Matheson, Jeffrey Rice Holmes (CPSO#: 63625)

Current Status: Active Member as of 01 Sep 2017

CPSO Registration Class: Restricted as of 28 May 2015

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:McGill University, 1991

Practice Information

Primary Location of Practice
1st Floor
555 Kingston Road West
Ajax ON  L1S 6M1
Phone: (905) 477-4677
Fax: (866) 380-2423
Electoral District: 05
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Dr. Jeffrey R.H. Matheson Medicine Professional Corporation

Certificate of Authorization Status: Issued Date:  Dec 21 2005

Shareholders:
Dr. J. Matheson ( CPSO# 63625 )

Business Address:
1st Floor
555 Kingston Road West
Ajax ON  L1S 6M1
Phone Number: (905) 477-4677

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1991
Expired: Terms and conditions of certificate of registration Expiry: 14 Jun 1992
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 19 Jun 1992
Transfer of class of certificate to: Restricted certificate Effective: 28 May 2015
Terms and conditions amended by Discipline Committee Effective: 01 May 2017
Terms and conditions amended by Discipline Committee Effective: 01 May 2017
Suspension of registration removed Effective: 01 Sep 2017

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
Discipline Committee Effective: 01 May 2017 Active View Details [+]


            As from 12:01 a.m., May 1, 2017, by order of the Discipline Committee of the
            College of Physicians and Surgeons of Ontario, the following term, condition
            and limitation is imposed on the certificate of registration held by Dr.
            Jeffrey Rice Holmes Matheson:

            Prescribing Privileges 

            (1)   Dr. Matheson shall not issue new prescriptions or renew existing
                  prescriptions for any of the following substances:

                  (a)   Narcotic Drugs (from the Narcotic Control Regulations made under
                        the Controlled Drugs and Substances Act, S.C., 1996, c. 19);
                  
                  (b)   Narcotic Preparations (from the Narcotic Control Regulations made
                        under the Controlled Drugs and Substances Act, S.C., 1996, c. 19); 
                  
                  (c)   Controlled Drugs (from Part G of the Food and Drug Regulations
                        under the Food and Drugs Act, S.C., 1985, c. F-27); 
                  
                  (d)   Benzodiazepines and Other Targeted Substances (from the
                        Benzodiazepines and Other Targeted Substances Regulations made
                        under the Controlled Drugs and Substances Act., S.C., 1996, c. 19);
                        or (A summary of the above-named drugs [from Appendix I to the
                        Compendium of Pharmaceuticals and Specialties] is attached hereto
                        as Schedule "A"; and the current regulatory lists are attached
                        hereto as Schedule "B"); and
                  
                  (e)   All other Monitored Drugs (as defined under the Narcotics Safety
                        and Awareness Act, 2010, S.O. 2010, c. 22 as noted in Schedule
                        "C"); and as amended from time to time.
                  
            Posting a Sign     

            (2)   Dr. Matheson shall post a sign in the waiting room(s) of his office, in a
                  clearly visible and secure location, in the form set out at Schedule "D".
                  For further clarity, this sign shall state as follows: "Dr. Matheson
                  shall not prescribe Narcotic Drugs, Narcotic Preparations, Controlled
                  Drugs, Benzodiazepines and Other Targeted Substances, or any other
                  Monitored Drugs. Further information may be found on the College of
                  Physicians and Surgeons of Ontario website at www.cpso.on.ca". 

            (3)   Dr. Matheson shall post a certified translation in any language in which
                  he provides services, of the sign described in paragraph 5.(2) above, in
                  the waiting room(s) of his office.


            (4)   Dr. Matheson shall provide the certified translation(s) described in
                  paragraph 5.(3), to the College within thirty (30) days of this Order. 

            (5)   Should Dr. Matheson elect to provide services in any other language(s),
                  he must notify the College prior to providing any such services. 

            (6)   Dr. Matheson shall provide to the College the certified translation(s)
                  described in paragraph 5.(4) prior to beginning to provide services in
                  the language(s) described in paragraph 5.(5). 

