In late 2019, Dr. Raymond Stein, a clinical immunologist and a member of the College of Physicians and Surgeons of Ontario (CPSO) for over 40 years, crossed professional boundaries, verbally and physically, with a longstanding patient. During the CPSO’s investigation the following year, Dr. Stein attempted to bully an acquaintance into providing a false alibi to help exonerate him at the CPSO.

At the hearing, the Ontario Physicians and Surgeons Discipline Tribunal (OPSDT) found out that Dr. Stein engaged in disgraceful, dishonourable or unprofessional conduct and imposed a six-month suspension, ordered him to complete a recognized program on ethics and boundaries and delivered a reprimand. 

FACTS

Disgraceful, dishonourable or unprofessional conduct towards Patient A

Patient A began seeing Dr. Stein when she was 26 years old. By 2019, she had been his patient for 30 years. On October 26, 2019, Patient A attended an appointment with Dr. Stein. A few days later, Dr. Stein called Patient A from his personal cell phone. The call alarmed Patient A as she thought Dr. Stein was delivering bad news about her medical condition. Dr. Stein told her he had tickets to a Beatles concert on December 2, 2019, and told Patient A he would accompany her to the concert. He asked her to meet him at his office and they would go together from there. Patient A felt uncomfortable but agreed because Dr. Stein had been her doctor for so long and she respected him.

In late October 2019, Dr. Stein referred Patient A to a specialist and told her not to mention their planned outing. The OPSDT noted that this request showed his awareness of the inappropriateness of taking her to the concert.

On December 2, 2019, after several texts confirming the plans, Patient A went to Dr. Stein’s office. When he saw Patient A, he put his arms around her waist and said, “can you imagine me escorting you to your daughter’s wedding?” Patient A felt uncomfortable. Dr. Stein then gave her a Christmas card and a gift, which she opened at home. She viewed the card and gift as inappropriate coming from her physician.

As they walked into the concert, Dr. Stein put his arm tightly around Patient A’s waist. Patient A disengaged. While they were seated at the concert, Dr. Stein grabbed Patient A’s upper right thigh. Patient A pulled her leg back and leaned away. Again, she felt uncomfortable.

When Dr. Stein drove Patient A home, he commented that he knew where she lived. Patient A realized this information would have been available from her patient records. Patient A did not want him close to her residence and insisted he drop her on the street. By this point, Patient A was nervous about Dr. Stein’s intentions and wanted to be away from him. Patient A was upset about the evening. Dr. Stein sent a text to Patient A after the event, but Patient A did not reply and did not see Dr. Stein again.

Disgraceful, dishonourable or unprofessional conduct by interfering in College investigation

On December 20, 2019, the College received a mandatory report from a physician about an incident involving one of her patients and Dr. Stein. The College commenced an investigation. On January 14, 2021, an individual, Ms. X, contacted the College and reported that she was acquainted with Dr. Stein and had known him socially for three years. On Labour Day weekend of 2020, she was a guest at Dr. Stein’s cottage. Dr. Stein asked Ms. X if she lived in Oakville. He later came to her again asking her to sign a letter confirming that she was with him on the evening of December 2, 2019. He told her he needed an alibi.

Ms. X refused which upset Dr. Stein. Ms. X left and was upset by Dr. Stein’s request. She felt bullied by Dr. Stein for putting her in a difficult position, and the experience caused her stress.

Finding of professional misconduct

The OPSDT found that the uncontested facts supported a finding that Dr. Stein violated his professional obligations in two ways. First, he breached acceptable physician-patient boundaries with Patient A by:

• effectively directing her to attend a concert with him, which he recognized was inappropriate;
• making flirtatious remarks to her;
• giving her a Christmas card and a gift;
• putting his arm around her waist and grabbing her thigh;
• commenting that he knew her address; and 
• making her uncomfortable and upset to the extent that she terminated a 30-year-long physician-patient relationship.

Second, Dr. Stein interfered with the CPSO’s investigation when he tried to cover up his attendance with Patient A at the concert by asking an acquaintance to sign a false statement that would give him an alibi. His actions upset this acquaintance who felt that Dr. Stein was bullying her. Therefore, the OPSDT accepted the parties’ joint submission that in both respects, Dr. Stein’s actions were disgraceful, dishonourable and unprofessional.

DECISION

The OPSDT ordered the following:

1. Dr. Stein to be reprimanded;
2. Dr. Stein’s certificate of registration to be suspended for six months;
3. Dr. Stein to complete an Ethics and Boundaries program within 12 months of the order and to provide proof of completion within one month of completing the program; and
4. Dr. Stein to pay costs to the College in the amount of $6000.

Decision Date: September 28, 2023

Jurisdiction: Ontario Physicians and Surgeons Discipline Tribunal

Citation: College of Physicians and Surgeons of Ontario v. Stein, 2023 ONPSDT 21 (CanLII)