Astawan, Leanne (CPSO#: 80212)

Current Status: Active Member as of 18 Apr 2008

CPSO Registration Class: Restricted as of 20 Mar 2017

Indicates a concern or additional information

Summary

Former Name: Susanto, Liany (used until: 26 Nov 2003 )

Gender: Female

Languages Spoken: English

Education:University of Indonesia, 1989

Practice Information

Primary Location of Practice
Suite 120
121 Charles Street West
Kitchener ON  N2G 1H6
Phone: (519) 578-4230
Electoral District: 03

Specialties

Specialty Issued On Type
Family Medicine Effective: 16 Jun 2004 CFPC Specialist

Postgraduate Training

Please note: This information may not be a complete record of postgraduate training.

Queen's University, 01 Oct 2003 to 31 Mar 2004
International Specialist Physician - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 01 Oct 2003
Expired: Terms and conditions of certificate of registration Expiry: 31 Mar 2004
Subsequent certificate of registration issued: Restricted certificate Effective: 08 Jun 2004
Expiry date attached to certificate of registration. Expiry Date: 07 Jun 2009
Terms and conditions amended by Effective: 07 Jun 2009
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 18 Apr 2008
Transfer of class of certificate to: Restricted certificate Effective: 20 Mar 2017
Terms and conditions imposed on certificate by member Effective: 20 Mar 2017

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
member Effective: 20 Mar 2017 Active View Details [+]
            As from March 20, 2017, the following is imposed as a term, condition and
            limitation on the certificate of registration held by Dr. Leanne Astawan, in
            accordance with an undertaking and consent given by Dr. Astawan to the College
            of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT 
                                          ("Undertaking")
                  
                                                of
                  
                                    DR. LEANNE ASTAWAN
                                          ("Dr. Astawan")
                  
                                                to 
                  
                        COLLEGE OF PHYSICIANS AND SURGEONS OF ONTARIO
                                          (the "College")
                  
                  
                  
                  
            A.    PREAMBLE

            (1)   In this Undertaking:

                  "Code" means the Health Professions Procedural Code, which is Schedule 2
                  to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, as
                  amended; 
                  
                  "ICR Committee" means the Inquiries, Complaints and Reports Committee of
                  the College;
                  
                  "OHIP" means the Ontario Health Insurance Plan;
                  
                  "Public Register" means the College's register that is available to the
                  public.
                  
            (2)   I, Dr. Astawan, certificate of registration number 80212, am a member of
                  the College.  

            (3)   I, Dr. Astawan, acknowledge that following an investigation arising from
                  a complaint regarding my care and treatment of a patient, the ICR
                  Committee referred specified allegations of professional misconduct and
                  incompetence to the Discipline Committee in a Notice of Hearing dated
                  October 15, 2015 (the "Notice of Hearing").

            (4)   I, Dr. Astawan, acknowledge that, after the College receives an original
                  copy of this Undertaking as signed by me, the College will withdraw the
                  Notice of Hearing.

            B.    UNDERTAKING

            (5)   I, Dr. Astawan, undertake to abide by the provisions of this Undertaking,
                  effective immediately.  

            (6)   Clinical Supervision of Complementary/Alternative Medicine Practice

                  (a)   I, Dr. Astawan, undertake to practise Complementary/Alternative
                        Medicine under the guidance of a clinical supervisor(s) acceptable
                        to the College (the "Clinical Supervisor(s)"), for twelve (12)
                        months ("Clinical Supervision").
                  
                  (b)   I, Dr. Astawan, acknowledge that I have reviewed the Clinical
                        Supervisor(s)'s undertaking, attached hereto as Appendix "A", and
                        understand what is required of the Clinical Supervisor(s). The
                        Clinical Supervisor(s) will, at minimum: 
                  
                        (i)   Meet with me at my Practice Location, or another location
                              approved by the College, once every month. 
                  
                        (ii)  Review at least twenty (20) of my patient charts for patients
                              to whom I have provided Complementary/Alternative Medicine at
                              every meeting.  After the second month of supervision, if I
                              provided less than 20 patients with Complementary/Alternative
                              Medicine in the previous month, then the Clinical Supervisor
                              shall review the patient charts for all patients to whom I
                              provided Complementary/Alternative Medicine in that month;
                  
                        (iii) Review and discuss my compliance with the College
                              Complementary/Alternative Medicine Policy and discuss any
                              concerns arising from the chart reviews, including the
                              consent obtained, and the fees and charges billed to patients
                              for treatments or products provided; 
                  
                        (iv)  Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; 
                  
                        (v)   Perform any other duties, such as reviewing other documents
                              or conducting interviews with staff or colleagues, that the
                              Clinical Supervisor(s) deem necessary to my Clinical
                              Supervision; and
                  
                        (vi)  Submit written reports to the College at least once every
                              month or more frequently if the Clinical Supervisor(s) has
                              concerns about my standard of practice, the fees and charges
                              billed to my patients, or my compliance with the College's
                              Complementary/Alternative Medicine Policy.
                  
