‘The College does not care’: How the medical watchdog closed the door on sex-abuse complainants

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More than a dozen women shuffle into the public gallery of a hearing room where a renowned Toronto pain specialist is about to learn his professional fate. One woman in her mid-30s has a brace wrapped around her left knee and walks with a cane. Another woman, older, uses a walker.

Many of these women turned to Allan Gordon, a neurologist and director of the Wasser Pain Management Centre at Mount Sinai Hospital, after other doctors had failed to find the reason for their debilitating pain. He was their last great hope.

Now, they have come to stare their healer in the face, to hear an acknowledgement of the trauma they allege he inflicted on them.

But as they sit on this October day in 2018, waiting for the College of Physicians and Surgeons of Ontario to mete out a measure of justice, their hearts sink.

Not a word is uttered of the multiple sexual-abuse allegations levelled against Dr. Gordon by his former patients.

Unbeknownst to them, the college’s complaints committee has decided to close the women’s cases and not publicly acknowledge their allegations.

Instead, the doctor pleads “no contest” before a discipline panel to the less serious offence of professional misconduct for failing to obtain a patient’s “informed consent” for a pelvic exam. This means he does not contest the facts, but also does not admit guilt.

As part of his settlement, Dr. Gordon agrees to resign and never reapply to practice medicine in Ontario or any other jurisdiction.

Days after the hearing, the 73-year-old receives his reprimand. “The [discipline panel] regrets that you are appearing before us today after a long and distinguished career,” a member of the panel tells him.

One former patient, a 32-year-old lawyer, tells The Globe and Mail afterward that she feels “incredibly betrayed” by the college. The many hours she spent describing Dr. Gordon’s alleged sexual abuse to investigators, causing her to relive it over and over again, were all for naught.

“I never got to look at him and say, ‘You abused my trust,’” she says.

The college won’t divulge how many patients accused Dr. Gordon of sexual abuse or how far back their complaints stretch.

The college has removed from its website any mention that Dr. Gordon once stood accused of sexually abusing a patient during a medical exam in May, 2015. The college’s complaints committee investigated allegations of sexual abuse from many other patients, but they were never publicly disclosed. The allegations are coming to light now as a result of The Globe’s investigation.

The Globe has identified 10 former patients, and interviewed seven, who allege Dr. Gordon sexually abused them at the Wasser pain clinic as far back as 2005. Three of the patients have filed civil lawsuits against Dr. Gordon and the hospital.

In a statement of defence to one of the lawsuits, Dr. Gordon denies the allegations. They have not been tested in court.

Documents obtained by The Globe – including lawsuits and college reports summarizing the patients’ complaints – describe the alleged abuse that took place during physical examinations: One woman accuses Dr. Gordon of thrusting his crotch against her vagina; another accuses him of sexually stimulating her clitoris; another accuses him of inserting a finger in her anus without her consent.

In the college reports sent to his accusers, Dr. Gordon asserted through his lawyer that the care he provided to patients was “appropriate and medically necessary.” He also denied failing to obtain consent or doing any medically inappropriate touching.

In an e-mail to The Globe, his lawyer, Jaan Lilles, reiterated that the care Dr. Gordon provided to the patients was “appropriate” and that the college took no further action on the complaints.

“Dr. Gordon has never been found to have committed an act of sexual impropriety,” Mr. Lilles said. “He had a distinguished career and helped thousands of patients with intractable pain problems.”

Nancy Whitmore, registrar of the college, defended the settlement with Dr. Gordon. While a discipline hearing does not always go the college’s way, she told The Globe in an interview, a settlement guarantees the outcome.

Dr. Gordon left the profession in a “dishonourable” way by agreeing to resign and never practice medicine again, something that remains on the college’s public register forever, Dr. Whitmore said.

“I think what we’ve done very well is we have protected the public interest,” she said. “As a registrar, the most severe thing I can do is take away a licence to practice medicine.”

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Patients rely on the College of Physicians and Surgeons to protect them. The college is responsible for regulating the practice of medicine, and must by law revoke the licence of any doctor found guilty of sexually abusing a patient.

