Saturday, 8 October 2011

‘Robin Hood’ doctor prescribes extra govt allowance for food but earned big money

“A doctor is there to be a doctor, not to advocate for the poor, or to be the official opposition in government through taxpayer’s money,” says Toronto City Councillor Robert Ford, a conservative candidate for the city’s top job in the October 2010 municipal elections. “That’s frightening, when I think about it. You can’t have people in the medical field doing that.”  (From older article, see below)

3 October 2011
Dr. Roland Wong appeared before the College of Physicians and Surgeons of Ontario on Monday, hand in hand with poverty.
He was dressed in a grey suit and a sharp blue-and-silver striped tie. His poor supporters rolled in with walkers, combat boots and a red banner that declared “Raise Welfare and Disability Rates.”
Dr. Wong is a modern Robin Hood among Toronto’s poor. By his own admission, he filled out more than 14,000 special diet allowance forms in one year alone so that poor people could buy healthy food. Worth up to $250 a month each, they cost the Ontario government — and all of us — around $3 million.
The hearing is investigating whether Dr. Wong followed professional practices and standards in prescribing those allowances or whether, as the college lawyers posit, he acted in a way that was “disgraceful, dishonourable or unprofessional.”
Is he a villain, stealing money to give away to undeserving people? Or is he a hero, stepping forward to feed the hungry when so few others will?
Poverty stood silently beside him, a constant shadow. The college lawyers insist the hearing is about Dr. Wong and Dr. Wong’s actions alone. But we in the spectator seats knew that welfare rates are also on trial here. A single person on welfare in Ontario gets $592 a month. Take out rent and bus tokens, and how is it possible to not end up anemic and diabetic on what’s left over?
“The low levels of welfare are a serious health issue,” said Peter Rosenthal, the lawyer representing Dr. Wong. “This is not about the inadequacies of the social welfare system per se. What it is, is a case about how the medical profession deals with those inadequacies.”
Dr. Wong has dealt with it by filling out more special diet forms than any other physician in the province. According to college lawyer Carolyn Silver, an audit by the Ministry of Community and Social Services revealed Dr. Wong completed 13 per cent of Ontario’s special diet forms in a 3½-year period. Out of the forms that prescribed the greatest amounts of money, Dr. Wong filled out half of them during that period — often with no explanatory notes, evidence of physical exams or requests for lab tests.
In a separate review of 130 special diet forms filled out by Dr. Wong, the ministry discovered that he had diagnosed 98 per cent of the patients with chronic constipation and four food allergies. In one case, Dr. Wong certified that all 10 members of a family had those conditions, which translated to a fat monthly cheque of $2,500.
Did the poor hear about Dr. Wong and flood his dim office in the basement of a Chinatown building, as he claims? Or was he prescribing a political treatment by signing all those forms, combatting the government’s miserly welfare rates in the way only he as a doctor could?
But one disturbing fact that surfaced Monday was that the poor have made Dr. Wong quite rich. The government pays doctors $20 to fill out each special diet allowance form, and up to $40 for an additional assessment. So while he ticked the boxes marked soya allergies (worth $83 a month to the patient), diabetes ($42) and chronic constipation ($10), Dr. Wong was charging the government around $60 a form, the five-member panel heard.
In 2008, he billed $718,000 for the work required to do the special diet allowances — $540,000 more than an average Ontario family health doctor bills overall for a year.
Over four years, he made $1.8 million from the special diet allowance forms alone.
That’s a lot of money, even when you don’t compare it to the $28,416 the average single guy on welfare made during that time.
The College tribunal will judge him on whether his work deserved that money. They could revoke, suspend or limit his licence and fine him.
The court of public opinion will judge him on what he did with that money. Is he truly a Robin Hood or just a sympathetic scammer?
He says, and his lawyer confirmed, the police investigation into his actions turned up no fraud.
“A lot of the money went back in taxes,” the 61-year-old doctor told me out front of the red brick college building. “A lot was used to buy food for people — I gave it to food banks.”
The rest, he says, is going to pay his lawyers.
The hearing continues.
Mayoral candidate assails activist doctors  (original link & location)

