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CBC
01-07-2025
- Health
- CBC
Plastic surgeon's 6-week suspension for professional misconduct 'slap on the wrist': former patient
Social Sharing A Manitoba woman who was injured by a plastic surgeon more than a decade ago is worried after the doctor was temporarily suspended for medical errors — and she wants the disciplinary system to change to protect others. For six years, Melanie Drain lived with the end of a drainage tube inside her breast. She says the piece of equipment broke off when her plastic surgeon, Dr. Manfred Ziesmann, yanked the tube days after he performed a breast reduction surgery on her in 2010. Drain, who lives in Stony Mountain, Man., complained to the College of Physicians and Surgeons of Manitoba. In 2017, Ziesmann was reprimanded and ordered to take a record-keeping course, with the college determining he had failed to include enough information in her medical record, she said. At the time, she felt the decision didn't go far enough and feared more patients would be injured. When Ziesmann, who has been licensed as a plastic surgeon since 1987, was disciplined earlier this year for professional misconduct in connection with three other patients he treated after her, Drain felt her fears were confirmed. "If the College of Physicians and Surgeons had done something more in 2017, this might have saved other people from going through any type of physical harm [like] I had from him," she told CBC News. During a March disciplinary hearing, Ziesmann admitted to displaying "a lack of knowledge, skill and judgment in the practice of medicine" in all three cases, involving surgical procedures for three patients from 2012 to 2023. Under a joint recommendation with the college, he was given a six-week suspension, which began on March 24. He was also ordered to pay the college more than $34,000 in costs. That suspension is a "slap on the wrist" considering the number of complaints involving Ziesmann, which go back decades, said Drain. Gaps in record-keeping Drain appealed the college's decision in her case in 2019, but the regulatory body dismissed it. In a letter shared with CBC, the college said there were no errors in the investigation. The appeal panel also found the doctor didn't show unethical behaviour or professional misconduct in her case, and the breakage of the tube is a known surgical complication. Ziesmann's participation in the record-keeping course offered reassurance to the panel, the letter said. However, the college's latest decision says he admitted to not adhering to the standard of documentation set out by the college. One of Ziesmann's patients signed a consent indicating a larger breast implant would be inserted in her right breast, and a smaller implant in the left — even though the right breast, which already had an implant, was larger than the left. However, the decision said there was no discussion about implant size in his chart notes for meetings with the patient in 2021 and 2022. During the surgery, Ziesmann inserted the larger implant into the left breast and the smaller implant into the right breast, "contrary to the consent form," according to the decision. Ziesmann also admitted he didn't document "sufficient steps" involving the identification of a lesion on another patient, who had developed skin cancer, in 2023, the decision said. Gaps in Ziesmann's record-keeping were also found in the care he provided another patient, who complained about breast augmentation surgery and other procedures between 2012 and 2022. In its decision, the inquiry panel said Ziesmann had a professional obligation to document the conversations he had with that patient on treatment options but failed to do so, breaching various standards of medical practice over the 10 years he treated her. Drain said the similarities between her case and those referred to in the regulator's most recent disciplinary action are concerning. "A person shouldn't be allowed to keep repeating history over and over and over," she said. Ziesmann's lawyer said he would not comment on any specific patient or allegations, except to say that all surgeries carry the risk of many types of complications. "It would be premature and perhaps erroneous to come to any conclusion about any patient complaint without a full and complete understanding of all of the facts and medical issues involved," lawyer Gregory Fleetwood said in an emailed statement. 'College has to prove itself trustworthy': prof While Ziesmann's case points to a number of serious medical mistakes, Arthur Schafer, a professor at the University of Manitoba specializing in bioethics, said it is hard for outside parties to determine whether the college's judgment on a doctor was strong enough. College panels review a great deal of evidence to determine disciplinary action, some of which is not publicly released, so it can be difficult to know how they came to a decision, said Schafer. In this case, he thinks the college did take steps to safeguard the public, referencing both interim conditions Ziesmann was under before the college's March decision — including that he be monitored during surgeries while the college investigated — and the final decision to temporarily suspend him. "That's pretty