            Coursework

             (7)  At his own expense, Dr. Matheson shall participate in and successfully
                  complete, within 6 months of the date of this Order, the following
                  programs: 

                  a)    Medical Record Keeping;
                  
                  b)    Opioid Prescribing; and
                  
                  c)    Individualized instruction in medical ethics satisfactory to the
                        College, with an instructor selected by the College.
                  
            Compliance

            (8)   Dr. Matheson must inform the College of each and every location that he
                  practises or has privileges, including, but not limited to, hospital(s),
                  clinic(s) and office(s), in any jurisdiction (collectively the "Practice
                  Location(s)"), within five (5) days of commencing practice at that
                  location.

            (9)   Dr. Matheson shall be solely responsible for payment of all fees, costs,
                  charges, expenses, etc. arising from the implementation of any of the
                  terms of this Order. 

            (10)  Dr. Matheson shall co-operate with unannounced inspections of his
                  Practice Location(s) and patient charts by the College and to any other
                  activity the College deems necessary in order to monitor his compliance
                  with the terms of this Order. 

            (11)  Dr. Matheson shall provide his irrevocable consent to the College to make
                  appropriate enquiries of the Ontario Health Insurance Plan ("OHIP"), the
                  Drug Program Services Branch, the Narcotics Monitoring System ("NMS")
                  implemented under the Narcotics Safety and Awareness Act, 2010 and any
                  person or institution that may have relevant information, in order for
                  the College to monitor his compliance with the terms of this Order. 

            (12)  Dr. Matheson acknowledges that the College may provide this Order to any
                  Chief(s) of Staff, or a colleague with similar responsibilities, at any
                  Practice Location where he practices or has privileges ("Chief(s) of
                  Staff"), or other person or individual as necessary for the
                  implementation of this Order and shall consent to the College providing
                  to said Chief(s) of Staff, person or organization with any information
                  the College has that led to this Order and/or any information arising
                  from the monitoring of his compliance with this Order.

Previous Hearings

Committee: Discipline
Decision Date: 01 May 2017
Summary:

On May 1, 2017, the Discipline Committee found that Dr. Jeffrey Rice Holmes Matheson 
committed an act of professional misconduct in that he has failed to maintain the standard of 
practice of the profession and in that he has engaged in an act or omission relevant to the practice 
of medicine that, having regard to all the circumstances, would reasonably be regarded by 
members as disgraceful, dishonourable, or unprofessional. 
 
Dr. Matheson is a family physician practising in Ajax. Beginning in 2002, Dr. Matheson 
developed a specialty in Chronic Pain Management.  
 
PRESCIBING PRACTICES  
 
During the period from July, 2013 to October, 2014, the College received four telephone calls 
from four pharmacists raising concerns about Dr. Matheson’s prescribing practices.  
 
The College retained an expert to review Dr. Matheson’s opioid prescribing. The expert 
concluded that Dr. Matheson did not meet the expected standard of practice as outlined in the 
Canadian Guidelines either at the level of primary care physicians, or at a reasonably higher 
standard of physicians, like Dr. Matheson, holding themselves out as a specialist in the field. 
The experts concerns included that: 
-  Dr. Matheson consistently demonstrated a lack of understanding of the expectations outlined 
   in the Canadian guidelines with respect to instituting opioid therapy, following up, changing 
   from one opioid to another and the medical implications of high-dose opioids. 
-  Dr. Matheson consistently demonstrated an almost cavalier approach to switching opioids, 
   most often increasing the total daily morphine equivalent, by as much as 30% rather than 
   allowing for incomplete tolerance and decreasing by 30 – 50%, all the time with no 
   documentation of discussion around the driving or fall risk. 
-  Dr. Matheson’s greatest failure of judgment is perhaps his complete lack of adherence to and 
   recognition of the importance of the fundamental importance of the Canadian guidelines to 
   an opioid practice. That he would initiate a specialty pain practice in October 2013, 3 years 
   after the Canadian guidelines were published in large volumes without adequately tracing 
   this process, all shows a significant lack of judgment to the point of negligence causing harm. 
-  Dr. Matheson’s prescribing of opioids and failure to follow any standards of care beyond 
   opioid agreements is nothing short of reckless…there is a risk to both his clients health and 
   that of the public at large. 
 
