Muirhead, William Maclaren (CPSO#: 51134)

Current Status: Revoked: Discipline Committee as of 17 May 2016

CPSO Registration Class: None as of 17 May 2016

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:The University of Western Ontario, 1982

Practice Information

Primary Location of Practice
Practice Address Not Available

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1982
Expired: Terms and conditions of certificate of registration Expiry: 30 Jun 1984
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 25 Sep 1984
Transfer of class of certificate to: Restricted certificate Effective: 20 Sep 2012
Expired: Failure to Renew Membership Expiry: 15 Aug 2013
Suspension of registration imposed: Discipline Committee Effective: 05 Mar 2014
Suspension of registration removed Effective: 05 Sep 2015
Revoked: Discipline Committee. Effective: 17 May 2016

Previous Discipline Hearings

Committee: Discipline
Decision Date: 17 May 2016
Summary:

On May 17, 2016, the Discipline Committee of the College of Physicians and Surgeons of 
Ontario found that Dr. William MacLaren Muirhead has committed an act of professional 
misconduct in that he engaged in sexual abuse of a patient and in that he has engaged in conduct 
or 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. Muirhead treated Patient A, a university student, between September 2008 and December 
2011 after she was referred by university student health services for management of anxiety and 
depression.  
Patient A’s visits with Dr. Muirhead were frequent, taking place multiple times per week. Some 
appointments lasted more than two hours. At first, Dr. Muirhead would ask Patient A to sit on a 
chair close to his so that their knees would touch. The sessions would end with a hug. Dr. 
Muirhead encouraged Patient A to be dependent upon him.  
Their sessions then moved primarily to the back room of Dr. Muirhead’s office, which had a 
mattress on the floor and a desk against the wall. Initial removal of Patient A’s shirt and back 
massaging progressed to cuddling, digital penetration of her vagina on most visits, and sexual 
intercourse. Dr. Muirhead and Patient A spent most of the time in these sessions in the back 
room. 
When Dr. Muirhead learned of the College’s previous investigation of him, he warned Patient A 
in an email chat not to tell the College about any activities in the “back room.” Dr. Muirhead 
instructed Patient A to explain his statement in emails to her of “I love you,” as “I love you like 
he loved his dogs.” Patient A did as Dr Muirhead requested, and did not initially admit to a 
sexual relationship with him despite being asked by the College investigator. Dr. Muirhead told 
Patient A that so many people, including her, were dependent on him. He convinced her that 
action by the College against him would ruin her life and her marriage. Patient A was also 
concerned about Dr. Muirhead’s “explosive” reaction if she were to tell the College the truth.  
Patient A estimated that Dr. Muirhead gave her a total of $23,000.00 over time.  
 
PENALTY AND COSTS 
The Discipline Committee ordered and directed that: 
   -  the Registrar revoke Dr. Muirhead's certificate of registration effective immediately; 
   -  Dr. Muirhead appear before the panel to be reprimanded within 90 days of this Order 
      becoming final; 
   -  Dr. Muirhead reimburse the College for funding provided to patients under the program 
      required under section 85.7 of the Code, by posting an irrevocable letter of credit or other 
      security acceptable to the College, by July 31, 2016, in the amount of $16,060.00; and 
   -  Dr. Muirhead pay costs to the College in the amount of $10,000.00 by October 31, 2016.

Decision: Download Full Decision (PDF)
Hearing Date(s): May 16 & 17, 2016


Committee: Discipline
Decision Date: 05 Mar 2014
Summary:

On March 5, 2014, the Discipline Committee found that Dr. Muirhead committed an act of 
professional misconduct, in that he failed to maintain the standard of practice of the profession, 
and that he has engaged in conduct or 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. Muirhead admitted to the allegations. 
 
Dr. Muirhead  is a general practitioner, whose practice was limited to psychotherapy. He is no 
longer a member of the College, having allowed his certificate of registration to expire on August 
15, 2013.  
 
Dr. Muirhead engaged in numerous boundary violations including: 
  
      Financial transactions with patients.  
      Repeatedly hugged certain patients in therapy sessions; 
      Exchanged gifts with two patients; 
      Employed  two patients to work in his office and perform his yard work, and also 
      requested and permitted one patient to perform administrative tasks in his office; 
      Had contact with four patients outside of therapy, meeting two of these patients at 
      restaurants and/or movies; 
      Visited two patients at their homes; 
      Told six patients that he loved them; 
      In emails, encouraged several patients to delete their communications with him and keep 
      the nature of their relationship with him a secret.  
      In email exchanges with two patients, disclosed confidential information about another 
      patient in relation to her complaint to the College and requested and permitted a patient to 
      assist him in the preparation of his response to the complaint; 
      Offered to pay for car repairs for a patient; and  
      Offered to pay for concert tickets for a teenaged patient being seen by Dr. Muirhead for 
      counseling in the context of her parents' marital difficulties. 
 
