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Marciniak, Zbigniew Andrzet

CPSO#: 33744

MEMBER STATUS
Active Member as of 16 Jun 1980
CURRENT OR PAST CPSO REGISTRATION CLASS
Restricted as of 24 Jun 2020

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English, Polish

Education: Poznan University of Medical Sciences, 1973

Practice Information

Primary Location of Practice
Sports Medicine Rehabilitation
Clinic
1539 Bloor Street West
Toronto ON  M6P 1A5
Phone: (416) 539-0302
Fax: (416) 539-0395 Electoral District: 10

Additional Practice Location(s)

Medical Dental
and Rehabilitation Clinic
2334 Lake Shore Blvd. West
Etobicoke, Ontario
Etobicoke ON  M8V 1B6
Canada
Phone: 416-259-0910
Fax: 416-255-8531
County: City of Toronto
Electoral District: 10

Specialties

Specialty Issued On Type
No Speciality Reported

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 16 Jun 1980
Transfer of class of registration to: Independent Practice Certificate Effective: 27 Sep 1982
Transfer of class of certificate to: Restricted certificate Effective: 24 Jun 2020
Terms and conditions imposed on certificate by member Effective: 24 Jun 2020

Practice Restrictions

Imposed By Effective Date Expiry Date Status
member Effective: 24 Jun 2020 Active
             As from June 24, 2020, the following are imposed as terms, conditions and
            limitations on the certificate of registration held by Dr. Zbigniew Andrzet
            Marciniak in accordance with an undertaking and consent given by Dr. Marciniak
            to the College of Physicians and Surgeons of Ontario:

                        UNDERTAKING, ACKNOWLEDGEMENT AND CONSENT
                                          ("Undertaking")
                  
                                                of
                  
                              DR. ZBIGNIEW ANDRZET MARCINIAK
                                          ("Dr. Marciniak")
                  
                                                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 Committee" means the Discipline Committee of the College;
                  
                  "IEP" means Individualized Education Plan;
                  
                  "OHIP" means the Ontario Health Insurance Plan; 
                  
                  "Public Register" means the College's register that is available to the
                  public;
                  
                  "QAC" means the Quality Assurance Committee of the College.
                  
            (2)   I, Dr. Marciniak, certificate of registration number 33744, am a member
                  of the College.  

            (3)   I, Dr. Marciniak, acknowledge that concerns have been identified with
                  respect to my knowledge, skill and judgment. I am aware of the College's
                  concern about protecting the public.

            (4)   I, Dr. Marciniak acknowledge that due to COVID 19, I am not currently
                  seeing patients in-person.



            B.    UNDERTAKING

            (5)   I, Dr. Marciniak, undertake to abide by the provisions of this
                  Undertaking, effective immediately.

            (6)   I, Dr. Marciniak, undertake to notify the College within 5 days of
                  resuming seeing patients in-person.

            (7)   Clinical Supervision

                  (a)   Upon resuming seeing patients in-person, I, Dr. Marciniak,
                        undertake to practise under the guidance of a clinical supervisor
                        or supervisors acceptable to the College (the "Clinical Supervisor"
                        or "Clinical Supervisors"), for six (6) months ("Clinical
                        Supervision"). 
                  
                  (b)   I, Dr. Marciniak, acknowledge that I have reviewed the Clinical
                        Supervisor's undertaking attached hereto as Appendix "A", and
                        understand what is required of the Clinical Supervisor. The
                        Clinical Supervisor will, at minimum:
                  
                        (i)   Facilitate the education program set out in the
                              Individualized Education Plan ("IEP"), attached hereto as
                              Appendix "B";
                  
                        (ii)  Review the materials provided by the College and have an
                              initial meeting to discuss the objectives for the Clinical
                              Supervision and practice improvement recommendations;
                  
                        (iii) Meet with me at my Practice Location, or another location
                              approved by the College, once every two (2) weeks for a
                              minimum of three (3) months;
                  
                        (iv)  After a minimum of three (3) months of Clinical Supervision,
                              if my Clinical Supervisor recommends and the College approves
                              a reduction in the level of supervision, my Clinical
                              Supervisor will meet with me at my Practice Location, or
                              another location approved by the College, once every month
                              for a further three (3) months;
                  
                        (v)   Review at least fifteen (15) of my patient charts at every
                              meeting;
                  
                        (vi)  Discuss any concerns arising from the chart reviews;
                  
                        (vii) Make recommendations to me for practice improvements and
                              ongoing professional development and inquire into my
                              compliance with the recommendations; 
                  
                        (viii)Perform any other duties, such as reviewing other documents
                              or conducting interviews with staff or colleagues, that the
                              Clinical Supervisor deems necessary to my Clinical
                              Supervision; and
                        (ix)  Submit written reports to the College at least once every
                              month for three (3) months or until the College approves a
                              reduction in the level of supervision, and then once at the
                              end of supervision, or more frequently if the Clinical
                              Supervisor has concerns about my standard of practice.
                  
