. B. was a sales representative for a company providing supplies to the Clinic. As a part of her job, she would give him gifts such as coffee and donuts, chocolates and a bottle of scotch whiskey.
3. On Friday, January 5, 2001, Ms. B. had acute back pain and asked Mr. Doig to see her. He agreed to see her at around noon even though that was outside his normal clinic hours. She became Mr. Doig's patient for that day.
4. On Friday, January 5, 2001, Mr. Doig assessed and treated Ms. B. for acute back pain. During the course of the treatment and follow-up, Mr. Doig:
   • Massaged Ms. B.'s lower back, mid-back and upper buttocks for about an hour. This procedure was done with proper towel draping and did not make Ms. B. uncomfortable.
   • Had Ms. B. do stretches, some of which were assisted by him, in his presence with only thong underpants and a tank top on. These stretches were done with Ms. B. lying on her back on a plinth with Mr. Doig beside her and assisting her. The stretches included bringing her knees up to her opposite shoulders one at a time while the other leg was over the side of the table with Mr. Doig pushing the knee towards the shoulder. Another procedure required Ms. B. to sit with one leg across the other with Mr. Doig putting his hands on her shoulders.
   • Discussed Ms. B.'s tattoo and commented that he had a similar tattoo. The tattoo was located in her lower abdominal area and was half covered by the lace of her thong underpants.
   • Then had Ms. B. stand up. She was still only in her tank top and her thong underpants. Most of the time, Mr. Doig was behind Ms. B. although she would have faced him for part of this time. Mr. Doig rubbed Ms. B.'s back and shoulders and then touched her breasts.
5. Mr. Doig and Ms. B. were alone at the clinic for most of this session.
6. Mr. Doig waived his fee for the visit.
7. During Mr. Doig's and Ms. B.'s previous contacts, they had discussed personal matters including difficulties in their respective marriages and families.
8. At the conclusion of the visit, Ms. B. gave Mr. Doig the rolls of leuktape she had brought and, in what she later described as trying to deal with the awkwardness of the moment, suggested they have lunch together.
9. On Monday, January 8, 2001, Mr. Doig telephoned Ms. B. and discussed the visit of the previous Friday.
10. Attached to this statement of agreed facts was the chart for Ms. B. submitted to the College by Mr. Doig.
11. The conduct agreed to above, taken as a whole and considering all of the surrounding circumstances, constitutes sexual abuse as defined in the Health Professions Procedural Code.

The Decision

The panel accepted the Joint Submission on Finding and found Mr. Doig guilty of professional misconduct, on the basis set out in the Joint Submission on Finding, that is, that he sexually abused the complainant.

The mitigating factors in this case, as presented by counsel for the College were: (1) this was the first offence for Mr. Doig in his 27 years of professional practice; (2) this was a single incident; (3) Mr. Doig was co-operative with the process; and (4) he had three letters of reference attesting to his good character. On the other hand, the aggravating factors, also presented by counsel for the College, were as follows: (1) this was a very serious offence ranging from lack of draping to touching of breasts; (2) this involved a trust situation in which the complainant was a patient and was undressed; (3) the touching did not involve consent; and (4) Mr. Doig and the complainant were alone at the clinic for most of the session.

The panel accepted the Joint Submission on Order. The panel felt that it must send a strong message to Mr. Doig and to all members of the physiotherapy profession. The public must know that physiotherapists must carry out their duties and responsibilities with dignity and with respect for the patient.

The Penalty

The panel made the following order regarding penalty:

1. That the certificate of registration of Mr. Doig be suspended for a period of three months.
2. That it be a term, condition and limitation upon the certificate of registration of Mr. Doig that he successfully complete, in the opinion of the Registrar, at least two courses consisting of at least six hours of instruction on the maintenance of boundaries and the prevention of sexual abuse within six months of today's date.
3. That it be a term, condition and limitation upon the certificate of registration of Mr. Doig that he successfully complete, in the opinion of the Registrar, a course of remediation over a period of about 12 months regarding the maintenance of boundaries and the prevention of sexual abuse, that includes the following:
4. Fully co-operating with a remediator appointed by the College at two meetings where the remediator will review and evaluate Mr. Doig's current policies, procedures and practices regarding the maintenance of boundaries and the prevention of sexual abuse and provide a written report with any recommendations.
5. Implementing any recommendations made by the remediator.
6. Paying for the costs of the remediation sessions (maximum $500 each) within 30 days of being invoiced.
7. That it be a term, condition and limitation upon the certificate of registration of Mr. Doig that he successfully complete, in the opinion of the Registrar, a follow-up evaluation to assess whether Mr. Doig has successfully integrated the information learned in the course of remediation, that includes the following:
8. Undergoing the evaluation, which will take place about six months after the course of remediation.
9. Fully co-operating with an evaluator appointed by the College at one meeting where the evaluator will review and evaluate Mr. Doig's procedures and practices regarding the maintenance of boundaries and the prevention of sexual abuse and provide a written report.
10. Paying for the costs of the evaluation (maximum $500) within 30 days of being invoiced for them.
11. That it be a term, condition and limitation upon the certificate of registration of Mr. Doig that he not act as a supervisor for a holder of a supervised practice certificate of registration or under any arrangement in which a supervisor is required for another member by the College until he has satisfactorily fulfilled paragraphs 1 to 4 of this order.
12. That Mr. Doig reimburse the College for any funding provided to Ms. B. for therapy and counselling under section 85.7 of the Health Professions Procedural Code.

The panel of the Discipline Committee believed that this penalty would protect the public and serve the objectives of general and specific deterrence, both paramount objectives in this case.

The panel's written decision and reasons was issued on April 10, 2002.