Varenbut, Michael (CPSO#: 63881)

Current Status: Active Member as of 21 Feb 2016

CPSO Registration Class: Restricted as of 10 Aug 2011

Indicates a concern or additional information

Summary

Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education:University of Toronto, 1991

Practice Information

Primary Location of Practice
Suite 100
13291 Yonge Street
Richmond Hill ON  L4E 4L6
Phone: (905) 773-7759
Electoral District: 05
View Professional Corporation Information

Professional Corporation Information

Corporation Name: Daiter-Varenbut Medicine Professional Corporation

Certificate of Authorization Status: Inactive: Jan 30 2015

Specialties

Specialty Issued On Type
Family Medicine Effective: 08 Jun 1993 CFPC Specialist

Postgraduate Training

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

University of Toronto, 17 Jun 1991 to 15 Jun 1992
Other - Comprehensive Internship

University of Toronto, 01 Jul 1992 to 30 Jun 1993
Resident 2 - Family Medicine

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 17 Jun 1991
Transfer of class of registration to: Independent Practice Certificate Effective: 23 Jun 1992
Transfer of class of certificate to: Restricted certificate Effective: 10 Aug 2011
Terms and conditions imposed on certificate by member Effective: 10 Aug 2011
Suspension of registration imposed: Discipline Committee Effective: 21 Nov 2015
Suspension of registration removed Effective: 21 Feb 2016

Practice Restrictions

Imposed By Effective Date Expiry Date Status  
member Effective: 10 Aug 2011 Active View Details [+]
            As  from  August  10,  2011,  the following is imposed as a term, condition and
            limitation on the certificate of  registration held by Dr. Michael Varenbut, in
            accordance with an undertaking and consent given by Dr. Varenbut to the College
            of Physicians and Surgeons of Ontario:

                  Dr. Varenbut will not perform  or  be involved in the provision of ultra-
                  rapid opioid detoxification ("UROD")  (also  known as anesthesia-assisted
                  rapid opioid detoxification ("AAROD")).
                  
                  

Previous Hearings

Committee: Discipline
Decision Date: 20 Nov 2015
Summary:

On November 20, 2015, the Discipline Committee found that Dr. Varenbut committed an act of 
professional misconduct in that he 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. Varenbut admitted to the 
allegation. 
Between approximately 2005 and 2013, Dr. Varenbut held appointments at various times at six 
hospitals and a university. Between 2005 and 2013, Dr. Varenbut failed to disclose, in certain 
applications for renewal of privileges or appointment at a number of different institutions, that he 
had been the subject of College investigations in the previous year, or that restrictions had been 
imposed on his certificate of registration, where that information was required to be disclosed. 
Prior to completing the applications, Dr. Varenbut was not provided with specific advice on 
completing them or that the scope of disclosure requested can vary from year to year, and from 
one hospital to another. Dr. Varenbut did disclose in his applications, where appropriate, the 
existence of his College Discipline Committee finding. Dr. Varenbut also provided his consent to 
allow the hospital/institution to obtain information from the College in relation to College 
matters, where this was sought. Dr. Varenbut did not exercise his hospital privileges during the 
relevant time period and had no clinical patient responsibility in any of the hospitals/institutions. 
The appointments were obtained and maintained as a corollary to his teaching appointments or 
so that if a patient on methadone in the community required hospitalization, a physician qualified 
in methadone treatment would be available to provide a prescription for methadone while the 
patient was hospitalized.  
 
On February 19, 2013, the Discipline Committee found that Dr. Varenbut engaged in 
professional misconduct in relation to his failure to maintain the standard of practice of the 
profession arising out of a patient’s access to care. In February of 2013, Dr. Varenbut had an 
academic appointment at the University. The University procedures require clinical faculty to 
report decisions of the Discipline Committee to the Department Chair within seven days. In July 
of 2012, Dr. Varenbut reported the discipline referral to his academic supervisor at the 
University. He also voluntarily relinquished his academic role and took a voluntary one year 
sabbatical, pending the outcome of the discipline referral. On April 19, 2013, Dr. Varenbut 
received a letter from the Chair of the Department expressing concern that he had not disclosed 
his discipline finding to her directly within seven days as required pursuant to the procedure 
manual. Prior to this letter, Dr. Varenbut had not notified the Department Chair of the discipline 
finding. 

Dr. Varenbut admitted that he engaged in professional misconduct by failing to provide complete 
and/or accurate information in a timely manner to the University and/or hospitals where he had 
an academic appointment and/or from whom he sought reappointment.    

