As from August 26, 2023, the following are imposed as terms, conditions and limitations on the certificate of registration held by Dr. Ira Paul Bernstein in accordance with an undertaking and consent given by Dr. Bernstein to the College of Physicians and Surgeons of Ontario:
UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
("Undertaking")
of
DR. IRA PAUL BERNSTEIN
("Dr. Bernstein")
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;
"Discipline Tribunal" means the Ontario Physicians and Surgeons Discipline Tribunal of the College;
"ICR Committee" means the Inquiries, Complaints and Reports Committee of the College;
"OHIP" means the Ontario Health Insurance Plan;
"Ontario Physicians and Surgeons Discipline Tribunal" means the Discipline Committee established under the Code;
"Public Register" means the College's register that is available to the public.
(2) I, Dr. Bernstein, certificate of registration number 62382, am a member of the College.
(3) I, Dr. Bernstein, acknowledge that the College conducted an investigation bearing File Number CAS-369121-S9G6R5 (the "Investigation") into whether I engaged in professional misconduct and/or am incompetent in my family medicine practice and in my conduct, including my care and conduct in relation to the COVID-19 pandemic and my prescribing and promotion of ivermectin for COVID-19, and my completion of COVID- 19 vaccine exemptions.
(4) I, Dr. Bernstein, acknowledge that I signed an interim undertaking in lieu of the ICR Committee making an Order under section 25.4 of the Code on May 25, 2022 (the "2022 Undertaking").
(5) I, Dr. Bernstein, acknowledge that this Undertaking replaces the 2022 Undertaking.
(6) I, Dr. Bernstein, acknowledge that, in addition to accepting this Undertaking, the College will also deliver a caution in person.
B. UNDERTAKING
(7) I, Dr. Bernstein, undertake to abide by the provisions of this Undertaking, effective immediately.
(8) Practice Restrictions
(a) I, Dr. Bernstein, undertake to restrict my practice as follows:
(i) I will not provide medical exemptions in relation to vaccines for COVID-19;
(ii) I will not provide medical exemptions in relation to mask requirements for COVID-19;
(iii) I will not provide medical exemptions in relation to diagnostic testing for COVID-19; and
(iv) I will not prescribe ivermectin or hydroxychloroquine in relation to COVID-19.
(9) Professional Education
(a) I, Dr. Bernstein, undertake to participate in and successfully complete all aspects of the detailed IEP, attached hereto as Appendix "A", including all of the following professional education (the "Professional Education"):
(i) The following learning modules in Evidence-Informed Decision Making in Public Health, National Collaborating Centre for Methods and Tools, McMaster University:
1. Introduction to Evidence-informed Decision Making;
2. Searching for Research Evidence in Public Health;
3. Critical Appraisal of Intervention Studies;
4. Assessing the Applicability and Transferability of Evidence.
(ii) Review, reflection, and a written summary of the following policies and other self-study:
1. The College's Practice Guide: Medical Professionalism and College Policies;
2. Social Media, CPSO Policy;
3. The Spread of Misinformation, Dialogue. 2023., College of Physicians and Surgeons of Ontario;
4. Murthy V.H. Confronting Health Misinformation: The U.S. Surgeon General's Advisory on Building a Healthy Information Environment. 2021;
5. The following sections from McIntosh, K. COVID-19: Epidemiology, virology, and prevention. UpToDate. Retrieved August 8, 2023:
(i) Prevention; and
(ii) Post-Exposure Management.
6. The following section from Cohen, P., Gebo, K. COVID-19: Evaluation of adults with acute illness in the outpatient setting. UpToDate. Retrieved August 8, 2023:
(i) Therapies that we do not recommend.
7. Medical Records Documentation, CPSO Policy.
(iii) Review, and reflection of the following self-study:
1. Pasquetto I.V., et al. MisinfoRx: A Toolkit for Healthcare Providers.
(iv) PROBE: Ethics & Boundaries Program, by receiving a passing evaluation or grade, without any condition or qualification. I, Dr. Bernstein, will agree to abide by any recommendations of the PROBE program.
