Standard of Practice

Standard of practice is the benchmark used in the regulatory and disciplinary context to measure a health professional’s conduct against the expectations of the profession. In discipline proceedings, a finding that a member failed to maintain the standard of practice of the profession is a core route to a finding of professional misconduct, and it draws on the College’s published standards, policies, and guidelines.

The regulatory standard of practice is related to, but not identical with, the civil standard of care. Both ask what a reasonable practitioner would have done, but they serve different ends: the disciplinary standard protects the public and governs the profession, while the civil standard determines liability and compensation. A College standard or policy is relevant evidence in both settings, but in a civil case the standard of care is ultimately established through expert evidence rather than by the policy alone.

Posts tagged Standard of Practice analyze Ontario discipline decisions addressing the professional standard of practice and its relationship to the civil standard of care.

Navy title card reading "CPSO v Hart: Ketamine prescribing, a no-complaints release, and a suspension" from paulcahill.ca

CPSO v Hart: Ketamine Prescribing, a No-Complaints Release, and a Six-Month Suspension

A physician’s practice was found deficient across assessment, consent, prescribing, monitoring, record keeping and OHIP billing, on the evidence of two complainants and 34 further charts reviewed by two independent assessors. Patients were also asked to sign a form promising not to sue him and not to complain to the College. A look at what the Tribunal did with that, and why a discipline finding is not compensation.

August 6, 2026

Navy title card reading "CNO v Paulson: missed medications, false charting, and a three-month suspension" from paulcahill.ca.

CNO v Paulson: False Charting, Missed Medications, and the Electronic Audit Trail

A registered practical nurse admitted failures across two Guelph hospitals: an admission assessment backdated without notation, medications charted but never given, and a bladder scan reported but not performed. The CNO Discipline Committee accepted a joint submission for a three-month suspension with twelve months of oversight. What the electronic audit trail proved, and where a discipline finding stops short of a civil claim.

July 29, 2026

Navy title card reading "Remediation, Not Revocation: A contested second chance after a patient's death," crediting the Hamilton Spectator, from paulcahill.ca.

A Suspended Pain Doctor’s Possible Return: Commentary in the Hamilton Spectator

Hamilton Spectator coverage of Dr. Stefan Konasiewicz, whose six-month suspension could end in August. Paul Cahill comments on why a patient death led the discipline tribunal to remediation rather than revocation, and where a College proceeding ends and a civil claim begins.

June 18, 2026

Navy title card reading "CPSO v Konasiewicz, Case Comment" with the line "A patient death, deficient technique, and a suspension," from paulcahill.ca

CPSO v Konasiewicz: A Patient Death, Deficient Technique, and a Suspension

A neurosurgeon practising pain medicine was suspended for six months after the tribunal found his chronic pain care fell below the standard of practice, his treatment of a patient who died after nerve blocks was deficient, and he breached a College order restricting his injections. A look at why a patient death led to remediation rather than revocation, and where the discipline process ends and a civil claim begins.

March 30, 2026

Case comment on CPSO v Nahas, 2026 ONPSDT 8 (Ontario Physicians and Surgeons Discipline Tribunal), discipline decision imposing four-month suspension, substantial practice restrictions, mandatory six-month clinical supervision, and ongoing compliance monitoring on chronic pain management physician with multiple clinical deficiencies across 19 patient charts and a consent failure during clinical examination, applying the progressive discipline framework given pattern of prior ICRC cautions and previous discipline finding. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

CPSO v Nahas: Chronic Pain Practice, Consent Violations, and the Progressive Discipline Framework

Ontario discipline tribunal imposes four-month suspension, practice restrictions, and mandatory supervision on chronic pain physician with pattern of prior concerns.

March 20, 2026

Navy title card reading "CPSO v Maharaj, Case Comment" with the line "Revocation after unconsented, non-evidence-based care," from paulcahill.ca

CPSO v Maharaj: A Revoked Licence, and What It Means For Patients

The Ontario Physicians and Surgeons Discipline Tribunal revoked Dr. Maharaj’s licence after finding his care of 17 patients fell below the standard of practice and that he was incompetent. A look at the consent, evidence-based-treatment and privacy findings, and what a discipline decision does and does not mean for an injured patient.

March 11, 2026

Case comment on College of Physicians and Surgeons of Ontario v Duic, 2025 ONPSDT 11 (Ontario Physicians and Surgeons Discipline Tribunal), 3-month licence suspension of emergency medicine physician for failure to maintain standard of practice in assessment, workup, and discharge of 19-year-old patient with peritonitic abdomen who subsequently died of post-procedural septic shock. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

CPSO v Duic: Missed Peritonitis, Premature Discharge, and the Emergency Medicine Standard of Practice

Ontario ER physician suspended after sending home a 19-year-old with a peritonitic abdomen; she died of septic shock. CPSO v Duic, 2025 ONPSDT 11.

May 9, 2025

Case comment on College of Physicians and Surgeons of Ontario v Sharma, 2025 ONPSDT 5 (Ontario Physicians and Surgeons Discipline Tribunal), 10-month licence suspension of anesthesiologist for inattention during two procedures, manual alteration of electronic oxygen saturation records after adverse outcomes, and systematic OHIP billing misconduct across approximately 80 percent of audited patient charts. By Paul Cahill, LSO Certified Specialist in Civil Litigation.

CPSO v Sharma: Anesthesia Vigilance, Record Falsification, and OHIP Billing

Ontario anesthesiologist suspended ten months for lapses in vigilance, altering records after adverse events, and OHIP misbilling. CPSO v Sharma, 2025 ONPSDT 5.

May 2, 2025

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