rigorous," Schafer said. "He will be more carefully monitored than maybe any other physician in the province." But Schafer — who was a patient of Ziesmann's many years ago — said in general, the public should be concerned when physicians repeatedly make mistakes, because it suggests a lack of monitoring. He also said generally, the reason a doctor's licence might not have been revoked is because the college's panel thinks their behaviour can be corrected while protecting the public. "One has to hope that the performance of the college will be more rigorous going forward than perhaps what it has been up until now" in Ziesmann's case, said Schafer, noting it involves repeated mistakes with patient note-taking — a task that is paramount in medical practice, especially as patients are treated by different people. "If the patient's medical record isn't accurate and complete, then discovering what's gone wrong, correcting it, becomes that much more difficult," he said. The disciplinary panel in Ziesmann's March hearing also highlighted the importance of patient record-keeping, citing a decision from Manitoba's highest court that record-keeping is not merely administrative, but part of "proper medical practice and patient care." Schafer said the college's first priority should be to protect public safety, and cases where doctors repeat errors, despite being disciplined, can erode public trust. "The college has to prove itself trustworthy," he said. Patient safety, recovery support Dr. Guillaume Poliquin, an assistant registrar for the College of Physicians and Surgeons of Manitoba, said for privacy reasons, the regulatory body can't comment on the specifics of Ziesmann's case. He said the college is improving its monitoring of doctors who have been disciplined, but wouldn't go into more specifics, saying it's dependent on individual cases. Poliquin also said the college is also undergoing "significant changes" in how complaints about doctors are handled to ensure Manitoba patients are protected. The college is also working to identify doctors who are struggling earlier in their careers, and help them improve their practice, leaving more severe disciplinary actions as a last resort, said Poliquin. "Early intervention is what leads to ongoing success," he said. Serious allegations against doctors can also lead to legal action — as happened in Drain's case. Dissatisfied with the college's decision on Ziesmann, she decided to sue him. The Manitoba Court of King's Bench sided with her in 2023, with the judge ruling Ziesmann had breached the expected standard of care. It's not rare for a patient dissatisfied with a regulator's decision to pursue legal action, but it is rare that they win, said Jacob Shelley, an associate law professor who teaches health-care policy at Western University in London, Ont. In court, the threshold of medical negligence is hard to establish, he said. "[The doctors] are the ones in the room the entire time. They are the ones with the expertise. And so it's a really big hurdle for patients to actually be able to seek compensation," Shelley said. He believes an overarching change is needed to how patients' complaints are treated in Canada, with a stronger focus on patient safety. In cases like Ziesmann's, regulators should consider moving away from the "patient versus physician" model to one where the injured patient is more supported, he said. "We should talk about responsibility. We should talk about adequate training, and making sure people are competent and can meet the standard of care," said Shelley. "These are not easy problems to resolve. But what we do know is that patients suffer more as a result."
CTV News
05-06-2025
- Business
- CTV News
Ontario expediting process for U.S. doctors, nurses to work in province
Sylvia Jones, Deputy Premier and Minister of Health speaks during Question Period at Queen's Park in Toronto on Tuesday, May 13, 2025. THE CANADIAN PRESS/Cole Burston TORONTO — Doctors and nurses licensed in the United States will soon be able to more easily practise in Ontario, under changes announced today by the minister of health. Sylvia Jones says the move will increase the number of health-care professionals working in the province. The province is enabling qualified U.S.-licensed physicians, nurse practitioners, registered nurses, and registered practical nurses to start working in Ontario health settings before they register with the regulatory college. They will be allowed to work for up to six months while seeking registration with either the College of Physicians and Surgeons of Ontario or the College of Nurses of Ontario. Doctors and nurses would still have to go through he usual immigration processes, and to qualify they must be licensed in their home jurisdiction with no history of misconduct or incompetence. The government previously expedited the process for physicians, nurses, respiratory therapists and medical laboratory technologists registered in other jurisdictions in Canada to work in Ontario while going through the registration process. This report by The Canadian Press was first published June 5, 2025. Allison Jones, The Canadian Press
CTV News
03-06-2025
- Health
- CTV News
Interprovincial partnership to help fast-track international doctors' careers in P.E.I.
