‘Reckless’ doctor agrees to leave family medicine
Windsor physician’s prescription of narcotics led to death of patient
A Windsor doctor with a huge number of patients has agreed to give up family medicine after admitting to a host of allegations that include prescribing narcotics to a patient who died of an overdose.
“Dr. Barnard’s prescribing of narcotics was excessive, reckless and in one case we know it was fatal,” prosecutor Lindsay Caters said Monday at Dr. Tom Barnard’s hearing before the disciplinary committee of the Ontario College of Physicians and Surgeons.
Barnard, 68, was facing charges of professional misconduct and incompetence, but the incompetence allegation was withdrawn when an agreement was reached in which Barnard will basically retire from family medicine.
Barnard, who says he has 25,500 patients (most family doctors have 2,000 or fewer), has also agreed to no longer practise family medicine and no longer bill OHIP.
He plans to continue with his esthetics, cosmetics and nutritional counselling practice, though he’ll first be suspended for four months, starting in March, and then be under the supervision of other doctors. He’s also prohibited from prescribing narcotics and a list of other controlled drugs.
“Dr. Barnard, you’ve put your patients, including children, in harm’s way,” the committee’s chairman, Dr. John Watts, told Barnard after he was ordered to stand before the committee.
“You’ve brought shame and dishonour on yourself and the profession.”
Barnard is a former president of the Essex County Medical Society who has been a family doctor since 1980. In recent years, he’s been the lone physician at The Barnard Wellness Centre and the adjacent Fresh Medical Spa, where he focuses on natural approaches to well-being.
A series of investigations of Barnard began in 2012 when the college was contacted by the province’s chief coroner about the overdose death of a longtime patient from multiple drugs, including drugs prescribed by Barnard.
According to agreed-upon facts, an investigating physician said Barnard lacked knowledge about the risks of prescribing multiple drugs and treating chronic pain with opioids. He was prescribing drug combinations with known risks of harm and continued to prescribe them “when it was obvious the patient was unable to control her use and the medication was doing more “to her” than “for her.”
That investigation prompted a review of 25 patients’ charts by an expert who found problems in 12 of them, demonstrating the doctor’s “lack of knowledge, skill or judgment,” including a tendency to prescribe large quantities of narcotics and stimulants.
Four of those 12 patients were put at particularly high risk. They included: A pregnant woman who received morphine injections for a long period of time;
A patient with migraines who received morphine injections well in excess of recommended guidelines;
And a chronic pain patient who received narcotics despite anonymous phone calls warning that the patient was selling the drugs and a letter from the Children’s Aid Society expressing concern that there were large quantities of narcotics in a house with children.
A third investigation involved another physician checking into 37 of Barnard’s patients and finding the standard of care “was not met in any of the cases.”
She also concluded that only one of those 37 was not at risk of harm due to Barnard’s conduct. She reported that Barnard was administering human growth hormone to help patients with weight loss, despite the fact its use for weight loss has been “discredited and rejected by the medical community.”
The investigator also noted numerous examples of disjointed and episodic care, with poor record keeping and poor judgment that affected diagnosis and care management.
Several years after making her report, that investigator returned and reviewed 10 of Barnard’s patients and found that care continued not to meet standards.
Speaking to the Star on Monday, Barnard said the overdose death of his patient was a shock.
“Since then, this kind of witch hunt atmosphere has intensified,” he said, referring to the multiple investigations. He said he would have loved to work another 10 years, but now will limit his work to his esthetics, cosmetics and nutritional counselling practice, which includes treatments like Botox injections.
“I’m retiring from family practice to avoid a $70,000 hearing that I would have to pay for,” he said, expressing concern that many of his patients will have trouble finding another doctor.
What bothers him most about Monday’s result is how his family will react to this besmirching of his reputation, and not being able to help “the many, many people I’ve been able to help.”
The case against Barnard also included complaints from former patients. A couple, only identified as B and C, said Barnard became upset with them one day in his office. Shortly after, they received a letter from Barnard terminating their relationship.
Later, one of those patients went to a specialist appointment, only to learn Barnard had cancelled the appointment without informing the patient.
In another case, Barnard repeatedly ordered a broad spectrum of tests for a mother and her two children. The college says Barnard demonstrated a lack of knowledge about treating children with asthma, use of antibiotics and treatment for anxiety.
But Barnard said he has thousands of patients loyal to him and appreciative of his care.
He said his huge caseload of patients hearkens back to how he started, as a doctor in the remote north of Ontario. Back then, he was the “only game in town,” and took many, many patients because there was no other option.
“I still feel that way and regrettably my efforts to serve the public will be a little curtailed,” he said.
“At least I’ll be able to do the natural medicine, which I’m good at.”