                  (c)   I, Dr. Astawan, acknowledge that the charts reviewed shall be
                        selected by the Clinical Supervisor(s) based on the areas of
                        concern identified in the report(s) of the independent opinion
                        provider dated November 8, 2013, February 2, 2014 and May 14, 2014,
                        and concerns that may arise during the period of Clinical
                        Supervision.
                  
                  (d)   I, Dr. Astawan, undertake to cooperate fully with the Clinical
                        Supervision of my practice, conducted under the term of this
                        Undertaking and Appendix "A" to this Undertaking, and to abide by
                        the recommendations of my Clinical Supervisor(s), including but not
                        limited to, any recommended practice improvements and ongoing
                        professional development.
                  
                  (e)   I, Dr. Astawan, undertake to ensure that Appendix "A" to this
                        Undertaking is signed and delivered to the College within thirty
                        (30) days of the date I execute this Undertaking. 
                  
                  (f)   I, Dr. Astawan, undertake that if a person who has given an
                        undertaking in Appendix "A" to this Undertaking is unable or
                        unwilling to continue to fulfill its provisions, I shall, within
                        thirty (30) days of receiving notice of same, obtain an executed
                        undertaking in the same form from a similarly qualified person who
                        is acceptable to the College and ensure that it is delivered to the
                        College within that time.
                  
                  (g)   I, Dr. Astawan, undertake that if I am unable to obtain a Clinical
                        Supervisor on the provisions set out under sections (6)(e) and/or
                        (f) above, I will cease practicing Complementary/Alternative
                        Medicine until such time as I have obtained a Clinical Supervisor
                        acceptable to the College.  
                  
                  (h)   I, Dr. Astawan, acknowledge that if I am required to cease practise
                        Complementary/Alternative Medicine as a result of section (6)(g)
                        above this will constitute a term, condition or limitation on my
                        certificate of registration and that term, condition or limitation
                        will be included on the public register.
                  
                  (i)   I, Dr. Astawan, undertake that during the period of supervision, I
                        shall   maintain a log of all patients to whom I provide
                        Complementary/Alternative Medicine treatment.  The log shall
                        include: the name of the patient, the date of the treatment, and
                        the nature of the treatment (including any supplements or products
                        sold to the patient) and the charges incurred by the patient for
                        the treatment and/or product. 
                  
            (7)   Practice Restrictions - Conflict of Interest 

                  (a)   I, Dr. Astawan, undertake to post a sign in a form acceptable to
                        the College, regarding the sale of items to patients. I shall post
                        the sign in all waiting rooms, examination rooms and consulting
                        rooms, in all of my Practice Locations, in a clearly visible and
                        secure location.  
                  
                  (b)   I, Dr. Astawan, undertake to submit to the College a copy of the
                        sign referenced in 7(a) above for approval within 30 days of the
                        execution of this Undertaking. 
                  
                  (c)   I, Dr. Astawan, acknowledge and agree that I have completed a
                        comprehensive review of the regulations with respect to physician
                        conflict of interest, namely Part IV of Ontario Regulation 114/94
                        made under the Medicine Act, 1991 ("Conflict of Interest
                        Regulations") and professional misconduct, namely Ontario
                        Regulation 856/93 ("Professional Misconduct Regulations") and that
                        I am aware of my duty to comply fully with the Conflict of Interest
                        Regulations and the Professional Misconduct Regulations as amended
                        from time to time.  
                  
                  (d)   I, Dr. Astawan, acknowledge that I am prohibited from selling or
                        supplying any medical product or biological preparation including
                        supplements at a profit and that it is professional misconduct to
                        charge a fee that is excessive in relation to services performed.  
                  
                  (e)   I, Dr. Astawan, undertake to ensure I shall bill patients in
                        compliance with all applicable legislation and regulations,
                        including Ontario Regulation 114/94 and Ontario Regulation 856/93.
                  
