Ontario College of Pharmacists v. 1724665 Ontario Inc (DOB Global Pharmacy)  2013 ONCA 381 is an important case and the first one to consider the impact of international internet pharmacies and the ability of a provincial regulatory college to regulate them.  A call centre operating in Ontario arranged for prescription drugs manufactured mostly in India to be delivered to patients in the USA.   The call centre referred to itself as a "pharmacy"  and used other prohibited words such as "pharmacist" and "drug".  The drugs did not enter Canada.  The corporate entities running this business and their employees were not licensed in Ontario.  The argument was that they were not selling prescription drugs within Ontario because the drugs did not enter Canada, the patients were in the USA among other things.  The OCA upheld the trial judge's conclusion that there was a sufficient connection to Ontario to ground the Ontario College of Pharmacists' jurisdiction over the business.

A Useful Decision from the Ontario Supreme Court

Yazdanfar v. College of Physicians & Surgeons of Ontario 2013 ONSC 6420 (CanLii) is a useful decision that considers many issues.  The case was lengthy taking up over 68 days of hearing and considered allegations of professional misconduct and incompetence involving over 30 patients.    There were concerns around the physician's advertising of her professional services by using patients' testimonials in addition to the evidence around incompetent practice.  The College investigator gave expert opinion evidence, after interviewing the physician, who was compelled to attend the interview.  The transcript of that interview, was entered into evidence.  The Discipline Committee imposed very strict and severe conditions on the physician's practice that effectively made it difficult for her to practice.  The physician argued, among other things, that there were no written guidelines involving some of the practice concerns in issue.  The Court confirmed the well known principle that standards of practice do not need to be written down and exist by reference to evidence of a common understanding within the profession as to expected behaviour of a reasonable professional….(para 36).  The Court  held that a compelled statement is admissible in the context of a discipline hearing.  This is important because there has been some question about whether the criminal law concept of the right to silence has a place in this regulatory context (para 73).  The Court approved the use of the in house investigator as an expert and noted this was common practice within the regulatory context (para 75).  It further upheld the College's advertising guidelines around the use of testimonials and superlatives noting the vulnerable position of patients in relation to physicians (para 114).  Finally, the Court concluded that even though the imposition of conditions may have been tantamount to a revocation of licence to practice, the more important value was protection of the public.  The penalty was reasonable. (para 164)

HPRB's Interference Quashed by BCSC

In Moore v. The College of Physicians and Surgeons of B.C. & the Health Professions Review Board, 2013 BCSC 2081, the BCSC "slapped the Board's wrists" and reigned in its interventionist approach in this case.  The College's Registrar is authorized under section 32(3) of the HPA to investigate and dismiss certain kinds of complaints.  An individual who was a prisoner in the correctional system at the time, complained that a physician had wrongly changed his prescription for a particular drug.  The Registrar investigated the complaint.  The complainant's story was inconsistent with the physician's version of events.  Nevertheless, in view of the nature of the complaint, and the evidence considered, the Registrar dismissed it.  The Review Board decided that the investigation was inadequate and directed the Registrar to review the file, interview the complainant and ask him certain specified questions.  The BCSC concluded that the Review Board's decision was patently unreasonable in that it failed to take into account the statutory provisions around the Registrar's role (para 113) and did not accept the deference it owed to the College (para 118).  It said that the Registrar's decision fell within a range of outcomes that were reasonable and rational.  Therefore the Board was not entitled to intervene.  (para 121)