Email messages that Dr. Muirhead exchanged with five patients obtained in the College's 
investigation appear to describe romantic and/or sexual relationships between Dr. Muirhead and 
these patients. The patients deny actual sexual contact. 
 
Independent experts retained by the College opined that Dr. Muirhead failed to maintain the 
standard of practice in the following respects:   
 
      Recordkeeping with inadequate progress notes; some files failing to contain basic 
      information   such as address or birthdate; the patient's family history, history of 
      psychiatric disorder and developmental history, diagnosis or treatment plan ;   there were 
      no complete Mental Status Examinations recorded;  
      In one case, the chart note was  inaccurate and misleading with regard to suicidal intent;  
      Did not adequately explain or obtain informed consent and document this for his 
      challenging form of therapy;  
 
 
      Frequently told his female patients that if they allow themselves to be close to him and 
      feel strong feelings as well as physical sexual arousal, this would improve the result or 
      outcome of their therapy. There is no evidence that this amount of closeness is either 
      necessary or sufficient to have a good outcome;  
      Placed excessive pressure on patients for positive feelings, affection and sexual and 
      physical sensations of arousal. Sometimes the pressure for closeness was demanded with 
      the threat that without it, therapy would stop; 
      Saw many patients who know each other. He did ask them not to talk about therapy with 
      one another but they did. This complicates the resistance and the competitiveness for love 
      that patients feel, especially when he commented to patients that those who are very close 
      to him do well and those who are not close to him do not do well;  
      In six cases, exchanged emails with patients which characterize an intimate, loving 
      relationship rather than a therapeutic relationship, with inappropriate self-disclosure by 
      him;  
      Engaged in inappropriate contact with some patients outside therapy. 
      Occasionally talked to his patients about other patients and had one patient type his 
      response to a College complaint made by another patient; 
      Engaged in unacceptable boundary crossings and violations, including hugging patients, 
      signing his emails "Love H", borrowing money from patients, visiting patients in his 
      home or theirs, telling patient they are very special, and engaging in inappropriate 
      self-disclosure to patients; 
      In his email exchanges, the interactions characterize a personal relationship more than a 
      therapeutic one. He does not firmly indicate that this is not and never will be a personal 
      relationship. This is a failure to maintain boundaries and a failure in knowledge of 
      clinical practice guidelines for psychotherapy;  
      Asked patients to delete their emails with each other;  
      In respect of one complainant, he failed to maintain the standard of practice in his 
      assessment in his medical records, in failing to establish an alliance, in his selection of the 
      type of therapy and in his failure to obtain informed consent. In addition, he 
      inappropriately offered to meet the patient outside the office, told the patient to delete 
      emails from him and gave her his cell phone number. 
      In respect of three patients, he failed to maintain the standards of family or couple 
      psychotherapy.  
 
In the opinion of expert retained by Dr. Muirhead, Dr. Muirhead had knowledge and skill in this 
type of treatment, but there were deficits in recordkeeping including failures to document mental 
status examinations, and boundary violations including hugging patients, employing patients, 
lending money to patients and giving and receiving large gifts. The expert also noted that emails 
discussing emotions and love, sexual fantasies or closeness can be confusing to patients. 
 
The Discipline Committee ordered and directed that: 
 
      Dr. Muirhead  appear before the panel to be reprimanded;  
      The Registrar suspend Dr. Muirhead's Certificate of Registration for a period of eighteen 
      (18) months, commencing immediately; 
 
The Registrar  impose the following terms, conditions and limitations on Dr. Muirhead's 
Certificate of Registration: 
              
a)    After the completion of the suspension referred to in paragraph 3 above, Dr. 
      Muirhead shall complete a remedial program in psychotherapy under the guidance 
      and supervision of a preceptor or preceptors acceptable to the College (the 
      "Remedial Program").  The Remedial Program must be approved in advance by 
      the College and shall consist of any remedial elements the College deems 
      appropriate, including, without limitation, the following:  
              