                  (f)   I, Dr. Astawan, undertake to provide every patient with an itemized
                        invoice for billing of all Complementary/Alternative Medicine
                        services and products that I provide, including, but not limited
                        to: laboratory services, procedure fees and charges arising from
                        any product I sell.  The itemized invoice shall indicate which
                        products or services are subject to HST, and shall clearly indicate
                        any additional charges that I am applying to that invoice. 
                  
            (8)   Complementary/Alternative Medicine Policy 

                  (a)   I, Dr. Astwan, acknowledge that I have completed a detailed review
                        of the   College's policy regarding "Complementary/Alternative
                        Medicine."  The College's most current "Complementary/Alternative
                        Medicine" is currently found on the College's website at:
                  
                        
                        http://www.cpso.on.ca/Policies-Publications/Policy/Complementary/Alternative
                        Medicine
                  
                        I acknowledge my understanding that I must at all times comply with
                        this policy and any amendments to it.
                  
                  (b)   I, Dr. Astawan, undertake to submit to the College copies of all
                        consent forms for Complementary/Alternative Medicine treatments for
                        approval by the College within two months of the date of the
                        execution of this undertaking. 
                  
            (9)   Reassessment of Practice

                  (a)   I, Dr. Astawan, undertake that, approximately six (6) months after
                        the completion of the Clinical Supervision set out in section (6)
                        above and Appendix "A" to this Undertaking, I will submit to a
                        reassessment of my Complementary/Alternative Medicine practice
                        ("the Reassessment") by an assessor or assessors selected by the
                        College (the "Assessor(s)").  I acknowledge that the Reassessment
                        may include a chart review (including invoices and consent forms),
                        direct observation of my care, interviews with colleagues and
                        co-workers, feedback from patients and any other tools deemed
                        necessary by the College.
                  
                  (b)   I, Dr. Astawan, undertake to co-operate fully with the
                        Reassessment, conducted under the term of this Undertaking. 
                  
                  (c)   I, Dr. Astawan, acknowledge that my Clinical Supervisor(s) may
                        receive and review the findings of the Assessor(s), and may discuss
                        with the Assessor(s) any issues or concerns arising from the
                        Reassessment.  I also acknowledge that the results of the
                        Reassessment will be provided to me and reported to the College and
                        the report may form the basis of further action by the College. 
                  
            (10)  Monitoring 

                  (a)   I, Dr. Astawan, undertake to inform the College of each and every
                        location that I practise or have privileges, including, but not
                        limited to, hospital(s), clinic(s) and office(s), in any
                        jurisdiction (collectively my "Practice Location(s)"), within five
                        (5) days of executing this Undertaking.  Going forward, I further
                        undertake to inform the College of any and all new Practice
                        Locations within five (5) days of commencing practice at that
                        location.
                  
                  (b)   I, Dr. Astawan, undertake that I will submit to, and not interfere
                        with, unannounced inspections of my Practice Location(s) and
                        patient records by a College representative for the purposes of
                        monitoring my compliance with the provisions of this Undertaking.
                  
                  (c)   I, Dr. Astawan, give my irrevocable consent to the College to make
                        appropriate enquiries of OHIP, and/or any person who or institution
                        that may have relevant information, in order for the College to
                        monitor my compliance with the provisions of this Undertaking. 
                  
                  (d)   I, Dr. Astawan, acknowledge that I have executed the OHIP consent
                        form(s), attached hereto as Appendix "B"
                  
            C.    ACKNOWLEDGEMENT

            (11)  I, Dr. Astawan, acknowledge that all appendices attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (12)  I, Dr. Astawan, acknowledge and undertake that I shall be solely
                  responsible for payment of all fees, costs, charges, expenses, etc.
                  arising from the implementation of any of the provisions of this
                  Undertaking. 

            (13)  I, Dr. Astawan, acknowledge that I have read and understand the
                  provisions of this Undertaking and that I have obtained independent legal
                  counsel in reviewing and executing this Undertaking, or have waived my
                  right to do so.

            (14)  I, Dr. Astawan, acknowledge that the College will provide this
                  Undertaking to any Chief of Staff, or a colleague with similar
                  responsibilities, at any Practice Location ("Chief(s) of Staff").

            (15)  I, Dr. Astawan, acknowledge that a breach by me of any provision of this
                  Undertaking may constitute an act of professional misconduct and/or
                  incompetence, and may result in a referral of specified allegations to
                  the Discipline Committee of the College.