Canadian Medical Association Journal

  1. Laura Eggertson
+Author Affiliations
  1. Ottawa, Ont.
Doctors should not be advocating for the poor, says a Toronto, Ontario, mayoral candidate who filed a complaint that has a family doctor facing potential loss or suspension of his licence to practice.
“A doctor is there to be a doctor, not to advocate for the poor, or to be the official opposition in government through taxpayer’s money,” says Toronto City Councillor Robert Ford, a conservative candidate for the city’s top job in the October 2010 municipal elections. “That’s frightening, when I think about it. You can’t have people in the medical field doing that.”
Ford asked the College of Physicians and Surgeons of Ontario to investigate Dr. Roland Wong last year for improperly filling out special diet forms that until recently allowed welfare recipients to obtain financial assistance to purchase food needed to allay the effects of such medical conditions as food allergies, celiac disease and diabetes (CMAJ 2010. DOI:10.1503/cmaj.109-3232).
Ford says as many as “three or four” people told him that Wong had filled out forms to allow people on social assistance to access extra money to help them deal with food allergies, even though they were not allergic.
Wong, who specializes in occupation and community medicine, says he has completed as many as 15 000 special diet forms for social assistance recipients in one year.
But Wong insists he has never harmed anyone or acted improperly or illegally in doing so. In addition to signing forms for his own patients, he also signed them for people attending mass clinics arranged by poverty advocates around the province.
“The Inquiries, Complaints and Reports committee of the College of Physicians and Surgeons of Ontario has also referred to the Discipline Committee the allegation that Dr. Wong is incompetent as defined by subsection 52(1) of the Health Professions Procedural Code, which is Schedule 2 to the Regulated Health Professions Act, 1991, (“the Code”)” the notice says.
Wong now faces a disciplinary hearing at the college, which is investigating whether he failed to meet the standards of the profession or engaged in conduct that “would reasonably be regarded by members as disgraceful, dishonourable or unprofessional,” according to the notice of hearing issued by the college.
The hearing, which has not yet been scheduled, could result in the loss or suspension of Wong’s licence, or in a fine.
Wong says the complaint against him is politically motivated and the province is putting pressure on the college to act.
“It is a form of harassment,” he says. “I don’t think it’s come up too often when a complaint was not made by a patient, but by a politician.”
In its fiscal year 2010/11 budget, Ontario cancelled the diet allowance program, which provided additional benefits of up to $250 per month for 136 250 people on social assistance to buy healthy food because of their medical conditions. The province cited ballooning costs as the rationale for the cut, as the program’s price tag had swelled to $220 million in fiscal 2009/2010, up from $6 million in 2001/02.
Community and Social Services Minister Madeleine Meilleur also cited an auditor general’s report saying the program was being abused. Meilleur noted that doctors and other health care professionals were signing the forms without properly examining clients.
Ford claims he has “no axes to grind” and says people often come to him with complaints, including health-related ones. He says he has never before gone to the college about a doctor and does not know if Wong improperly filled out forms. “Being the son of a [former] MPP [member of the provincial parliament] … and being close friends of the [federal] Finance Minister, Jim Flaherty — I think people know that I know how politics works. I know how to get things done and which departments to complain to,” he says.
Other physicians have spoken out against the cancellation of the diet allowances, arguing that it will cost the province more in the long-term because of the health consequences. They also say Wong cannot be held accountable for $200 million spent under the program.
“He is a very strong advocate for this,” says Dr. Gary Bloch, a family physician at St. Michael’s Hospital in Toronto and a member of Health Providers Against Poverty. “This is clearly an attempt to muzzle him. Luckily, he’s not someone who is easily muzzled. He has not drawn back from talking about this.”
That was evident in an Apr. 6 address that Wong gave at an event organized by the Ontario Public Interest Research Group to protest cuts to the program. “Income level is the best predictor of health,” he told the protesters. “For every rich person with diabetes, about 2.6 people will have diabetes. Large numbers of people die needlessly because of misguided provincial policies. More will die as [Ontario Premier Dalton] McGuinty’s misguided policies continue to suffocate the poor.”
Wong adds that caring for the less fortunate is a Canadian value. “My background is that I’ve seen enough to know the amount of money they [welfare recipients] were getting, around $500 [a month], isn’t going to carry them too far. I suppose I’m different than other people — I’m willing to take some risks. I’m willing to help them,” he says.

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