In College of Physicians and Surgeons of Ontario v. Thirlwell, the Ontario Physicians and Surgeons Discipline Tribunal revoked the licence of a psychiatrist who issued more than 1,400 COVID-19 exemption letters in a three-month period — primarily for profit and without meeting established medical standards.
For patients concerned about improper medical practices, this decision is a powerful example of regulatory oversight and the importance of maintaining professional standards.
According to the Tribunal’s written reasons, Dr. Celeste Jean Thirlwell:
Issued approximately 1,425 COVID-19 exemption letters between August and October 2021
Charged patients directly (between $50 and $300 per letter, with family discounts)
Failed to adhere to College and Ministry of Health guidelines for valid exemptions
Did not properly document patient encounters
Failed to counsel patients regarding risks of remaining unvaccinated, unmasked, or untested
Stored patient information improperly on personal systems
Conducted loud patient phone calls in public spaces
Responded aggressively and unreasonably to the College’s investigation
The Tribunal found her conduct to be:
Professional misconduct
Disgraceful, dishonourable, and unprofessional
Incompetent within the meaning of Ontario’s Health Professions Procedural Code
The Tribunal noted that Dr. Thirlwell likely earned up to $427,500 during the three-month period, based on her pricing structure. The Panel concluded the exemptions were not based on recognized medical contraindications, but rather on patients’ fears, misinformation, and emotional distress.
The decision emphasized that enabling avoidance of public health measures during a pandemic undermines public trust and can expose patients and the broader public to harm.
The Tribunal ordered:
Revocation of her certificate of registration effective February 12, 2026
A formal written reprimand to appear on the College’s public register
Payment of $10,370 in costs
Revocation is the most serious penalty available to the Tribunal and is imposed primarily for public protection.
This case underscores several important principles in Ontario medical regulation:
Physicians must follow established medical guidelines — especially in public health crises.
Financial incentives cannot override professional obligations.
Proper documentation and privacy safeguards are fundamental duties.
Failure to cooperate with a regulatory investigation can aggravate misconduct.
The Tribunal also considered prior cautions and remedial agreements involving the physician, finding that previous corrective efforts had not resulted in meaningful change.
Most Ontario physicians provide careful, evidence-based care. However, when a doctor:
Issues medical documentation without proper assessment
Fails to document appropriately
Acts outside accepted standards
Places financial gain ahead of patient welfare
— regulatory consequences can follow.
If you believe a healthcare provider has failed to meet professional standards and caused harm, you may have legal options.
As an experienced Ontario medical malpractice lawyer, Paul Cahill represents patients and families affected by negligent or substandard medical care.
Medical negligence cases may involve:
Failure to follow established guidelines
Improper documentation
Inadequate informed consent
Professional misconduct causing patient harm
Regulatory findings that support civil claims
Regulatory discipline decisions — like Thirlwell — are separate from civil lawsuits, but they may raise important issues about standard of care and professional conduct.
If you or a family member believe a physician’s conduct fell below the standard of care and caused injury, early legal review is critical.
Contact Paul Cahill to discuss your situation confidentially and determine whether you may have a viable medical malpractice claim in Ontario.
Decision Date: February 11, 2026
Jurisdiction: Ontario Physicians and Surgeons Discipline Tribunal
Citation: College of Physicians and Surgeons of Ontario v. Thirlwell, 2026 ONPSDT 5 (CanLII)
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