The Discipline Committee ordered and directed that: 
•  The Registrar suspend Dr. Varenbut’s certificate of registration for three (3) months, 
   commencing on November 21, 2015. 
•  Dr. Varenbut appear before the panel to be reprimanded 
•  Dr. Varenbut pay to the College costs in the amount of $4,460 within 30 days of this Order.  

Decision: Download Full Decision (PDF)
Hearing Date(s): November 20, 2015


Committee: Discipline
Decision Date: 19 Feb 2013
Summary:

On February 19, 2013, the Discipline Committee found that Dr. Michael Varenbut committed an 
act of professional misconduct, in that he failed to maintain the standard of practice of the 
profession. Dr. Varenbut admitted the allegation.  
 
Dr. Varenbut is an Addiction Medicine specialist and is a co-founder of the Ontario Addiction 
Treatment Centres (OATC), the country's largest network of methadone clinics. OATC provides 
a range of harm reduction treatment modalities, including Methadone Maintenance Treatment 
("MMT").   
 
In 2005, Patient A sought help for her drug addiction from OATC.  She received treatment from 
OATC clinics in Thunder Bay, Sudbury and Peterborough between 2005 and the spring of 2008. 
In mid-2006, Dr. Varenbut became the Most Responsible Physician with respect to her care.  
 
Throughout her involvement with OATC, Patient A's attendance for her regular urine samples, 
supervised methadone doses and clinic appointments was sporadic.   Clinic staff felt Patient A 
was challenging and demanding and that her non-compliance and the hostile conduct of her 
partner created more challenges than most patients within their clinic structure.    
After travelling to southern Ontario for a medical procedure in the spring of 2008, Patient A 
stopped taking her methadone dose. In August of 2008, Patient A asked to re-start the methadone 
program at OATC. At the time she was using cocaine and other opiates, including by injection. 
Clinic staff told her she would have to leave urine samples twice a week and have blood work 
and an ECG done before she could see a doctor.   Clinic staff indicated that these preconditions 
were now required for all patients seeking to be initiated on the program.   Although Patient A 
provided 24 witnessed urine samples at the OATC clinic between August 2008 and March 2009, 
she didn't complete her blood work until early March of 2009 and did not obtain an ECG.  She 
was not given an appointment with Dr. Varenbut, who viewed her failure to complete the other 
tests as demonstrating a lack of commitment to the program and thus was unwilling to waive the 
requirements. 
 
In early 2009, Patient A stressed the importance of seeing a physician as she wanted to go on 
methadone and receive take-home doses for a vacation out of the country. In early April, 2009, 
after returning from her trip, she attended at the clinic to provide a urine sample and was advised 
by clinic staff that Dr. Varenbut was terminating her care and OATC would not provide her with 
methadone treatment.  
 
Dr. Varenbut failed to maintain the standard of care with respect to Patient A by: 
 
      a)    failing to provide Patient A with a physician appointment within a reasonable time 
            after she sought to be re-admitted to the MMT program in August 2008; 
      b)    failing to make a timely decision about whether or not to accept Patient A back 
            into the MMT program; and  
 
      c)    unreasonably delaying Patient A's access to methadone treatment, of which she 
            was in urgent need. 
 
 
 
Dr. Varenbut intends to stop his methadone practice and has already started to transfer his MMT 
patients to other physicians. Since the time of Patient A's involvement with Dr. Varenbut and the 
OATC clinics, the following changes have been implemented at OATC: 
      (i)   An Involuntary Discharge Policy which details the protocol to be followed when 
            terminating a MMT patient has been implemented at all OATC clinics. 
      (ii)  The OATC has a "Best Practice Committee" comprised of five OATC physicians, 
            a Clinical Case Manager, clinic nurses and other ad hoc members of the team. A 
            dedicated subcommittee of the Best Practice Committee, the "Involuntary 
            Discharge Committee", has been formed which collaborates on any decision to 
            discharge a patient involuntarily from OATC.  
 
In 2008, an assessment of Dr. Varenbut's MMT practice based on a review of his care of 15 
patients was conducted for the College's Methadone Committee. The Committee concluded that 
his care of these patients complied with the MMT Guidelines. 
 
The Committee ordered and directed that: 
      Dr. Varenbut appear before the panel to be reprimanded. 
      Dr. Varenbut pay to the College costs in the amount of $14,600 within 60 days of the date 
      of this Order. 
 

Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): February 19, 2013