McMaster University and the Government of Prince Edward Island have announced an interprovincial partnership for a physician fellowship program. (Source: Government of Prince Edward Island) McMaster University and the Government of Prince Edward Island have announced the first-of-its-kind interprovincial partnership. The PEI-McMaster Collaborative Hospitalist Fellowship is a training model designed for international medical graduates. The fellowship trains physicians to specialize in providing direct care to a wide range of patients, from the beginning to end of their stay, a news release from the provincial government said. 'This is a first-of-its-kind collaboration in Canada. Our approach provides an accelerated and practical route for highly trained specialist international physicians to transition into the Canadian health system and begin contributing to patient care quickly,' Haroon Yousuf, hospitalist fellowship director and associate professor in the department of medicine at McMaster University said. Fellows will complete most of their training at McMaster, with one of the 13 training blocks delivered in P.E.I. After completing the program, physicians are required to practice in the province for a minimum of one year. 'By collaborating with McMaster University and the College of Physicians and Surgeons of Prince Edward Island, this initiative helps international physicians integrate into the Canadian health system while giving PEI a boost in our workforce,' said Mark McLane, minister of Health and Wellness for Prince Edward Island. 'It's a forward-looking strategy that benefits everyone and shows our commitment to expanding pathways for International Medical Graduates in the province.' The collaboration was inspired in part by the hiring of Ali Abdullah, an internationally trained internal medicine specialist, who completed McMaster's hospitalist fellowship and began his practice in P.E.I. in 2024. 'This collaboration shows what's possible when universities and governments work together to rethink training and recruitment,' Yousuf said. 'Together, we can break down barriers and create new opportunities, across the country and beyond.' Interested candidates can apply on McMaster University's website. For more P.E.I. news, visit our dedicated provincial page.
CTV News
22-05-2025
- Health
- CTV News
Former B.C. health officer convicted of child sexual abuse relinquishes licence for life
A former Kelowna health official currently serving a five-and-a-half-year sentence for sexual interference with a young boy has agreed to permanently terminate his physicians' licence, the regulatory body says. Albert Stefanus De Villiers entered a consent agreement with the College of Physicians and Surgeons of B.C. on May 2, a summary of which was released to the public Tuesday. The college says De Villiers voluntarily surrendered his licence and agreed to not re-apply for registration to practise medicine in B.C., or any other jurisdiction, ever. The doctor was found guilty of sexual interference on Feb. 7, 2023, in Alberta court. A second charge of sexual assault was stayed, according to the college. De Villiers' crimes took place between 2018 and 2020 while he was employed as the top public health doctor in northern Alberta. His victim was seven years old when the abuse began. The boy testified De Villiers showed him pornography and touched him several times at the doctor's home in Grand Prairie. At the time of his arrest in 2021, De Villiers was the chief medical officer of health for B.C.'s Interior Health authority. The regulatory body says De Villiers' 'irrevocable commitment' to resign from the college is effective back to March 1, 2023. The college says it considered the judge's written reasons and his conviction of an indictable offence when deciding its own penalty against De Villiers, in addition to the court-imposed prison sentence. 'The inquiry committee concluded that Dr. De Villiers's conduct was egregious and determined that his irrevocable commitment to resign as a registrant of CPSBC and to never reapply for registration in British Columbia or any other jurisdictions was appropriate in the circumstances,' the decision reads. With files from The Canadian Press
Yahoo
14-05-2025
- Health
- Yahoo
B.C. opioid rules were to reduce overdoses. But they cut cancer patients' pain meds
