The College of Physicians and Surgeons of PEI received a complaint by Patient B in February 2020, against Dr. Nicole Fancy with regard to boundary violations of the physician -patient relationship in that Dr. Fancy inappropriately pursued a friendship with Patient B despite recently treating Patient B at a mental health clinic. Dr. Fancy voluntarily underwent a psychiatry/psychology evaluation.
The Council for the College accepted the Fitness to Practise Committee Report and Findings and adopted the Committee’s recommendations with some changes, on June 8, 2021, Ordered as follows:
… that whereas the Council of the College of Physicians and Surgeons of PEI confirmed the findings of the Fitness to Practise Committee of the College, regarding the complaint by Patient B against Dr. Nicole Fancy, that Dr. Nicole Fancy committed professional misconduct pursuant to subsections XI(1)(a) and (h) of the Medical Act Regulations:
-Failing to maintain accepted professional standards and procedures in the practice of medicine; and
-Engaging in conduct or an act relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by medical practitioners as disgraceful, dishonourable, or unprofessional,
and that Dr. Nicole Fancy is an incapacitated member pursuant to the Medical Act, Part 1, subsection 1(j), supported by the independent medical evaluation completed by a psychiatrist, and a psychologist, in December 2020.
“Incapacitated member means a member suffering from a physical or mental condition, emotional disturbance or excessive use of alcohol or drugs, of a nature and extent making it desirable in the interests of the public or the member that he no longer be permitted to practice or that his practice be restricted.”
It is Ordered that:
- Fancy be given a written reprimand.
- This Order includes a minimum of a 3 month suspension which is in addition to and which shall run consecutively with the suspension handed down this same date, in the Order pertaining to the matter self reported by Dr. Fancy.
- Fancy pay the College a fine of $5 000.00.
- Fancy pay the College a sum of $10 000.00, as payment of costs associated with the College’s investigation and disciplinary proceedings.
- Fancy be required to participate in and successfully complete within 6 months of the date this Order is received by Dr. Fancy, an individualized course in professional boundaries satisfactory to the College, at her own expense. Dr. Fancy shall provide to the College a report of successful completion of the course.
- Fancy be required to participate in and successfully complete within 6 months of the date this Order is received by Dr. Fancy, a course in the approach and management of patients with Borderline Personality Disorder for the general practitioner, that is satisfactory to the College, at her own expense. Dr. Fancy shall provide to the College a report of successful completion of the course.
- Fancy be suspended from practice for a minimum of 3 months, and until she is fit to practise in accordance with the following, and shall comply, with an undertaking for the following practice restrictions:
- Fancy shall remain under the care of her family physician and the Physician Health Program to ensure her mental health concerns are addressed, as well as any other physical or mental health problems are treated as they arise, with satisfactory quarterly reports submitted to the College office, from both the family physician and the Physician Health Program.
- Fancy shall complete a course of insight-oriented psychotherapy with a psychiatrist or psychologist, for a duration of no less than 12 months. Dr. Fancy will complete a minimum of 3 months of therapy before consideration of return to practice, with satisfactory quarterly reports submitted to the College office.
- Fancy shall enter into a Monitoring Agreement with the College and with the help of the Physician Health Program, where she agrees to abstain from the consumption of alcohol, cannabis, and other substances and to participate in a structured toxicology screening program for the duration of two years. Parameters of screening are set out by the Physician Health Program and will include random observed blood or urine collection utilizing chain of custody protocols no less than 36 times in the first year and 24 times in the second year.
- Fancy shall complete a minimum of 3 months of abstinence from alcohol, cannabis and other substances before considering a return to practice, with confirmation provided to the College by the Physician Health Program. Dr. Fancy is encouraged to access abstinence-based supports.
- Fancy be restricted from being the most responsible physician for patients with primary mental health issues.
- Fancy shall limit on-call demands where possible, and shall only practice within her core competencies as a family physician.
- Fancy will be restricted from working in a solitary family practice, but instead is to practice within an interdisciplinary team or group family practice to facilitate appropriate triaging of patients with mental health issues, and facilitate workplace supervision.
- Fancy shall live outside the community where she practices, unless Council orders otherwise, to promote work-life balance and professional boundaries.
- Fancy will practise with a workplace monitor to review her patient roster and provide direction and oversight regarding the appropriateness of the physician-patient relationship, with satisfactory quarterly reports submitted to the College office.
- Fancy will have no further contact either personally or professionally with Patient B.
- Fancy will release the Committee findings, College rulings and reports to her treating physicians.
- Council expects Dr. Fancy to participate in the psychotherapy program and to abstain from alcohol and drugs for an extended period of time so that her progress can be assessed, before she applies to have her license reinstated. After months of active treatment of insight-directed psychotherapy and months of abstinence in an abstinence program outlined above (both of which can happen concurrently), Dr. Fancy may choose to apply to return to practice, and must undergo a repeat independent medical evaluation of her fitness to practice by a psychiatrist or another qualified physician approved by the College to conduct the evaluation. Dr. Fancy shall arrange for the psychiatrist or physician to report findings and make a recommendation, and Council will review these before making a decision about return to practice.