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Brown, Jeffrey Marlowe

CPSO#: 58417

MEMBER STATUS
Active Member as of 10 Aug 2019
CURRENT OR PAST CPSO REGISTRATION CLASS
Independent Practice as of 24 Nov 2021

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Italian

Education: University of Toronto, 1987

Practice Information

Primary Location of Practice
4-7681 Highway 27
Woodbridge ON  L4L 4M5
Phone: 905 771 7771
Fax: 905 771 7772 Electoral District: 05

Professional Corporation Information


Corporation Name: Brown Medicine Professional Corporation
Certificate of Authorization Status: Issued Date:  Feb 11 2005

Shareholders:
Dr. J. Brown ( CPSO# 58417 )

Business Address:
4-7681 Highway 27
Woodbridge ON  L4L 4M5
Phone Number: 905 771 7771

Business Address:
8300 Highway 27
Woodbridge ON  L4H 0R9
Phone Number: (905) 771-7771

Specialties

Specialty Issued On Type
No Speciality Reported

Terms and Conditions

(1) Dr. JEFFREY MARLOWE BROWN may practise only in the areas of medicine in which Dr. BROWN is educated and experienced.

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 15 Jun 1987
Expired: Terms and conditions of certificate of registration Expiry: 13 Jun 1988
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 26 Sep 1988
Transfer of class of certificate to: Restricted certificate Effective: 10 May 2019
Terms and conditions imposed on certificate Effective: 10 May 2019
Suspension of registration imposed: Discipline Committee Effective: 10 Jun 2019
Suspension of registration removed Effective: 10 Aug 2019
Transfer of class of registration to: Independent Practice Certificate Effective: 24 Nov 2021

Previous Hearings

Committee: Discipline
Decision Date: 10 May 2019
Summary:

On May 10, 2019, on the basis of an Agreed Statement of Facts and Admission, the Discipline Committee found that Dr. Brown committed an act of professional misconduct, in that he 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, and failed to maintain the standard of practice of the profession.

AGREED STATEMENT OF FACTS AND ADMISSION

Dr. Brown is a 58-year-old physician who practices in Thornhill, Ontario. Dr. Brown practices primarily in the areas of weight loss medicine and complementary/alternative medicine at a weight loss clinic in Thornhill. Dr. Brown graduated from the University of Toronto in 1987 and received his certificate of independent practice from the College in 1988.

The College commenced an investigation into Dr. Brown’s practice in 2014, followed by investigations into two public complaints received in 2014 and 2017.

As part of its investigation, the College obtained independent opinions from Dr. Michael Lyon, a physician who practices in the area of medical weight management, Dr. Jennifer Pearlman, a physician who practices in the area of women’s health and wellness, including complementary/alternative medicine and bio-identical hormone replacement therapy, and Dr. Pauline Pariser, a primary care physician. Dr. Pearlman reviewed 25 of Dr. Brown’s patient charts, while Dr. Lyon reviewed 24 patient charts and observed 6 of Dr. Brown’s patient encounters. Dr. Pariser reviewed Dr. Brown’s patient records for his family members. In its investigation of the one of the public complaints, the College also obtained an independent opinion from Dr. Yoni Freedhoff, a physician who practices in office-based weight management.

Dr. Brown obtained opinions from Dr. Esther Konigsberg, a physician who practices complementary/alternative medicine and bio-identical hormone replacement therapy, and Dr. Deborah Martin, a physician who practices in metabolic medicine.

Failure to Maintain The Standard Of Practice Of The Profession

Record-Keeping
The charts reviewed were obtained by the College from Dr. Brown’s practice in 2014 and included care in some cases provided as far back as ten years of patients that entered and exited the weight loss program, restarting the weight loss program often many times over the years. Dr Brown’s practice was to re-assess patients at each restart and create a new chart, including a new patient history profile and CPP.

The expert reviews of Dr. Brown’s medical records revealed a number of deficiencies in Dr. Brown’s charting, including:
1. Organization: Dr. Brown’s charts were disorganized, with test results and patient history profiles inserted throughout the chart and sometimes duplicated, and with no way to identify who made a particular chart entry other than Dr. Brown;
2. Legibility: Dr. Brown’s chart entries were frequently illegible;
3. Completeness: In a number of charts, Dr. Brown did not document physical examinations, or record in the chart key relevant information about weight loss patients such as height, body mass index (BMI), or relevant diagnoses such as diabetes or metabolic syndrome;
4. Consent: Dr. Brown did not clearly document informed patient consent to receive Complementary/Alternative Medicine in accordance with College Policy #3-11, Complementary/Alternative Medicine;
5. CPPs: Dr. Brown did not have complete Cumulative Patient Profiles in a number of charts;
6. Prescribing: Dr. Brown failed to clearly state prescription and supplement additions in a number of patient charts;
7. Testing: Dr. Brown did not always record tests that he ordered or lab work received in the patient charts; and
8. Rationale for testing or prescribing: Dr. Brown failed to document his rationale for ordering tests or for prescribing medications despite normal test results in a number of charts.

Since the commencement of the investigation Dr. Brown voluntarily enrolled in and successfully completed the University of Toronto Medical Record Keeping course on November 16, 2016.

