Alberta child psychiatrist sanctioned for boundary violations after exchanging gifts, personal email addresses with patient

An Alberta child psychiatrist is facing sanctions after failing to maintain appropriate boundaries with her patients, including exchanging gifts and providing a personal email address.The College of Physicians and Surgeons of Alberta (CPSA) Complaints Director announced in a March news release that its disciplinary tribunal had ruled that Dr. Monica Cavanagh should be reprimanded and ordered to take an ethics course after she admitted to the conduct. The case stems from her interaction with two siblings and their parents, who had been her patients. Dr. Cavanagh initially began treating the older child before taking on the parent and then the younger child. According to tribunal’s findings, Dr. Cavanagh failed to maintain appropriate boundaries with the parent, including engaging in casual conversations, “excessive disclosure” of personal information, exchanging gifts, providing a personal email address and providing medical appointments that were not billed for.“[T]he repeated failure to uphold professional boundaries raised significant concerns for the hearing tribunal. It is a physician’s responsibility to establish and maintain boundaries with patients, and these boundaries should be upheld in all forms of communication,” the tribunal wrote.However, over time, Dr. Cavanagh became uncomfortable with the situation and felt that the parent was “intruding on her privacy and jeopardizing her well-being,” prompting her to terminate care for all three patients.The tribunal noted the abrupt termination of care did not meet the standards of the profession and determined that Dr. Cavanagh had not considered “the consequences of termination or how to transition care appropriately.”“The CPSA has established a clear process for instances when a physician decides to end the physician-patient relationship unilaterally. Unfortunately, that process was not followed in this case,” the tribunal noted.The tribunal also had some concerns over the “unconventional treatment approaches” that Dr. Cavanagh used for the parent and the older child. The decision document does not go into detail about what was unconventional about her treatment approaches, but the tribunal noted the importance of “aligning conduct with the CPSA standards on practicing outside of established conventional medicine.”Dr. Cavanagh’s legal counsel posited that although the conduct was serious, it “did not fall at the higher end of the spectrum” and was “initially motivated by concern for her patients’ well-being” rather than willful negligence or disregard for the patients’ welfare. Her counsel also reiterated that she had cooperated fully with the investigation and admitted to the unprofessional conduct.Dr. Cavanagh’s counsel also pointed out that she is a psychiatrist working in “a small community facing significant resource constraints.” This was a factor that the tribunal took into consideration in determining the appropriate sanctions. Dr. Cavanagh works in Canmore, a town of just 15,000, more than an hour's drive west from Calgary. The college’s legal counsel also noted that she works in “a field that is in high demand, yet often scarce in certain regions of Alberta.”“There exists a significant public need for the services provided by the Investigated Member and it is beneficial to support her in further improving her skills,” the tribunal wrote.As a result, the tribunal ruled that Dr. Cavanagh receive a reprimand and enroll in an individual practice review with the college and a complete a course on ethics and boundaries, at her own expense. If she does not complete and pass the course, she will be required to undertake a one-on-one medical ethics remediation program.In addition, Dr. Cavanagh will also be required to pay for the costs of the hearing and investigation, totalling $10,000.“Considering the circumstances of the case, the sanction is fair. Additionally, emphasizing rehabilitation and remediation is suitable given the nature of the conduct involved,” the tribunal said.

Alberta child psychiatrist sanctioned for boundary violations after exchanging gifts, personal email addresses with patient

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