Discipline tribunal notes they discussed personal matters, not clinical care
The Ontario Physicians and Surgeons Discipline Tribunal has imposed a temporary suspension on an obstetrician/gynaecologist who engaged in professional misconduct through failing to maintain appropriate boundaries between his personal communications and his professional contact with a patient.
In College of Physicians and Surgeons of Ontario v. Costescu, 2026 ONPSDT 6, the registrant earned his registration certificate for independent practice in Ontario in 2012. He practised at a medical centre, providing services in the field of transgender medicine, until the end of 2024. He then offered other kinds of services at outpatient facilities.
In September 2024, Patient A met the registrant for a surgical consultation for a gender-affirming procedure. The patient recognized the registrant from earlier interactions on an online app, during which they had exchanged photographs and engaged in personal communications.
When the consultation ended, Patient A learned about a waiting list for the surgery. After the appointment, the patient sent a message on the app “liking” the registrant’s profile. The registrant and the patient, members of the same marginalized community, began exchanging messages.
Patient A said he believed he saw the registrant during the appointment. The registrant confirmed he was the physician from that time, apologized for making the patient feel uncomfortable, and suggested that the patient might want to switch to another physician.
Patient A replied that he was willing to continue as the registrant’s patient but was nervous about the suggestion. After messaging on the app for around two weeks, they exchanged phone numbers and texted each other for several weeks more.
The registrant and Patient A shared personal information. However, they did not discuss any issues about clinical care or meet in person. Around November 2024, the patient stopped communicating with the registrant due to his discomfort with the registrant’s role as his physician.
Upon calling the hospital to switch surgeons, Patient A learned that the registrant had closed his hospital practice, which would not affect the waiting time for surgery.
In the present proceeding, the registrant and the College of Physicians and Surgeons of Ontario made a joint submission on penalty and costs.
Suspension imposed
Accepting the joint penalty and costs submission, the Ontario Physicians and Surgeons Discipline Tribunal ordered the suspension of the registrant’s registration certificate for four months. The tribunal required the registrant to:
- Appear before the panel for a reprimand
- Complete a specific ethics and boundaries course
- Pay the regulator $6,000 in costs at the standard tariff rate for a half-day hearing
Based on the uncontested facts, the tribunal determined that the registrant engaged in acts that the profession would reasonably consider disgraceful, dishonourable, or unprofessional, amounting to professional misconduct under s. 1(1)33 of Ontario Regulation 856/93, made under Ontario’s Medicine Act, 1991.
The tribunal held that the registrant failed to fulfill his responsibility to maintain appropriate boundaries and shifted the burden to Patient A to end the boundary violation by suggesting that he might wish to transfer his care to another doctor. The tribunal noted that the registrant communicated with the patient on personal matters via the app and text messages.
Lastly, the tribunal acknowledged the withdrawal of all other misconduct allegations.