As a result of concerns raised by the College and its expert during the investigation, Dr. 
Matheson voluntarily ceased prescribing narcotics and controlled substances on March 16, 2015. 
On May 28, 2015, Dr. Matheson signed a formal interim undertaking to cease prescribing 
narcotics and controlled substances.  
 
OUT OF HOSPITAL PREMISES 
 
Dr. Matheson was a medical director of premises that were subject to the inspection / assessment 
regime at the College under regulation. Pursuant to the regulation, no person may perform 
procedures as defined in the regulation, in premises, unless the College “passes” the premises or 
passes it with conditions that allow procedures to be performed. 
 
On September 9, 2014, the College’s Out of Hospital Premises Inspection Program received 
notice that Dr. Matheson’s premises was intending to move in December 2014 and advised Dr. 
Matheson that the premises must be assessed prior to becoming operational.  
 
The new premises were inspected on February 2, 2015. Dr. Matheson was provided with the 
Inspection Assessment Report, which noted some deficiencies, and was asked twice to submit 
feedback for consideration by the Premises Inspection Committee. Although Dr. Matheson was 
given deadlines on both of those occasions, he did not respond. 
 
On June 11, 2015, Dr. Matheson’s premises were subject to an unannounced visit by the 
Premises Inspection Program. During the inspection, Dr. Matheson acknowledged that he had 
been performing “Level 2” procedures at the premises since February. 
 
On June 19, 2015, Dr. Matheson’s premises received a grade of “Fail”. The Premises Inspection 
Committee informed Dr. Matheson of its concern that there was a risk to patient health and 
safety as Dr. Matheson performed procedures at this premises without the approval of the 
Committee. The Committee further informed Dr. Matheson that he failed, by act or omission, to 
comply with any duty or requirement under the regulation. 
 
On May 1, 2017, the Discipline Committee ordered and directed on the matter of penalty and 
costs that: 
-  the Registrar suspend Dr. Matheson’s certificate of registration for four (4) months 
   commencing May 1, 2017; 
-  Dr. Matheson appear before the panel to be reprimanded;  
-  the Registrar impose the following terms, conditions and limitations on Dr. Matheson’s 
   Certificate of Registration: 
 
