College of Physicians v Hart: Ketamine Ban and 6-Month Suspension

• The Ontario Physicians and Surgeons Discipline Tribunal suspended a physician for six months and prohibited him from prescribing ketamine and testosterone replacement therapy.
• Assessors reviewed 34 patient charts and found improper consent, incorrect dosing, omitted prostate exams for men over 40, and unindicated hormone treatments.
• The practitioner committed severe professional misconduct by pressuring and harassing a patient to deter her from filing a CPSO complaint.
• The tribunal held that the physician violated professional standards governed by Ontario Regulation 856/93 under the Medicine Act, 1991.

Legal advisers must urge clinics to conduct rigorous audits of informed consent documentation, patient assessment logs, and dosing records to ensure compliance with CPSO ketamine TRT prescribing discipline standards.

In a recent regulatory decision, the Ontario Physicians and Surgeons Discipline Tribunal ordered a six-month suspension for a solo clinic owner and practitioner while placing a total ban on his ability to order ketamine and testosterone replacement therapy. The proceeding, styled as College of Physicians and Surgeons of Ontario v Hart (2026 ONPSDT 29), evaluated extensive evidence concerning systemic deficiencies in the physician's knowledge, clinical skill, and professional judgment.

The disciplinary panel reviewed a broad evidentiary record that included two formal grievances from patients, expert reviews of 34 additional patient files, and billing data from the Ontario Health Insurance Plan. The findings exposed wide-ranging procedural failures across the physician's practice, particularly involving Ontario medical discipline ketamine prescribing standards and long-term hormone management protocols.

The evidence presented to the tribunal revealed significant safety oversights in the administration of ketamine and hormone treatments. In one instance, a patient was provided with false and misleading information prior to receiving ketamine, subsequently suffering severe adverse symptoms such as dissociation, rapid heart rate, loss of physical balance, slurred speech, and bodily weakness. When that patient indicated an intent to seek administrative oversight, the physician subjected her to pressuring behavior, harassment, and coercion in an attempt to prevent her from filing a formal complaint with the College of Physicians and Surgeons of Ontario. In a separate incident involving ketamine-assisted psychotherapy, the practitioner shouted at a client during a remote consultation and threatened to terminate the phone appointment upon learning she was inside a vehicle.

With respect to testosterone replacement therapy, the tribunal documented instances where treatment was initiated without clinical justification or despite clear contraindications. The practitioner routinely failed to perform necessary diagnostic evaluations—specifically failing to conduct digital rectal exams for male patients aged 40 and older—and permitted extended periods on testosterone therapy without conducting required in-person patient assessments.

The tribunal concluded that the practitioner engaged in disgraceful, dishonourable, and unprofessional conduct, demonstrating a persistent and egregious disregard for his professional duty under Ontario Regulation 856/93, enacted pursuant to the Ontario Medicine Act O Reg 856 93 framework. Accepting a joint penalty submission, the panel found the proposed six-month suspension satisfied the governing legal standard by maintaining public confidence in the disciplinary process, while warning the practitioner that any future infractions would result in even harsher penalties.

The College of Physicians v Hart ketamine ban carries immediate risk management implications for health law attorneys advising facilities that offer off-label psychiatric treatments or hormone administration. Legal advisers must urge clinics to conduct rigorous audits of informed consent documentation, patient assessment logs, and dosing records to ensure compliance with CPSO ketamine TRT prescribing discipline standards.

Furthermore, the case underlines that any effort to impede a patient from raising concerns with regulatory bodies will be treated as an aggravating factor resulting in severe sanction. Practitioners must maintain transparent grievance procedures and avoid any conduct that could be perceived as intimidating prospective complainants.

This outcome reflects an active regulatory environment before the discipline tribunal. In other recent matters, the tribunal handed down an eight-month suspension on July 22 to a pediatrician who inappropriately accessed a multi-hospital electronic medical record network to market private circumcision services to parents of newborns. Additionally, on June 10, the tribunal issued a reprimand and an eight-month suspension to a doctor who did not contest allegations of workplace sexual harassment that breached statutory standards.

Health law counsel advising clinics offering ketamine-assisted psychotherapy or hormone replacement therapies must audit client consent protocols and chart documentation, noting that attempting to dissuade patients from filing CPSO complaints will be sanctioned as severe professional misconduct.

Source: Original reporting via Canadian Legal Newswire