                  (c)   I, Dr. Marciniak, acknowledge that the charts reviewed shall be
                        selected by the Clinical Supervisor based on the educational needs
                        identified in the IEP set out at Appendix "B" to my Undertaking, as
                        well as the areas of concern identified in the report of the
                        assessor, and concerns that may arise during the period of Clinical
                        Supervision.
                  
                  (d)   I, Dr. Marciniak, undertake to cooperate fully with the Clinical
                        Supervision of my practice described in section (7) of this
                        Undertaking and Appendix "A" attached, and undertake to abide by
                        the recommendations of my Clinical Supervisor, including but not
                        limited to recommended practice improvements and ongoing
                        professional development. 
                  
                  (e)   I, Dr. Marciniak, acknowledge that in making its determination that
                        I may return to unsupervised practice, the College may require that
                        I sign a further undertaking imposing terms, conditions and
                        limitations on my certificate of registration or requiring ongoing
                        re-assessments, clinical supervision and/or monitoring. 
                  
                  (f)   I, Dr. Marciniak, undertake to ensure that Appendix "A" to this
                        Undertaking is signed and delivered to the College within thirty
                        (30) days of the date I resume seeing patients in person. 
                  
                  (g)   I, Dr. Marciniak, undertake that if a person who has given an
                        undertaking in Appendix "A" to this Undertaking is unable or
                        unwilling to continue to fulfill its provisions, I 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.
                  
                  (h)   I, Dr. Marciniak, undertake that if I am unable to obtain a
                        Clinical Supervisor as set out in sections (7)(f) and (7)(g) above,
                        including returning a signed Appendix "A" within thirty (30) days,
                        I will cease practising medicine until such time as I have obtained
                        a Clinical Supervisor acceptable to the College.  
                  
                  (i)   I, Dr. Marciniak, acknowledge that if I am required to cease
                        practise as a result of section (7)(h) above this will constitute a
                        term, condition or limitation on my certificate of registration and
                        said term, condition or limitation will be included on the public
                        register.
                  
            (8)   Professional Education

                  (a)   I, Dr. Marciniak, undertake to participate in and successfully
                        complete the following professional education (the "Professional
                        Education"):
                  
                        (i)   The following courses: 
                  
                              1.    OCFP MSK Education:  Joint Assessment Made Easy:
                                    https://cpd.ocfp.on.ca/enrol/index.php?id=87;
                  
                              2.    OCFP Practising Wisely:  Reducing Unnecessary Testing
                                    and Treatment:
                                    https://cpd.ocfp.on.ca/enrol/index.php?id=97; and
                  
                              3.    Medical Record-Keeping Course, University of Toronto:
                                    www.cpd.utoronto.ca/recordkeeping/
                  
                        (ii)  Review, reflect upon and prepare a written summary of the
                              following resources: 
                  
                              1.    Ontario Regulation 114/94 of the Medicine Act - section
                                    17.: https://www.ontario.ca/laws/regulation/940114#BK1;
                                    and
                  
                              2.    The Practice Guide, CPSO:
                                    www.cpso.on.ca/Physicians/Policies-Guidance/Practice-Guide;
                  
                        (iii) Review and discuss the following resources with my Clinical
                              Supervisor: 
                  
                              1.    Medical Records Documentation Policy, CPSO:
                                    www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Medical-Records-Documentation;
                                    and
                  
                              2.    Guide to enhancing referrals and consultations between
                                    physicians, CFPC and Royal College:
                                    www.royalcollege.ca/rcsite/documents/health-policy/referrals-consultation-guide-e.pdf
                  
                        (iv)  all aspects of the detailed IEP, attached hereto as Appendix
                              "B"; and
                  
                        (v)   any additional professional education recommended by my
                              Clinical Supervisor.
                  
                  (b)   I, Dr. Marciniak, 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 where relevant, 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.
                  
                  (c)   I, Dr. Marciniak, acknowledge that a report or reports may be
                        provided to the College regarding my progress and compliance with
                        the Professional Education.
                  (d)   I, Dr. Marciniak, undertake to complete the Professional Education
                        within three (3) months of the date I sign this Undertaking, or, if
                        no satisfactory program is available by that time, by the first
                        possible opportunity thereafter.
                  
