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Wojcicka, Anna Maria

CPSO#: 63380

MEMBER STATUS
Expired: Failure to Renew Membership as of 08 Aug 2023
EXPIRY DATE
09 Aug 2023
CURRENT OR PAST CPSO REGISTRATION CLASS
Restricted as of 03 Feb 2015

Summary

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Former Name: No Former Name

Gender: Female

Languages Spoken: English, Polish

Education: Bialystok University, 1977

Practice Information

Primary Location of Practice
Practice Address Not Available

Professional Corporation Information


Corporation Name: Anna Wojcicki Medicine Professional Corporation
Certificate of Authorization Status: Inactive: Aug 24 2022

Specialties

Specialty Issued On Type
Radiation Oncology Effective:25 May 1998 RCPSC Specialist

Postgraduate Training

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



University of Toronto, 02 Feb 1991 to 30 Jun 1991
Resident 1 - Radiation Oncology

University of Toronto, 01 Jul 1991 to 30 Jun 1992
Resident 1 - Radiation Oncology

University of Toronto, 01 Jul 1992 to 30 Jun 1993
Resident 2 - Radiation Oncology

University of Toronto, 01 Jul 1993 to 30 Jun 1994
Resident 3 - Radiation Oncology

University of Toronto, 01 Jul 1994 to 30 Jun 1995
Resident 4 - Radiation Oncology

University of Toronto, 01 Jul 1995 to 30 Jun 1996
Resident 4 - Radiation Oncology

Registration History

Action Issue Date
First certificate of registration issued: Postgraduate Education Certificate Effective: 26 Feb 1991
Expired: Terms and conditions of certificate of registration Expiry: 30 Jun 1996
Subsequent certificate of registration issued: Restricted certificate Effective: 18 Jul 1996
Expired: Terms and conditions imposed on certificate by Registration Committee Effective: 17 Jul 1997
Subsequent certificate of registration issued: Restricted certificate Effective: 06 Aug 1997
Expired: Terms and conditions imposed on certificate by Registration Committee Effective: 28 Jul 1998
Subsequent certificate of registration Issued: Independent Practice Certificate Effective: 28 Jul 1998
Transfer of class of certificate to: Restricted certificate Effective: 03 Feb 2015
Terms and conditions imposed on certificate by Inquiries, Complaints and Reports Committee Effective: 03 Feb 2015
Terms and conditions amended by Registration Committee Effective: 17 Feb 2016
Suspension of registration imposed: Discipline Committee Effective: 29 Feb 2016
Suspension of registration removed Effective: 29 Mar 2016
Expired: Failure to Renew Membership Expiry: 08 Aug 2023
Expired: Failure to Renew Membership Expiry: 09 Aug 2023

Previous Hearings

Committee: Discipline
Decision Date: 17 Feb 2016
Summary:

On February 17, 2016, the Discipline Committee found that Dr. Anna Maria Wojcicka committed an act of professional misconduct in that she has failed to maintain the standard of practice of the profession.

Dr. Wojcicka is a radiation oncology and internal medicine specialist who currently provides radiation oncology consultation services and practices general medicine in an office located at 6165 Vivian Road, Mount Albert,Ontario. She also provides complex medical rehabilitation care at Southlake Regional Health Centre in Newmarket, Ontario.

The College initiated an investigation into Dr. Wojcicka’s Bioidentical Hormone Replacement Therapy (BHRT) practice in 2012 after the College received information about membership fees and services relating to the Vivian Medical Spa, also located at 6165 Vivian Road, Mount Albert, Ontario.

The College retained an expert, Dr. Z, to provide an opinion on the care of 22 patients who were receiving BHRT from Dr. Wojcicka at 6165 Vivian Road. On the basis of her chart reviews and an interview, Dr. Z concluded that Dr. Wojcicka’s care did not meet the standard of practice of the profession in all 22 cases in that she failed to meet some component of the College’s Policy on Complementary and Alternative Medicine for each patient.

In 14 of the 22 cases, Dr. Z also found that Dr. Wojcicka’s care demonstrated a lack of knowledge, skill and judgment and that her practice posed a risk of harm to patients.

Dr. Z’s concerns with respect to Dr. Wojcicka’s BHRT practice included:

a) 17 cases of prescription BHRT administered without performing a pelvic exam;
b) 3 cases where BHRT was prescribed and no physical exam was documented in the chart;
c) 4 cases of pelvic ultrasound being performed without reasonable cause;
d) 15 charts where a conventional diagnosis is not listed;
e) 17 charts where salivary or blood hormone levels are used to guide treatment;
f) 1 chart in which there is no documented discussion or consent surrounding administration of BHRT;
g) 1 chart in which a woman who has had a total hysterectomy received a Pap test;
h) 3 charts in which BHRT is prescribed to a smoker over 40; 1 in a patient with history of migraine; 1 with undiagnosed vaginal bleeding;
i) 1 chart in which a patient’s method of contraception is discontinued without proper counselling; and
j) 1 chart in which a patient’s diastolic blood pressure is read as over 100 and they are not directed to urgent care.

In response to Dr. Z’s report, Dr. Wojcicka provided her own rebuttal defending her care of the patients reviewed. Dr. Wojcicka also retained Dr. Y to provide an opinion with respect to her BHRT practice.