But how the college handled the allegations against Dr. Gordon raises questions about whether the regulator is equipped to investigate sexual-abuse complaints. The case is not an isolated incident.

The province’s medical watchdog dropped allegations against one in four doctors accused of sexual abuse over the past six years. In every case, the discipline committee found that the doctors engaged in “disgraceful, dishonourable or unprofessional” conduct – a catch-all provision intended to capture a persistent disregard for their professional obligations. The doctors either admitted to less serious misconduct or pleaded no contest, even though their discipline decisions outlined sexual acts such as kissing a patient on the lips, visiting patients at their home and expressing love, and examining the breasts and abdomen of a patient with a bowel obstruction.

The college’s ability to investigate sexual-misconduct allegations has been questioned before. In 2016, a government-appointed panel called for sweeping changes to the handling of such complaints against health professionals. All too often, the regulators use their discretion to find doctors, nurses and others accused of sexually abusing patients guilty of less serious offences, such as “professional misconduct,” concluded a task force set up by former Ontario health minister Eric Hoskins.

The task force recommended that the government take away the health regulatory colleges’ ability to prosecute and adjudicate sexual-abuse complaints and place that power in the hands of a new centralized body and independent tribunal.

Far too many patients do not have confidence in the current system, the task force concluded. The colleges have repeatedly demonstrated that they are unable to uphold Ontario’s zero-tolerance threshold on the sexual abuse of patients – a standard enshrined in legislation since 1994.

Instead of immediately accepting the task force’s recommendation, Dr. Hoskins put it out for further study. He resigned as health minister in February, 2018, to lead a national pharmacare project. The study was shelved by the then-Liberal government before it was completed.

While legislation introduced in 2017 adopted many of the task force’s recommendations, Dr. Hoskins contends it did not go far enough and that the colleges should lose their power to investigate sexual abuse.

Until an independent body assumes responsibility for sexual-abuse cases, he said in an interview, “I don’t believe we will be able to get to that point where we are truly doing justice, primarily to women but to all individuals who bravely come forward.”

The Protecting Patients Act, which came into force in May, 2018, requires colleges in Ontario to revoke the licence of a health-care practitioner found guilty of touching a patient’s genitals, anus, breast or buttocks in a sexual manner. Prior to the new legislation, practitioners lost their licence only if found guilty of sexual intercourse or other forms of physical sexual relations with a patient.

As part of its investigation, The Globe reviewed all 230 decisions handed down by the College’s discipline committee between 2013 and 2018. In 65 cases, doctors were accused of sexual abuse. They were found guilty in 48 instances, with penalties ranging from temporary licence suspensions to revocations. (One case was dismissed by the discipline panel.) But despite a zero-tolerance policy, the College dropped sexual-abuse allegations and reached settlements with 16 doctors, including Dr. Gordon, over the six-year period.

Allowing a doctor to resign in the midst of a patient’s sexual-abuse complaint is “completely unacceptable,” said Marilou McPhedran, a senator and human-rights lawyer who has chaired three independent inquiries in Ontario on the sexual abuse of patients, including the most recent task force. “This kind of secrecy and silence protects perpetrators.”

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While an inherent power imbalance exists between patients and doctors, Dr. Gordon’s former patients had dealt with multiple health problems all their lives, making them particularly vulnerable.

Several of the women who spoke to The Globe were reluctant to complain to the college. Not only were they worried no one would believe them, they said, they felt conflicted because they finally had a doctor who put a name to their confounding symptoms.

One of the women, a 27-year-old creative director who suffers from migraines and jaw pain, did not contact the college about her allegation until 2018, after Mount Sinai had revoked Dr. Gordon’s hospital privileges and he had left the Wasser clinic. Had she complained earlier that he had groped her breasts, she said, she would not have a diagnosis for her rare condition or a referral to a surgeon.

“All things considered, he was a boon for me medically, but that does not mean he didn’t hurt me.”

The complainants requested anonymity in order to share intimate details of the allegations. The Globe granted their requests. The college’s policies also impose a publication ban on naming patients in the course of proceedings.

Dr. Gordon joined Mount Sinai in 1975 and became chief of neurology in 1981. In 1998, he opened the doors of the Wasser Pain Management Clinic.

