City dermatologist penalized again for misconduct

A Winnipeg dermatologist has been allowed to continue practising — albeit with a reduced scope — after pursuing a relationship with a female patient and seeing another patient without a required chaperone at a time when his office was normally closed.

A College of Physicians and Surgeons of Manitoba inquiry panel, in a June 30 disciplinary decision, said it was concerned with Dr. Earl Minuk’s level of contrition and future compliance, while noting his pattern of violating professional boundaries.

A shortage of specialists factored into the decision to allow him to continue to practise.

“CPSM carefully considers the need to protect the public while balancing the need for access to care. Dr. Minuk’s expertise includes managing a condition that can be disfiguring if left untreated,” the college said in a statement Tuesday.

“Given the limited alternative providers available, Dr. Minuk has been allowed to continue providing this essential service. It is important to note that Dr. Minuk’s previous practice restrictions are still in effect despite the very narrow scope of practice he is permitted.”

The misconduct drew a blistering response from Health Minister Uzoma Asagwara.

“I am deeply concerned and disgusted by the conduct outlined in this decision,” Asagwara said in a statement. “Patients must be able to trust that their physician will respect professional boundaries and put their care and safety first. The details outlined represent a serious abuse of that trust.”

“This was not an isolated incident. The decision describes a repeated pattern of boundary violations, previous complaints and measures that did not prevent further misconduct.”

The panel’s written decision, published Friday, said Minuk’s “serious and concerning” misconduct involved professional boundary violations with patients, “which strike at the core of the trust that is expected in the physician-patient relationship.”

Minuk, during clinical encounters, offered gifts and trips while pursuing a personal, romantic or sexual relationship with a female patient, referred to as “Patient B,” the decision said.

He sent inappropriate text messages, such as asking her out on dates multiple times, even after she rejected his requests, and made one or more phone calls to ask her on a date.

The incidents happened between September 2021 and February 2022.

A separate violation occurred when Minuk saw a female patient, referred to as “Patient A,” in his clinic on a Sunday, when it is normally closed, and without a chaperone present in November 2022.

At a May 26 hearing, Minuk admitted to breaching the college’s code of ethics, standards of practice, and practice directions, the decision said.

It said Minuk acknowledged his communication with “Patient B” was improper, and his failure to disclose certain text messages between them was inadvertent.

Minuk’s lawyer told the college Patient A had an emergency medical condition, and the breach was unintentional.

In a joint recommendation by the college and Minuk, he was reprimanded and agreed to cease practising medicine as of June 30 except for laser treatment of vascular lesions, and assessment, management and treatment of moles, skin cancer and pre-cancerous lesions.

Minuk has a clinic in St. James. A letter, dated May 11, on his website informed his patients the scope of his practice would change as of July 1. The letter did not mention disciplinary proceedings.

Minuk and his lawyer did not respond to a request for comment.

The college is an independent regulator responsible for physician discipline.

“Manitobans expect its decisions to protect patients, hold physicians accountable and maintain confidence in the medical profession,” the health minister said. “Our government will continue to listen to patients and work with (the college) to take necessary steps to protect the public.”

The panel concluded the restrictions on Minuk’s scope of practice will hold him accountable and serve as a deterrent.

Prof. Arthur Schafer, founding director of the University of Manitoba’s Centre for Professional and Applied Ethics, said many people will feel the college erred on the side of the physician, rather than the protection of the public.

“Dr. Minuk’s misconduct is serious and concerning.”

“I think the public will have questions about whether someone who has displayed the pattern of professional boundary violations that this physician has should be allowed to continue practising dermatology, even in this limited way and even with a chaperone,” he said.

The panel believes the decision protects public confidence and trust in the college’s ability to self-regulate.

“I’d put a question mark in this case. I’m not sure whether public confidence will be maintained or sustained by the requirement of the limitation of his practice,” Schafer said.

Minuk’s guilty plea was cited as a mitigating factor. The decision indicated he is trying “to address his ongoing professional boundary issues, which supports the goal of rehabilitation,” although the specific action or actions were redacted.

The panel said repeated professional boundary violations led to a June 2022 undertaking that required him to have a female attendant present as a chaperone at all times for any encounter with a female patient, even phone calls.

The undertaking was amended in December 2022 to forbid him from personally communicating and meeting with patients outside of his office or facilities where he provides treatment, except for situations involving patient health issues that cannot be reasonably dealt with in a regularly scheduled appointment.

Another amendment, in April 2023, required Minuk to display conspicuous signs in his clinic to inform patients about the chaperone requirements.

The decision outlined multiple past investigations triggered by complaints.

An investigation committee emphasized clear, respectful communication with patients after Minuk was accused of abruptly ending a 2009 appointment in a rude and unprofessional manner with a woman who was dissatisfied with her upper lip wrinkle treatment.

Minuk completed a self-directed learning program after a female patient said he commented on her being naked while she showed him a rash in her pubic area in October 2014.

He agreed not to have closed-door meetings with staff after a former employee from 2018 to 2020 said he made inappropriate comments that made her feel “significant discomfort.”

An investigation that prompted the undertaking looked into concerns about inappropriate communication and/or conduct with two female patients in December 2020.

The decision said a psychiatrist sought out by Minuk afterward provided recommendations on how to address patient safety concerns.

Another investigation took place after a female patient with alopecia accused Minuk in October 2021 of making insensitive comments to her about her hair loss and treating her in an unkind manner.

“Speaking for patients, there is a high element of trust when we go into the health-care system to seek care, or when we talk to someone about prevention or rehab, that whoever is providing us with the support, the knowledge, expertise and treatment, you’ve got someone who’s qualified to do so and that you can have confidence in,” said Wendy Nicklin, chair of Patients for Patients Safety Canada.

chris.kitching@freepress.mb.ca

Earl Minuk decision