Dr. Y reviewed the same 22 patient charts that were reviewed by Dr. Z and provided a report, dated July 8, 2015. The concerns noted in Dr. Y’s report included:

a) Dr. Wojcicka seemed reluctant in some cases to do pelvic examinations and PAP smears. She also does not undertake endometrial biopsies and so this would necessitate referring to a Gynaecolgist.
b) She relies heavily on saliva levels and it is not generally agreed that this is accurate testing. Dr. Y expressed concern in this regard, particularly looking at progesterone levels in saliva when they do not appear to be the same in blood or tissue levels.
c) The literature suggesting that compounded therapy using such things as BiEst and progesterone cream is not strong. There is great literature from Europe showing that transdermal estrogen such as Estrogel and oral progesterone such as Prometrium do have many of the benefits that Dr. Wojcicka is attributing to the compounded medications and Dr. Y did not think that is true.
d) Dr. Wojcicka does not appear to be letting patients know that so-called BHRT is available in the form of Estrogel and Prometrium. These are often covered by Drug Plans, whereas compounded therapy often is not and in addition, there are traditional physicians who do offer this type of BHRT.
e) Dr. Wojcika does a lot of redundant testing in her practice. She does salivary levels which cost the patient money and then she does blood levels. Dr. Y was not sure why she is doing blood levels if she is doing salivary levels,. In addition, there is often an abdominal ultrasound as well as a pelvic ultrasound and in many cases, this is not necessary.
f) Dr. Y saw no clear delineation of who is responsible for various conditions in patients. Dr. Y reported that Dr. Wojcicka says that she is doing BHRT, but then she is looking into other things that family doctors would look at such as liver problems, cholesterol testing and a lot of other blood work that she is doing, Dr. Y felt this should be left to the Family Doctor who is doing this anyway. It seems that there is a real potential here for double doctoring on some conditions.
g) Dr. Y reported that physical examination in women, particularly pelvic examination is a staple in looking after women with vaginal symptoms and in menopause and so he does not think this should be avoided by Dr. Wojcicka. Dr. Y also agreed with Dr. Z’s statement that the first thing to be done is not an ultrasound, but physical examination. Dr. Y also agreed with Dr. Z’s statement that there are good clinical trials showing the use of BiEst and TriEst for hormone replacement therapy. Studies using Estrogel and oral progesterone are readily available. Studies using transdermal progesterone are few and far between and this is not equivalent to choosing oral progesterone.

Despite his concerns, Dr. Y concluded that he did not see that Dr. Wojcicka’s patients had undergone any harm.

Dr. Z reviewed Dr. Y’s report and agreed with many of the issues raised by Dr. Y. Dr. Z’s opinion, contained in her report and addendum, did not change.

On February 2, 2015, after referring allegations of professional misconduct to the Discipline Committee, the Inquiries Complaints and Reports Committee directed the Registrar to impose terms, conditions and limitations on Dr. Wojcicka’s certificate of registration pursuant to s. 37 of the Health Professions Procedural Code. The Order required that Dr. Wojcicka cease to provide care with regards to BHRT to patients.

Dr. Wojcicka admitted to the allegations and agreed that the conduct described above constitutes professional misconduct, and that she has failed to maintain the standard of practice of the profession.

The Committee directed the Registrar to suspend Dr. Wojcicka’s certificate of registration for a period of one month commencing on February 29, 2016 at 11:59 p.m.

The Committee also directed the Registrar to place the following terms, conditions and limitations, effective immediately, on Dr. Wojcicka’s certificate of registration:

(a) Dr. Wojcicka is prohibited from practicing any Complementary or Alternative medicine;

(b) Dr. Wojcicka is prohibited from consulting and/or treating patients with respect to Bioidentical Hormone Replacement Therapy;

(c) Dr. Wojcicka must refer any female patient requesting or requiring hormonal or menopausal care or treatment to a gynaecologist;

(d) Dr. Wojcicka must post a sign in the waiting room and in each of the examination rooms at 6165 Vivian Road, and in any other location where she provides primary care to patients, in a clearly visible location. The sign must state the following:
“IMPORTANT NOTICE: Dr. Wojcicka must not practice complementary or alternative medicine and must not treat or consult patients with respect to Bioidentical Hormone Replacement Therapy; and Dr. Wojcicka must refer all female patients requesting or requiring hormonal or menopausal care or treatment to a gynaecologist. Further information may be found on the College of Physicians and Surgeons of Ontario website at www.cpso.on.ca”

(e) Within three to six months of this Order, Dr. Wojcicka must submit to an assessment of her office practice at 6165 Vivian Road by an assessor or assessors selected by the College. This assessment may include chart reviews, direct observation of Dr. Wojcicka’s care, interviews with colleagues and co-workers, feedback from patients and any other tools deemed necessary by the College. Dr.Wojcicka must abide by all recommendations made by the assessor(s), and the results of the Assessment will be reported to the College and may form the basis of further action by the College.

The Discipline Committee ordered that Dr. Wojcicka appear before the panel to be reprimanded.

The Committee also ordered Dr. Wojcicka to pay $5,000.00 in costs to the College within 30 days of the date of this Order.
 
 


Decision: Download Full Decision (PDF)
Appeal: No Appeal
Hearing Date(s): Feb 17, 2016