During his four decades at the hospital, he was known as a top pain specialist and the go-to doctor for patients afflicted with a rare disease called Ehlers-Danlos Syndrome, or EDS for short, a connective-tissue disorder that is often misdiagnosed and misunderstood. Symptoms include chronic migraines, debilitating muscle and joint pain, and abdominal pain.

One of Dr. Gordon’s patients with EDS started getting pain in her knees when she was a child. By the time she was a teenager, the pain had spread to her other joints. Now 27, she walks with a cane and is unable to work owing to chronic pain.

A geneticist diagnosed her with EDS in 2015 and referred her to the Wasser pain clinic, describing it as “the best of the best.” Dr. Gordon confirmed her diagnosis but also seemed fixated on her pelvis.

On her third visit with Dr. Gordon in November, 2016, she said in an interview, he announced that he was going to do an internal exam after testing the reflexes in her knees. “I was panicked. Had he told me that ahead of time, I would have said no.”

In her complaint to the college, she alleged that Dr. Gordon sexually stimulated her clitoris while asking questions of a sexual nature, according to documents obtained by The Globe. She elaborated in the interview, alleging that as he moved her underwear aside and put a finger inside her vagina, he asked whether she can achieve orgasm, even though she had told him at previous appointments that she and her partner were not having sex at all due to her joint pain.

The woman said she stared at the ceiling, waiting for the exam to be over. “It felt gross and wrong.”

She confided in her psychologist who, in turn, reported the incident to the college in September, 2017, and urged her to do the same. She delayed complaining until March, 2018, out of fear she might jeopardize her disability benefits or access to health care. “It was me against this world-renowned doctor,” she said.

She felt reassured, however, after meeting with Heather Carroll, an investigator at the college and former police officer. Ms. Carroll, who investigated sexual assaults at the Toronto Police Service, advised her to complain to the police. (She did not respond to The Globe’s request for comment.)

The woman did not go to the police. But neither has she been able to move on.

On Valentine’s Day, she said, she felt like she had been traumatized all over again when she opened a package from the college, notifying her it had closed her file months ago, on Oct. 12, 2018 – the same day as Dr. Gordon’s discipline hearing.

She has marked her copy of the eight-page report from the complaints committee with comments and bright purple underlining – an attempt to make sense of a document that has only raised further questions.

For one, the college brought in an independent expert, an academic neurological oncologist from Alberta, to offer an opinion on her allegations, says a copy of the report.

The expert said Dr. Gordon’s queries of the patient’s sexual activities are consistent with the medical profession’s standard of practice – patients with chronic pain often experience sexual dysfunction, according to the report stamped private and confidential. He said the exam was also “possibly indicated,” because the patient has chronic pelvic pain.

However, Dr. Gordon fell short of the standard of practice by not writing a legible clinical summary for the day of the alleged abuse, the expert noted in a six-page document attached to the report. Key information was missing from the patient’s medical record, he said, noting that it merely says, “the patient was seen on November 2, 2016 from 3:00 to 4:00 p.m.”

Dr. Gordon denied in the college report that he failed to obtain the patient’s consent or that any touching was not medically appropriate.

“Given that [Dr. Gordon] will no longer be in practice,” says the report, the complaints committee panel was “not of the view that it was necessary to take further action.”

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Other women who spoke to The Globe were also distressed after receiving similar reports from the college in February, saying its complaints committee had closed their files on Oct. 12, 2018.

One of the women, the lawyer, said she had no interest in reading a “defence of indefensible conduct” from the college and had hoped it would explain why it had not publicly disclosed the sexual-abuse complaints.

She complained to the college that Dr. Gordon performed a painful exam in October, 2016, by poking the area around her vagina with sharp objects. She also alleges in her complaint and in a lawsuit against Dr. Gordon and Mount Sinai that he put his finger in her anus without her consent.

The independent expert from Alberta also reviewed this woman’s case. He said he did not have enough information to express an opinion on whether Dr. Gordon sought the patient’s consent for a rectal exam.