(b) I, Dr. Bernstein, undertake to complete the Professional Education within three (3) months, or, if no satisfactory program is available by that time, by the first possible opportunity thereafter.
(c) I, Dr. Bernstein, undertake to provide proof to the College of my successful completion of the Professional Education, including proof of registration and attendance and participant assessment reports, within one (1) month of completing it. I acknowledge that the College will determine, in its sole discretion, whether I have successfully completed the Professional Education.
(d) I, Dr. Bernstein, acknowledge that a report or reports may be provided to the College regarding my progress and compliance with the Professional Education.
(e) I, Dr. Bernstein, acknowledge that if any of the programs or resources listed above become unavailable, substitution requests will be reviewed by the College and the College will determine in its sole discretion whether substitution is appropriate.
(10) Monitoring
(a) I, Dr. Bernstein, undertake to inform the College of each and every location at which I practise or have privileges, including, but not limited to, any hospitals, clinics, offices, and any Independent Health Facilities with which I am affiliated, in any jurisdiction (collectively my "Practice Location" or "Practice Locations"), 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. Bernstein, undertake that I will submit to, and not interfere with, unannounced inspections of my Practice Locations and patient records by a College representative for the purposes of monitoring my compliance with the provisions of this Undertaking.
(c) I, Dr. Bernstein, 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. Bernstein, acknowledge that I have executed the OHIP consent form, attached hereton as Appendix "B'.
C. ACKNOWLEDGEMENT
(11) I, Dr. Bernstein, acknowledge that all appendices attached to or referred to in this Undertaking form part of this Undertaking.
(12) I, Dr. Bernstein, 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. Bernstein, 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. Bernstein, acknowledge that the College will provide this Undertaking to any Chief of Staff, or a colleague with similar responsibilities, at any Practice Location ("Chief of Staff" or "Chiefs of Staff").
(15) I, Dr. Bernstein, 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 Tribunal of the College.
(16) I, Dr. Bernstein, 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. Bernstein, acknowledge that, during the time period that this Undertaking remains in effect, this Undertaking shall be posted on the Public Register.
(b) I, Dr. Bernstein, acknowledge that, in addition to this Undertaking being posted in accordance with section (17)(a) above, the following summary shall be posted on the Public Register during the time period that this Undertaking remains in effect:
A College investigation was conducted into whether Dr. Bernstein engaged in professional misconduct and/or is incompetent in his family medicine practice and in his conduct, including his care and conduct in relation to the COVID-19 pandemic and prescribing and promotion of ivermectin for COVID-19, and the completion of COVID-19 vaccine exemptions. As a result of the investigation:
Dr. Bernstein will restrict his practice as follows:
Dr. Bernstein will not provide medical exemptions in relation to vaccines for COVID-19;
Dr. Bernstein will not provide medical exemptions in relation to mask requirements for COVID-19;
Dr. Bernstein will not provide medical exemptions in relation to diagnostic testing for COVID-19; and
Dr. Bernstein will not prescribe ivermectin or hydroxychloroquine in relation to COVID-19.
Dr. Bernstein will engage in professional education including in respecting CPSO policies, public health guidance, and Ministry of Health directives during a declared pandemic, misinformation and evidence-based decision making, the prevention and treatment of COVID-19 in an outpatient setting, and medical record keeping.
D. CONSENT
(18) I, Dr. Bernstein, give my irrevocable consent to the College to provide the following information to any person who requires this information for the purposes of facilitating my completion of the Professional Education:
(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. Bernstein, give my irrevocable consent to the College to provide all Chiefs of Staff with any information the College has that led to the circumstances of my entering into this Undertaking and/or any information arising from the monitoring of my compliance with this Undertaking.
(20) I, Dr. Bernstein, give my irrevocable consent to any persons who facilitate my completion of the Professional Education, and to all Chiefs of Staff, to disclose to the College, and to one another, any of the following:
(a) any information relevant to this Undertaking;
(b) any information relevant for the purposes of monitoring my compliance with this Undertaking;
(c) any information which comes to their attention in the course of providing the Professional Education and which they reasonably believe indicates a potential risk of harm to my patients.