Rule changes designed to reduce opioid overdose deaths in British Columbia in 2016 inadvertently harmed cancer and palliative-care patients by reducing their access to pain killers, a new study has found. The study published this week in the Canadian Medical Association Journal describes the impact of a practice standard issued by the College of Physicians and Surgeons of B.C. that June, about two months after the province declared a public health emergency over opioid deaths. The rule changes were designed to mitigate prescription drug misuse, including the over-prescribing of opioids among patients with chronic non-cancer related pain. The rules weren't meant for cancer and palliative-care patients, but lead author Dimitra Panagiotoglou said there was a "spillover" effect as doctors applied "aggressive tapering" of the painkillers. "(With) the ongoing messages that physicians were getting at the time — opioids being bad — individuals decided to pull back on their prescribing, but there was this larger population-level effect in doing so," she said. "We focus on these two groups because far and wide, it's considered completely acceptable to prescribe opioids for these groups and the concerns around opioids are very different," she said of cancer and palliative-care patients. There were already downward trends in opioid prescriptions for people with chronic non-cancer pain and those receiving palliative care, Panagiotoglou said, and the study shows that trend continued after the change. But among cancer patients, there was a surprising "nose dive" in access to opioids right after the release of the new standard, said Panagiotoglou, who is an associate professor in the department of epidemiology, biostatistics and occupational health at McGill University. The rules were legally enforceable, and physicians found non-compliant could be disciplined or fined under the Health Professions Act and College of Physicians and Surgeons of BC bylaws. The rules were revised in 2018 to address concerns that they were being misinterpreted. The changes in 2016 set a recommended dose ceiling at 90 morphine milligram equivalents or less per day and used "strong language" around co-prescribing with benzodiazepines given the drug poisoning risk, Panagiotoglou said. Among cancer patients, the study found opioid dispensations were 15 per cent lower per person than expected two years after the implementation of the 2016 rules. Over 30 days, that translates to 4.5 fewer days of supply, it says. For people receiving palliative care, the per-person dosage was 6.1 per cent lower, translating to 1.8 fewer days' supply, the study says, while for patients with chronic non-cancer pain — the target population of the rules — dispensations were 8.2 per cent lower. "Over time, people were seeing a meaningful decline in their doses and in the days supplied," Panagiotoglou said of the period between the implementation of the 2016 practice standard and its revision in 2018. The study did not include opioids dispensed in hospitals or long-term care facilities, rather for prescriptions for people living at home. The study says the changes led doctors to increase "aggressive tapering" of patients' medication. Panagiotoglou said evidence suggests this can lead to pain and increase in overdose risk by pushing people toward illicit opioids. The B.C. college revised its standard in 2018 in response to concerns that misinterpretation was leading to "more conservative prescribing to all patients," not just those with chronic non-cancer pain, the study says. "When the language relaxed and ceiling thresholds were removed, for example, there's this rebound effect where you see, in fact, the amount being prescribed kind of stabilizes or inflects upwards," Panagiotoglou said. The study concludes that its findings show how practice standards can modify physician behaviour, but also highlight "how misinterpretation can harm patients." Panagiotoglou said the findings underscore the potential for "unintended consequences" of sweeping changes to practice standards. Physicians must be careful prescribing opioids, she said, especially given the underlying context of the toxic drug crisis that has claimed more than 16,000 lives in B.C. since the health emergency was declared in 2016. But Panagiotoglou said it's important to include a diversity of voices at the decision-making table, such as patient-care advocacy groups. The College of Physicians and Surgeons of B.C. said in an email it could not comment on the study because it was not directly involved in the research. But it said the 2016 practice standard was informed by the "best available guidance at the time," and it has since been "revised substantially." "In the 2016 practice standard, (the college) was explicit in acknowledging and endorsing the use of aggressive pharmacotherapy in the context of active cancer, palliative, and end-of-life care," it said in the statement. This report by The Canadian Press was first published May 14, 2025. Brenna Owen, The Canadian Press Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