The complaints committee says in its report that the acts of “touching/penetrating the patient’s anus without consent” could “ground a discipline referral.” But in closing her file, it says the public is protected because Dr. Gordon has resigned.

Another former patient, a 27-year-old graduate student who suffers from severe migraines, alleged that Dr. Gordon performed a sexually motivated internal exam on her with a cotton swab, according to the complaints committee’s report. She said Dr. Gordon routinely asked her about pain during sexual intercourse, something she had never complained about.

In a letter to the college, Dr. Gordon’s lawyer, Mr. Lilles, said the woman could provide almost no detail about the alleged exam, nor recall how long it lasted, “estimating it was somewhere between 1 second and 10 minutes."

The complaints committee says in its report that it is difficult to understand why Dr. Gordon would examine the vagina and pelvis of a migraine patient. But the committee said it also dismissed her complaint because Dr. Gordon had agreed to resign.

"With respect to the sexual abuse allegations, the Committee was faced with the disparity between what the [patient] alleged and what [Dr. Gordon] recalled,” the report says. Dr. Gordon “denied the [patient’s] allegations.”

The reports sent to the patients lay bare the challenges associated with holding doctors to account in cases where, unlike fraudulent medical billings or inappropriate prescribing, there is no paper trail of evidence.

Dr. Whitmore, the college registrar, said the nature of Dr. Gordon’s practice, including his interest in pelvic pain, made it difficult for investigators to determine whether the exams patients complained about were medically necessary.

“Some of the exams that he was doing, and I don’t think he was doing them well, but he was examining parts of the body that made sense for his clinical work,” said Dr. Whitmore, an obstetrician and gynecologist with years of experience performing intimate exams.

"There’s clear sexual abuse and there is clear poor practice and then there are perhaps cases that are difficult to be absolute around,” she said.

Svetlana Blitshteyn, a neurologist who specializes in autonomic disorders and Ehlers-Danlos Syndrome, told The Globe that pelvic, vaginal or anal exams are not performed unless a patient specifically seeks medical care for pelvic pain.

“It’s not appropriate for the physician to concentrate on pelvic pain when there is no primary complaint of that,” said Dr. Blitshteyn, director of a neurology clinic in Buffalo, N.Y.

The school solution

Can sexual misconduct in medicine be better prevented by starting earlier, at the training grounds for the next generation of doctors? Zosia Bielski took a look at the debate within medical schools.

The women who spoke to The Globe said they were surprised the college closed their files after its investigators pursued their complaints.

One former patient, the 32-year-old lawyer, said Ms. Carroll, the college investigator, contacted her after reviewing the medical records for Dr. Gordon’s patients and learning that she had complained to Mount Sinai. She said Ms. Carroll encouraged her to complain to the college, assuring her she was not alone.

The college initially built its case against Dr. Gordon around two patients whom The Globe has not been able to identify. “Patient A” accused Dr. Gordon of sexually abusing her in May of 2015 during an internal exam, and “Patient B” accused him of failing to obtain informed consent for a pelvic exam in March of 2016, according to a March 8, 2017, notice for a discipline hearing.

The college replaced the original notice of hearing with a revised version, which removed any mention of sexual abuse and Patient A from the public record. It was backdated to the same date as the original notice, which was provided to The Globe by a patient who saved it after noticing the discrepancy.

Mr. Lilles, the lawyer for Dr. Gordon, told The Globe the college withdrew Patient A’s allegations of sexual abuse in October, 2017, 12 months prior to the discipline hearing.

Shae Greenfield, a college spokesman, said the allegations were not dropped against Patient A as a result of Dr. Gordon’s settlement one year later. College officials have declined to explain why they dropped the allegations.

The discipline committee dealt with the second patient and her allegation that Dr. Gordon failed to obtain consent for a pelvic exam. The woman suffers from fibromyalgia and her main concern at the March, 2016, appointment was pain in her feet. The committee says in its written decision that a full body examination was “clinically indicated.”

It found that Dr. Gordon committed an act of professional misconduct by failing to obtain the patient’s consent, leaving her feeling “scared, threatened, and embarrassed.” Dr. Gordon “slightly” exposed her breast and touched it with a cotton swab and touched various spots on her exposed buttocks with the swab, the decision says.