      Prescribing Privileges  
      (1)   Dr. Matheson shall not issue new prescriptions or renew existing prescriptions for 
            any of the following substances: 
            (a)   Narcotic Drugs (from the Narcotic Control Regulations made under the 
                  Controlled Drugs and Substances Act, S.C., 1996, c. 19); 
            (b)   Narcotic Preparations (from the Narcotic Control Regulations made under 
                  the Controlled Drugs and Substances Act, S.C., 1996, c. 19);  
            (c)   Controlled Drugs (from Part G of the Food and Drug Regulations under 
                  the Food and Drugs Act, S.C., 1985, c. F-27);  
            (d)   Benzodiazepines  and  Other  Targeted  Substances  (from  the 
                  Benzodiazepines and Other Targeted Substances Regulations made under 
                  the Controlled  Drugs  and  Substances  Act., S.C.,  1996,  c.  19);  or  (A 
                  summary of the above-named drugs [from Appendix I to the Compendium 
                  of Pharmaceuticals and Specialties] is attached hereto as Schedule “A”; 
                  and the current regulatory lists are attached hereto as Schedule “B”); and 
            (e)   All  other  Monitored  Drugs  (as  defined  under  the Narcotics  Safety  and 
                  Awareness Act, 2010, S.O. 2010, c. 22 as noted in Schedule “C”); and as 
                  amended from time to time. 
      Posting a Sign      
      (2)   Dr. Matheson shall post a sign in the waiting room(s) of his office, in a clearly 
            visible  and  secure  location,  in  the  form  set  out  at Schedule  “D”.  For  further 
            clarity, this sign shall state as follows: "Dr. Matheson shall not prescribe Narcotic 
            Drugs,  Narcotic  Preparations,  Controlled  Drugs,  Benzodiazepines  and  Other 
            Targeted Substances, or any other Monitored Drugs. Further information may be 
            found  on  the  College  of  Physicians  and  Surgeons  of  Ontario  website  at 
            www.cpso.on.ca".  
      (3)   Dr.  Matheson  shall  post  a  certified  translation  in  any  language  in  which  he 
            provides services, of the sign described in paragraph 5.(2) above, in the waiting 
            room(s) of his office. 
      (4)   Dr.  Matheson  shall  provide  the  certified  translation(s)  described  in  paragraph 
            5.(3), to the College within thirty (30) days of this Order.  
      (5)   Should Dr. Matheson elect to provide services in any other language(s), he must 
            notify the College prior to providing any such services.  
      (6)   Dr. Matheson shall provide to the College the certified translation(s) described in 
            paragraph 5.(4) prior to beginning to provide services in the language(s) described 
            in paragraph 5.(5).  
      Coursework 
       (7)  At his own expense, Dr. Matheson shall participate in and successfully complete, 
            within 6 months of the date of this Order, the following programs:  
            a) Medical Record Keeping; 
            b) Opioid Prescribing; and 
            c) Individualized instruction in medical ethics satisfactory to the College, with 
               an instructor selected by the College. 
     Compliance 
     (8)    Dr. Matheson must inform the College of each and every location that he practises 
            or has privileges, including, but not limited to, hospital(s), clinic(s) and office(s), 
            in any jurisdiction (collectively the "Practice Location(s)"), within five (5) days of 
            commencing practice at that location. 
     (9)    Dr. Matheson shall be solely responsible for payment of all fees, costs, charges, 
            expenses, etc. arising from the implementation of any of the terms of this Order.  
     (10)   Dr.  Matheson  shall  co-operate  with  unannounced  inspections  of  his  Practice 
            Location(s) and patient charts by the College and to any other activity the College 
            deems necessary in order to monitor his compliance with the terms of this Order.  
     (11)   Dr.  Matheson  shall  provide  his  irrevocable  consent  to  the  College  to  make 
            appropriate  enquiries of the Ontario Health  Insurance Plan  ("OHIP"), the Drug 
            Program  Services  Branch,  the  Narcotics  Monitoring  System  ("NMS") 
            implemented under the Narcotics Safety and Awareness Act, 2010 and any person 
            or  institution  that  may  have  relevant  information,  in  order  for  the  College  to 
            monitor his compliance with the terms of this Order.  
     (12)   Dr.  Matheson  acknowledges  that  the  College  may  provide  this  Order  to  any 
            Chief(s)  of  Staff,  or  a  colleague  with  similar  responsibilities,  at  any  Practice 
            Location where he practices or has privileges ("Chief(s) of Staff"), or other person 
            or individual as necessary for the implementation of this Order and shall consent 
            to the College providing to said Chief(s) of Staff, person or organization with any 
            information the College has that led to this Order and/or any information arising 
            from the monitoring of his compliance with this Order. 
-  Dr. Matheson pay costs to the College in the amount of $6,663.60 within thirty (30) days of 
   the date this Order becomes final.

Decision: Download Full Decision (PDF)
Hearing Date(s): Hearing: May 1, 2017

Concerns

Source: Member
Active Date: February 16, 2016
Expiry Date:
Summary:
Summary of the Undertaking given by Dr. Jeffrey Rice Holmes Matheson to the College of Physicians and Surgeons of Ontario, effective February 16, 2016:

Dr. Matheson is the subject of a referral to the Discipline Committee into allegations that he has failed to maintain the standard of practice, is incompetent and has engaged in disgraceful, dishonourable or unprofessional conduct in his pain management practice. As a result of the referral:

•Dr. Matheson must co-operate with unannounced inspections of his practice to ensure compliance with the out of hospital premises regulation and with his previous undertaking not to prescribe narcotics or controlled drugs, which remains in full force and effect.