Suspension – Dr. Nicole Richard (nee Fancy)

June 8, 2021

The College of Physicians and Surgeons of PEI received a self-report from Dr. Nicole Fancy in early 2020, Â that she had entered into a sexual relationship with Patient A at the time that she had informed the patient that their physician-patient relationship had ended, which relationship then continued for months during the College investigation. 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, with regard to the complaint by Council (Self Report) 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:

1. Fancy be given a written reprimand for boundary violations related to her relationship to Patient A.
2. Fancy be given a further written reprimand for her professional misconduct and her attempts to avoid detection for these offences during an active investigation by the College and the Fitness to Practice Committee.
3. This Order includes a minimum of a 9 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 complaint made by Patient B.
4. Fancy pay the College a fine of $5 000.00.
5. Fancy pay the College a sum of $10 000.00, as costs associated with the College’s investigation and disciplinary proceedings.
6. 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.
7. 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.
8. Fancy be suspended from practice for a minimum of 9 months, and until she is fit to practise in accordance with the following, and shall comply with an undertaking for the following practice restrictions:
   1. Fancy shall remain under the care of her family physician and the Physician Health Program to ensure her mental health concerns are addressed, along with any other physical or mental health problems are treated as they arise, with satisfactory quarterly reports to submitted to the College, office from both the family physician and the Physician Health Program.
   2. 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 9 months of therapy concurrent with the requirement in the complaint by Patient B, before consideration of return to practice,  with satisfactory quarterly reports to be submitted to the College office.
   3. Fancy shall enter into a Monitoring Agreement with the College, 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.
   4. Fancy shall complete 9 months of abstinence from alcohol, cannabis and other substances concurrent with the requirement in the complaint by Patient B, 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.
   5. Fancy be restricted from being the most responsible physician for patients with primary mental health issues.
   6. Fancy shall limit on-call demands where possible, and shall only practice within her core competencies as a family physician.
   7. 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.
   8. Fancy shall live outside the community where she practices, unless Council orders otherwise, to promote work-life balance and professional boundaries.
   9. 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.
   10. Fancy will have no further contact with Patient A, either personally or professionally, and any communication required, such as regarding the repayment of the personal loan, can occur between Patient A and counsel for Dr. Nicole Fancy.
9. Fancy will release the Committee findings, College rulings and reports to her treating physicians.
10. 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.