            (9)   Reassessment of Practice  

                  (a)   I, Dr. Marciniak, undertake that, approximately six (6) months
                        after the completion of the Clinical Supervision set out above and
                        in Appendix "A" and Appendix "B" attached, I will submit to a
                        reassessment of my practice (the "Reassessment") by an assessor or
                        assessors selected by the College (the "Assessor" or "Assessors").
                        I acknowledge that the Reassessment may include a chart review of a
                        minimum of fifteen (15) charts, direct observation of my care,
                        interviews with me, colleagues and co-workers, feedback from
                        patients, and any other tools deemed necessary by the College.
                  
                  (b)   I, Dr. Marciniak, undertake to co-operate fully with the
                        Reassessment conducted under section (9) of this Undertaking. 
                  
                  (c)   I, Dr. Marciniak, acknowledge and provide consent that my Clinical
                        Supervisor may receive and review the findings of the Assessor, and
                        may discuss with the Assessor any issues or concerns arising from
                        the Reassessment. 
                  
                  (d)   I, Dr. Marciniak, acknowledge that the results of the Reassessment
                        will be provided to me and reported to the College and the
                        Reassessment may form the basis of further action by the College. 
                  
            (10)  Monitoring

                  (a)   I, Dr. Marciniak, 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" of "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. Marciniak, 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.    ACKNOWLEDGEMENT 

            (11)  I, Dr. Marciniak, acknowledge that all appendices attached to or referred
                  to in this Undertaking form part of this Undertaking.

            (12)  I, Dr. Marciniak, 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. Marciniak, 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. Marciniak, 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. Marciniak, 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 any one or more of the following:
                  consideration by the QAC, an investigation by the College, or further
                  action by the College, including a referral of specified allegations to
                  the Discipline Committee.

            (16)  I, Dr. Marciniak, 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. Marciniak, acknowledge that, during the time period that
                        this Undertaking remains in effect, this Undertaking shall be
                        posted on the Public Register.
                  
                  (b)   I, Dr. Marciniak, 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:
                  
                              Concerns have been identified with respect to Dr. Marciniak's
                              knowledge, skill and judgment. As a result:
                  
                                    - Dr. Marciniak will practise under the guidance of a
                                    Clinical Supervisor acceptable to the College for 6
                                    months. 
                  
                                    - Dr. Marciniak will engage in professional education
                                    in recordkeeping and certain clinical issues.
                  
                                    - Dr. Marciniak's practice will be reassessed by an
                                    assessor selected by the College approximately 6 months
                                    after the end of the period of Clinical Supervision.
                  
                  
                  
            D.    CONSENT

            (18)  I, Dr. Marciniak, 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.

            (19)  I, Dr. Marciniak, acknowledge that I have executed the OHIP consent form,
                  attached hereto as Appendix "C".

            (20)  I, Dr. Marciniak, give my irrevocable consent to the College to provide
                  the following information to any person who facilitates my completion of
                  the Professional Education and to all Clinical Supervisors and Assessors:

                  (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.
                  
            (21)  I, Dr. Marciniak, give my irrevocable consent to the College to provide
                  all Chiefs of Staff with any information arising from the monitoring of
                  my compliance with this Undertaking.

            (22)  I, Dr. Marciniak, give my irrevocable consent to all Clinical
                  Supervisors, Chiefs of Staff, Assessors, and any persons who facilitate
                  my completion of the Professional Education, to disclose to the College,
                  and to one another, any information:

                  (a)   relevant to this Undertaking;
                  
                  (b)   relevant to the provisions of the Clinical Supervisor's undertaking
                        set out at Appendix "A";
                  
                  (c)   relevant to the Reassessment;
                  
                  (d)   relevant for the purposes of monitoring my compliance with this
                        Undertaking; and  
                  
                  (e)   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.

Concerns

Source: Member
Active Date: June 24, 2020
Expiry Date:
Summary:
Summary of the Undertaking given by Dr Zbigniew Andrzet Marciniak to the College of Physicians and Surgeons of Ontario effective June 24, 2020.

Concerns have been identified with respect to Dr. Marciniak’s knowledge, skill and judgment. As a result:

•Dr. Marciniak will practise under the guidance of a Clinical Supervisor acceptable to the College for 6 months.

•Dr. Marciniak will engage in professional education in recordkeeping and certain clinical issues.

•Dr. Marciniak’s practice will be reassessed by an assessor selected by the College approximately 6 months after the end of the period of Clinical Supervision.

CPSO will be closed on March 29, 2024. We will re-open on Monday, April 1, 2024, at 8:00 am.