            (16)  I, Dr. Astawan, acknowledge that this Undertaking constitutes terms,
                  conditions, and limitations on my certificate of registration for the
                  purposes of section 23 of the Code. 

            (17)  Public Register

                  (a)   I, Dr. Astawan, acknowledge that, during the time period that this
                        Undertaking remains in effect, this Undertaking shall be posted on
                        the Public Register.
                  
                  (b)   I, Dr. Astawan, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (16)(a) above, the
                        following summary shall be posted on the Public Register until such
                        time as the period of supervision and reassessment are complete and
                        reported back to the ICR Committee. 
                  
                              Dr. Astawan was referred to the Discipline Committee on
                              allegations of professional misconduct and incompetence.  In
                              the face of these allegations, Dr. Astawan has undertaken
                              that:
                  
                                    Dr. Astawan will practise Complementary/Alternative
                                    Medicine under the guidance of a Clinical Supervisor
                                    acceptable to the College for 12 months. 
                  
                                    Dr. Astawan's practice will be reassessed by an
                                    assessor selected by the College within 6 months of the
                                    end of the period of Clinical Supervision.
                  
                                    Dr. Astawan shall ensure all consent forms for
                                    Complementary/Alternative Medicine treatments are
                                    submitted to the College for approval within two months
                                    of the date of this Undertaking.
                  
                                    Dr. Astawan shall post a sign, in a form approved by
                                    the College, in her office regarding the sale of items
                                    to patients. 
                  
                                    Dr. Astawan will provide her patients with itemized
                                    invoices for all services, treatments and products
                                    charged to the patient and will bill patients in
                                    compliance with all applicable regulations. 
                  
                  (c)   I, Dr. Astawan, acknowledge that, in addition to this Undertaking
                        being posted in accordance with section (16)(a) above, the
                        following summary shall be posted on the Public Register after the
                        period of supervision and reassessment are complete and reported
                        back to the ICR Committee. 
                  
                                    Dr. Astawan was referred to the Discipline Committee on
                                    allegations of professional misconduct and
                                    incompetence.  In the face of these allegations, Dr.
                                    Astawan has undertaken that:
                  
                                    Dr. Astawan shall post a sign, in a form approved by
                                    the College, in her office regarding the sale of items
                                    to patients. 
                  
                                    Dr. Astawan will provide her patients with itemized
                                    invoices for all services, treatments and products
                                    charged to the patient and will bill patients in
                                    compliance with all applicable regulations. 
                  
                  
            D.    CONSENT

            (18)  I, Dr. Astawan, give my irrevocable consent to the College to provide the
                  following information to all Clinical Supervisors, all Chief(s) of Staff
                  and/or Assessors:

                  (a)   any information the College has that led to the circumstances of my
                        entering into this Undertaking;
                  
                  (b)   any information arising from any investigation into, or assessment
                        of, my practice; and 
                  
                  (c)   any information arising from the monitoring of my compliance with
                        this Undertaking.
                  
            (19)  I, Dr. Astawan, give my irrevocable consent to all Clinical Supervisors,
                  Chiefs of Staff and Assessors, to disclose to the College, and to one
                  another, any information:

                  (a)   relevant to this Undertaking;
                  
                  (b)   relevant to the provisions of the Clinical Supervisor's undertaking
                        set out at Appendix "A" to this Undertaking;
                  
                  (c)   relevant to the Reassessment; and/or
                  
                  (d)   relevant for the purposes of monitoring my compliance with this
                        Undertaking.

Concerns

Source: Member
Active Date: March 20, 2017
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Leanne Astawan to the College of Physicians and Surgeons of Ontario, effective March 20, 2017:

Dr. Astawan was referred to the Discipline Committee on allegations of professional misconduct and incompetence. In the face of these allegations, Dr. Astawan has undertaken that:

Dr. Astawan will practise Complementary/Alternative Medicine under the guidance of a Clinical Supervisor acceptable to the College for 12 months.

Dr. Astawan’s practice will be reassessed by an assessor selected by the College within 6 months of the end of the period of Clinical Supervision.

Dr. Astawan shall ensure all consent forms for Complementary/Alternative Medicine treatments are submitted to the College for approval within two months of the date of this Undertaking

Dr. Astawan shall post a sign, in a form approved by the College, in her office regarding the sale of items to patients.

Dr. Astawan will provide her patients with itemized invoices for all services, treatments and products charged to the patient and will bill patients in compliance with all applicable regulations.