A long-time former patient of Dr. Gordon told The Globe she was not aware back in 2005, when she first started seeing him, that he should have sought her consent for pelvic exams. The woman, now 54, suffers from stabbing and burning pain while sitting and tightness in her entire pelvic region.

In a lawsuit filed in an Ontario court in July, 2018, she alleges that Dr. Gordon sexually abused her on numerous occasions beginning in 2005 by performing pelvic exams without her consent that did not serve “any useful medical purpose” and was “unduly focused” on sexual matters, once suggesting she should masturbate. She was his patient until 2016.

Dr. Gordon denies the allegations. He says in a statement of defence that he conducted his assessments in a professional manner, did not ask inappropriate questions and sought her “fully informed consent” for pelvic exams.

The woman told The Globe she was concerned that asking him to stop the pelvic exams would impair her chances of getting better. “I thought that I’ve got to let this doctor do what he’s got to do because I’m desperate for a solution to what’s wrong with me.”

Another former patient said reading the initial notice of hearing gave her the strength to come forward with her own complaint.

“Abuse is terrifying,” she told The Globe. “When you are abused, you are no longer in control of your body and what they are doing to it.”

Unfounded, revisited

In 2017, a Globe investigation found Canadian police dismissed one in five sexual-assault claims as baseless. Learn more about how police promised change and how ‘unfounded’ rates began to drop in cities across the country.

No province or territory in Canada has taken away the health regulatory colleges’ responsibility for probing sexual-abuse allegations.

Practices vary widely across Canada, with many provinces making it difficult to find out if a doctor has been disciplined for any offence.

In British Columbia, disciplinary hearings for any allegation are rare. The B.C. college receives about 1,000 complaints a year, but only six resulted in formal discipline in 2018. In Manitoba, provincial legislation bars the college from including the name of a doctor facing allegations in a notice of hearing. New Brunswick posts a brief summary of decisions on its website, and in Quebec, the college posts disciplinary decisions online for three months – information on older cases is only available on request. Alberta followed Ontario’s lead by introducing legislation in 2018 to strengthen protections for patients.

Other institutions have been criticized for their handling of sexual-abuse complaints and some have made changes.

The Canadian Forces opened an independent sexual-misconduct-response centre in September, 2015, upon the recommendation of former Supreme Court justice Marie Deschamps after she uncovered a highly sexualized culture in the military. The investigation of sexual-assault allegations is still being done by the military police.

Last fall, McGill University appointed a “special investigator” to examine all reports of sexual violence on campus. The move came after protests by students who alleged the school mishandled allegations of sexual misconduct against some professors.

The Globe based its review of discipline decisions of physicians in Ontario on monthly summaries of cases posted on the college’s website between 2013 and 2018.

The college recently removed the monthly summaries from its website and issues a news release for each discipline decision, which remains on the website for 90 days. The decision is also available on each doctor’s profile dating back to 1983 and in the college’s quarterly internal magazine.

Ontario was the first jurisdiction in the world to establish a zero-tolerance standard for sexual abuse of patients. But the Gordon case provides a rare look at how uneven the playing field remains for patients who complain that their doctor harmed them.

Dr. Gordon’s legal fees for the college investigation were covered by the Canadian Medical Protective Association, a not-for-profit physician-defence group.

Patients, by comparison, are forced to file parallel complaints with different organizations – the hospital, the college, the civil courts, the police – and do not have insurance that covers their costs.

Jennifer Freyd, a psychologist at the University of Oregon who has studied sexual violence, has coined a term for a failure to respond to abuse complaints: institutional betrayal.

While Prof. Freyd has not examined the Gordon case, her research has found that the trauma experienced by sexually abused patients is compounded by the failure of an institution to protect them. “There is so much harm that can come from that betrayal.”

For her part, the 27-year-old woman with EDS said she would never again turn to the college for help.

“My biggest fear is should this happen again I know I have no recourse,” she said. “The college does not care. It will hide things.”

If you have further information about this story, please e-mail khowlett@globeandmail.com and visai@globeandmail.com or contact them through The Globe and Mail’s SecureDrop