Medical college scolds psychiatrist for diagnosing local optician without meeting him

Ontario's medical regulator has found that a Toronto psychiatrist who wrote a critical evaluation of a Burlington optician without ever seeing or talking to him should have had consent before sharing his findings.

Regulatory college finds psychiatrist 'should have obtained consent to disclose information'

Jay Hakim, right, and his representative Marvin Ross argued in an appeal last summer that a psychiatric evaluation done without Hakim's knowledge should not be allowed to stand. (Kelly Bennett/CBC)

Ontario's medical regulator has found that a Toronto psychiatrist who wrote a critical evaluation of a Burlington optician without ever seeing or talking to him should have had consent before sharing a diagnosis.

Doctors have a sacred responsibility and there should be ramifications if they abuse that.- Marvin Ross, representative for optician Jay Hakim

In a letter, the College of Physicians and Surgeons of Ontario told the psychiatrist not to do it again.

The college wrote that the psychiatrist should have obtained consent to disclose a diagnosis to a third party.

The college also said the psychiatrist, Joel Sadavoy, should have alerted the optician that his findings "point to possibly serious mental illness requiring treatment."

Even though the college acknowledged concerns about the psychiatrist's action, the optician, Jay Hakim, plans to appeal again.

"Their failure to treat this more seriously is a travesty in our opinion and has implications for society," said a representative for Hakim, Marvin Ross.

"Doctors have a sacred responsibility and there should be ramifications if they abuse that."

A lawyer for Sadavoy, Marc Flisfeder, issued a brief statement in response to questions from CBC News. 

"Dr. Sadavoy respects this decision. He intends to continue his practice of complying with all College policies."

A tie to the Goldwater rule

When he found out he'd been analyzed without his knowledge, Hakim filed a complaint with the college, which initially found that Sadavoy acted appropriately.

Hakim appealed and a hearing was held last August in downtown Hamilton.

The timing of the appeal coincided with mounting conversations last summer in the United States about that country's Goldwater rule, whereby psychiatrists are called to refrain from diagnosing someone without meeting and examining that person.

Psychiatrists were tempted to label deficiencies they found in then-candidate Donald Trump.

Among the rationales touted in support of the Goldwater rule is that diagnosing someone from a distance can stigmatize that person and their family – and often turns out to be wrong.

At the hearing, Flisfeder said there was no requirement for Sadavoy to obtain consent from Hakim for the evaluation because none of Hakim's personal medical records had been disclosed to the psychiatrist.

The appeal board passed the file back to the regulator to reconsider its finding in March.

'He should have verified that consent ... had been obtained'

Last week, the regulator issued a letter to the psychiatrist with "some guidance" for him going forward.

The College of Physicians and Surgeons of Ontario wrote that a Toronto psychiatrist should have obtained consent to disclose a diagnosis to a third party.

The college told Sadavoy:

  • The responsibility for telling Hakim of the psychiatrist's involvement in the matter lies with him.
  • When a third party requests an evaluation of someone, a physician "needs to ascertain for what purpose the opinion is being sought," and the retainer for this matter did not. "He should have verified that consent, if necessary, had been obtained."
  • After arriving at possible diagnoses, Sadavoy "should have obtained consent to disclose information and should also have alerted Mr. Hakim to his diagnostic findings as they point to possibly serious mental illness requiring treatment."
  • Even though he had no access to clinical material or Hakim himself, Sadavoy "was still obligated to … be fair and objective" and not just rely on one side of a story.

The college acknowledged its policy on third-party reports wasn't clear when this incident happened. "In 2017, the college looks at such matters with a new perspective on transparency and an updated awareness of patient consent," the letter states.

It calls its resolution of the case an "educational disposition," meant to guide Sadavoy's conduct in the future.

About the Author

Kelly Bennett

Reporter, CBC Hamilton

Kelly Bennett is an award-winning reporter who lives in Hamilton. She grew up in Victoria and covered economics and arts as an investigative reporter in San Diego. She loves digging into great stories, hiking and playing the violin. Drop her a line anytime at kelly.bennett@cbc.ca.