Complementary/Alternative Medicine
Dr. Brown’s provision of Complementary/Alternative Medicine was deficient in that:
- Dr. Brown did not always reach a conventional diagnosis; and
- In one instance, in his prescribing of transdermal estrogen therapy.

Treatment of Family Members
Dr. Pariser opined that Dr. Brown failed to maintain the standard of practice of the profession by providing treatment to his family member in circumstances that were not episodic or emergent, contrary to College Policy #7-06, Physician Treatment of Self, Family Members or Others Close to Them, including completing a requisition for saliva hormone testing and allergy blood testing. Dr. Pariser opined that Dr. Brown’s conduct did not expose his family member to risk of harm.

Disgraceful, Dishonourable or Unprofessional Conduct

Conduct Towards College Investigators
On March 12, 2015, College Investigators attended at Dr. Brown’s office in order to notify him of an investigation into a patient complaint and to obtain relevant information and records, including a patient chart and supplement sample. Dr. Brown became upset with the investigators, and began to speak loudly and angrily. Dr. Brown interrupted the investigators and made disparaging comments about the investigators and disputed their authority to obtain the charts and the supplements. Dr. Brown subsequently provided the requested materials and apologized to the investigator for his conduct.

ADMISSION

Dr. Brown admits the facts specified above and admits that, based on these facts, he engaged in professional misconduct, in that he 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, and failed to maintain the standard of practice of the profession.

DISPOSITION

The Discipline Committee Ordered that:

- Dr. Brown attend before the panel to be reprimanded.
- The Registrar suspend Dr. Brown’s certificate of registration for a period of two (2)months effective June 10, 2019.
- The Registrar impose the following terms, conditions and limitations on Dr. Brown’s - certificate of registration:
(a) Dr. Brown shall, within six (6) months of the end of the period of the suspension, complete professional education in communications and ethics acceptable to the College;
(b) Within sixty (60) days of the date of this Order, Dr. Brown shall obtain a clinical supervisor acceptable to the College, who will supervise Dr. Brown for a period of twelve (12) months, and who will sign an undertaking in the form attached hereto as Schedule “A” (the “Clinical Supervisor”);
(c) The Clinical Supervisor will meet with Dr. Brown initially to discuss practice improvement recommendations;
(d) The Clinical Supervision shall be at a moderate level for three (3) months, commencing on the date following the expiry of the suspension of Dr. Brown’s certificate of registration. During moderate level supervision, the Clinical Supervisor will meet with Dr. Brown monthly, review a minimum of twenty (20) of Dr. Brown’s patient charts and observe Dr. Brown’s patient encounters for one (1) day at each meeting, and discuss Dr. Brown’s patient care and documentation, identify any concerns regarding the care and documentation, make recommendations for improvement, and provide a report to the College each month;
(e) After three (3) months, with approval of the College and on the recommendation of the Clinical Supervisor, the Clinical Supervision shall be at a low level for the remainder of the period of Clinical Supervision. During low level supervision, the Clinical Supervisor will review a minimum of twenty (20) of Dr. Brown’s patient charts per month, and discuss with Dr. Brown his patient care and documentation, identify any concerns regarding the care and documentation, make recommendations for improvement and report to the College every three (3) months;
(f) Within six (6) months after the completion of the Clinical Supervision, Dr. Brown will submit to a reassessment of his practice (the “Reassessment”) by an assessor or assessors selected by the College (the “Assessor(s)”). The Reassessment may include a chart review, direct observation of Dr. Brown’s care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the
College. The results of the Reassessment will be reported to the College and may form the basis of further action by the College;
(g) Dr. Brown shall cooperate fully with the Clinical Supervision and abide by all recommendations of his Clinical Supervisor(s) with respect to practice improvements and education;
(h) Dr. Brown shall consent to the disclosure by the Clinical Supervisor to the College, and by the College to his Clinical Supervisor, of all information the Clinical Supervisor or the College deems necessary or desirable in order to fulfill the Clinical Supervisor’s undertaking and to monitor Dr. Brown’s compliance with this Order. This shall include, without limitation, providing the Clinical Supervisor with any reports of any assessments of Dr. Brown’s practice in the College’s possession;
(i) If a Clinical Supervisor who has given an undertaking in Schedule “A” to this Order is unable or unwilling to continue to fulfill its terms, Dr. Brown shall, within twenty(20) 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;
(j) If Dr. Brown is unable to obtain a Clinical Supervisor in accordance with paragraphs 4(b) or 4(g) of this Order, he shall cease practising medicine until such time as he has done so, and the fact that he has will constitute a term, condition or limitation on his certificate of registration until that time;
(k) Dr. Brown shall co-operate with unannounced inspections and shall consent to the monitoring of his OHIP billings of his Practice by a College representative(s), for the purpose of monitoring and enforcing his compliance with the terms of this Order;
(l) Dr. Brown shall 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 within fifteen (15) days of this Order, and shall inform the College of any and all new Practice Locations within fifteen (15) days of commencing practice at that location; and
(m)Dr. Brown shall be responsible for any and all costs associated with implementing the terms of this Order.

- Dr. Brown pay the College costs in the amount of $6000, within thirty (30) days of the date of this Order.
 
 


Decision: Download Full Decision (PDF)
Hearing Date(s): May 10, 2019 9:00 a.m. start time