      (i)   A period of no less than three months, or such longer period as deemed 
            appropriate by Dr. Muirhead's preceptor(s) and the College, of high 
            supervision during which time Dr. Muirhead shall be restricted from being 
            the Most Responsible Physician and during which he shall see patients 
            only under the direct supervision of his preceptor(s);  
      (ii)  A period of no less than three months following the completion of the high 
            supervision period referenced above, or such longer period as deemed 
            appropriate by Dr. Muirhead's preceptor(s) and the College, of moderate 
            supervision, during which time Dr. Muirhead will meet with his 
            preceptor(s) on a bi-weekly basis to review patient records and discuss any 
            issues or concerns arising therefrom;  
      (iii) A period of no less than six months following the completion of the 
            moderate supervision period referenced above, or such longer period as 
            deemed appropriate by Dr. Muirhead's preceptors and the College, of low 
            supervision, during which time Dr. Muirhead will meet with his 
            preceptor(s) on a monthly basis to review patient records and discuss any 
            issues or concerns arising therefrom;  
      (iv)  Direct observation of Dr. Muirhead's patient care by the preceptor(s) as 
            deemed appropriate by the preceptor(s) and the College;  
      (v)   College-approved courses, which may include, without limitation, courses 
            in psychotherapy and the maintenance of appropriate physician-patient 
            boundaries; and 
      (vi)  A comprehensive practice assessment (the "Assessment") following the 
            completion of the above-referenced remediation, to be conducted by an 
            assessor appointed by the College, and Dr. Muirhead shall abide by any 
            recommendations of the College's assessor.  
              
b)    Dr. Muirhead may not have any professional contact with female patients, except 
      in the presence of a female chaperone (the "Practice Monitor"). In particular:  
              
      (i)   The Practice Monitor shall be a member of a registered health profession 
            pursuant to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18, 
            as amended, who is approved by the College and who has executed an 
            undertaking with the College in the form attached to this Order as 
            Appendix "A"; 
       
            (ii)  The Practice Monitor shall make a note in the relevant patient chart 
                  documenting each patient interaction for which she is present, and there 
                  will be a second written record kept chronologically for each patient seen 
                  (the "Log"). The Log shall be kept by the Practice Monitor. Dr. Muirhead 
                  shall ensure that contemporaneously with any interaction with any female 
                  patient in his office, the Practice Monitor initials the Log; 
            (iii) If the Practice Monitor has concerns that Dr. Muirhead's practice exposes 
                  his patients to risk of harm or injury, the Practice Monitor must agree to 
                  report this to the College immediately; 
            (iv)  Dr. Muirhead shall place a sign in the form attached to this Order as 
                  Appendix "B" in his waiting room and each of the examination rooms in 
                  his office stating that Dr. Muirhead shall not see female patients unless the 
                  Practice Monitor is present and observing all of the interaction with the 
                  female patient as it is occurring.  
 
      c)    Dr. Muirhead shall use a College-approved Electronic Medical Records system 
            for the purposes of keeping all clinical notes and records associated with his 
            practice, and shall make audit reports from this system available to the College on 
            request; 
 
      d)    Dr. Muirhead shall provide a written notice (the "Notice") to each patient he sees 
            in a form acceptable to the College advising them that Dr. Muirhead has agreed 
            that: 
 
            (i)   He shall not tell patients that he loves them, or imply that he loves or has 
                  loving feelings towards them, and he shall not solicit expressions of 
                  affection from patients; 
            (ii)  He shall not hug patients, or engage in any other physical display of 
                  affection with patients;  
            (iii) He shall not disclose information to patients about his personal life, 
                  including, without limitation, information concerning his financial 
                  situation;  
            (iv)  He shall refrain from accepting loans or gifts from patients, and he shall 
                  not make loans or gifts to patients;  
            (v)   He shall not employ patients or accept assistance from patients with 
                  administrative tasks;  
            (vi)  He shall not communicate with patients outside of therapy sessions in his 
                  office, including, without limitation, by means of telephone or e-mail, save 
                  and except for the sole purpose of scheduling appointments; and 
            (vii)  He shall not meet with patients outside his office.  
 
The Notice shall advise patients that the College may contact them to inquire whether they have 
experienced any inappropriate comments or behaviour during their treatment by Dr. Muirhead.  
Dr. Muirhead shall ensure that patients sign this written notice to acknowledge they have 
reviewed it, and Dr. Muirhead shall keep this signed document in each patient file; and 
 
e)    Dr. Muirhead shall bear any costs associated with the Remedial Program, the 
      Assessment or any other terms of this Order. 
              
Dr. Muirhead  pay costs to the College in the amount of $4,460.00 within 150 days from 
the date of this Order. 
              
              
              

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): March 5, 2014