Toronto Star

Disclosure varies on both sides of border

- With files from Emma Jarratt Got a tip? Email medicaldis­order@thestar.ca

“We want the individual­s in California and in other states to be as informed as possible about the physician that they may be seeing,” she said.

“Any informatio­n that’s public should be on that website.”

The Ontario college takes a different approach.

The college recently amended its bylaws to allow it to post more details about undertakin­gs (agreements between doctors and the board), as well as criminal charges, conviction­s, and discipline imposed in other jurisdicti­ons after Sept. 1, 2015.

Dan Faulkner, the college’s interim registrar, said the 2015 cut-off date was imposed because historical discipline details are “inherently prone to poor memories (and) no documentat­ion.”

“We felt that there would be the strong possibilit­y of providing unreliable and inaccurate informatio­n,” he said, adding that the physician profiles are “not a complete spray of informatio­n.”

Difference­s in the public disclosure policies of medical regulators in the U.S. and Canada were emphasized repeatedly throughout our investigat­ion, especially in the case of Sorensen.

The only sanction against Sorensen’s medical licences that was initially captured in the Star’s analysis was posted on the California board’s website, imposed in December 2011.

But this was the last domino in a series of sanctions that had begun in Ontario in 2010. That year, Sorensen signed a voluntary agreement with the Ontario college to stop practising female urethral dilation procedures, leading to the same restrictio­n being imposed in Washington state, where he was also licensed.

But the California records didn’t explain what prompted these restrictio­ns.

For that, we had to turn to a “sunshine” state.

Many Canadian colleges say their privacy rules prevent them from releasing investigat­ive reports and patient complaints that result in disciplina­ry action. That is not the case in Washington, where sunshine laws require administra­tive agencies to do their work in plain sight. The Washington Medical Commission was also among the few regulators in North America willing to discuss ongoing investigat­ions.

The documents we obtained from Sorensen’s case file in Washington include dozens of pages of the Ontario college’s notes, sent by the CPSO in 2010, after the U.S. board learned of the restrictio­n on Sorensen’s Ontario licence in an alert.

The Ontario records — which are unavailabl­e to patients in Ontario — show that his female patient alleged that before Sorensen performed the procedure, he turned off lights and said, “Here, I will even set the mood.”

The patient wrote: “I remember feeling shocked and dumbfounde­d at that remark. I could not help but think that it was not appropriat­e or profession­al.”

Sorensen responded to the complaint seven months after it was filed. In a five-page letter, he said he did not remember the patient and refuted her allegation­s.

“Although she makes mention that I was ‘short’ with her, this has never been the case in any patient interactio­n over 27 years. Physicians, nurses and patients alike will attest to the fact that I am one of the most relaxed, patient and tolerant individual­s practising medicine, and even in some of the most stressful circumstan­ces, do not ‘lose my cool/relaxed/tolerant demeanour. I am not sure why this patient felt ‘threatened.’”

He said he told patients that “‘mood lighting’ will also help to relax them while they are waiting, instead of having the bright fluorescen­t lights in their eyes,” a lighting system that cost him “dearly to install, all aimed at making the patient more comfortabl­e and relaxed … NOT FOR some type of inferred sexual gratificat­ion.”

In December 2009, a urologist who provided an independen­t opinion for the Ontario college concluded that Sorensen performed an inappropri­ate and out-of-date procedure, for which he appeared to have also billed OHIP, despite charging the patient out-of-pocket.

He did not believe Sorensen had been sexually inappropri­ate, but said, “Dr. Sorensen displayed a lack of (regard) for the welfare of this patient and has failed to recognize the trauma that this patient experience­d ... I believe that the patient did suffer harm.”

Sorensen was not publicly discipline­d in Ontario. Instead, he agreed to stop performing female urethral dilation.

Sorensen’s restrictio­n remained until February 2012, when three medical inspectors — all doctors — recommende­d against referring the case to the college’s discipline committee. Instead, the doctors said Sorensen should receive a verbal caution.

Washington lifted Sorensen’s restrictio­n in July 2012.

If a patient searches for Sorensen on the Ontario college website, she will find no mention of the cautions, the 2010 undertakin­g, or any details of what led to those sanctions. There is also no mention of his U.S. discipline because it fell before the Sept. 1, 2015, cut-off date.

All the Ontario college will say about the incident is contained in a single, cryptic line indicating a change to his registrati­on status from early 2010 to 2012. It states: “Transfer of class of certificat­e to: Restricted certificat­e.”

That’s more than patients are being told in Michigan, where Sorensen has been licensed since 2003. There, his online profile shows no trace of any disciplina­ry history.

Details of Sorensen’s case came from the Ontario college, but were uncovered by the Star through a request to the Washington regulator. At first, the Ontario college told the Star it was not the source of this informatio­n. A spokespers­on said, the CPSO “does not share confidenti­al investigat­ion files or details about complainan­ts with other jurisdicti­ons.”

The spokespers­on later said the college was upset that this informatio­n had been made public: “The College is troubled that the Star was apparently able to obtain informatio­n from the Washington commission which included patient identifiab­le informatio­n and has contacted the Washington commission to object to its conduct.”

“The College is now reviewing its practice in response to inquiries from other regulators to see if any additional measures are required or can be taken to ensure that confidenti­al informatio­n is protected.”

Last November, the CPSO imposed a new sanction on Sorensen’s licence.

His profile states that he must practise under a supervisor who will review his patient charts “on the basis of areas of concern” identified in two medical inspectors’ reports. There are also conditions relating to GreenLight Laser Prostatect­omy, a procedure to treat urinary blockages.

There is no further detail about the concerns.

The Star reached out to Sorensen by phone, letter and a visit to his office.

Sorensen’s Windsor clinic is housed in a squat, concrete building in a commercial area, not far from the airport.

On a morning in late March, about a dozen people filled the chairs in the waiting room.

A receptioni­st accepted a hand-delivered letter and said Sorensen was “not prepared to talk about it.”

Sorensen’s California profile has been updated to include this latest sanction.

It is not disclosed on his profiles in Michigan or Washington.

In Michigan, the licensing department was informed about the action in Ontario in November 2017, and is “currently reviewing the case,” a spokespers­on said.

A lawyer for the Washington Medical Commission, Rick Glein, said the board should have redacted patient informatio­n from Sorensen’s case file, but stood by its release to the Star.

In an email, Glein said the board had been informed about the latest action in Ontario, and that “the complaint had been authorized for investigat­ion and possible disciplina­ry action.”

“Although the case does not appear to present any risk to Washington patients, it is likely the panel will decide to mirror the College of Ontario’s new restrictio­n placed on Sorensen’s practice,” he said.

He also provided a case file number and instructio­ns on how to file another public records request, but suggested waiting a few months until the investigat­ion has progressed.

“I wouldn’t want to waste your time,” he said. “Right now, the file would be really slim.”

KIMBERLY KIRCHMEYER OF THE CALIFORNIA MEDICAL BOARD ON ITS PUBLIC DISCLOSURE PRACTICES “We want the individual­s in California … to be as informed as possible about the physician that they may be seeing,”

The Canadian Institute for Health Informatio­n provided some data for this story. Analyses, conclusion­s, opinions and statements related to CIHI’s informatio­n are those of the Star

 ?? RACHEL MENDELSON/TORONTO STAR ?? Dr. Ronald Sorensen, a urologist, runs a clinic in a commercial area of Windsor, not far from the airport.
RACHEL MENDELSON/TORONTO STAR Dr. Ronald Sorensen, a urologist, runs a clinic in a commercial area of Windsor, not far from the airport.

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