SUMMARY

DR. WILLIAM BLAKE BOWLER (CPSO# 50188)

1. Disposition

On January 18, 2018, the Inquiries, Complaints and Reports Committee (the Committee)
required general practitioner Dr. Bowler to appear before a panel of the Committee to be
cautioned with respect to his failure to uphold standards of practice with respect to clinical care
of patients and medical record-keeping.

2. Introduction

The College received information raising concerns about Dr. Bowler’s record-keeping and test
results management practices (failure to review laboratory results and consultation reports in a
timely manner, removing reports from office premises and not returning them) and
professional behaviour (use of profanity and angry outbursts). Subsequently, the Committee
approved the Registrar’s appointment of investigators to conduct a broad review of Dr.
Bowler’s practice.

3. Committee Process

As part of this investigation, the Registrar appointed a Medical Inspector (MI) to review a
number of Dr. Bowler’s patient charts, interview Dr. Bowler, and submit a written report to the
Committee.

A Family Practice Panel of the Committee, consisting of public and physician members, met to
review the relevant records and documents related to the investigation. The Committee always
has before it applicable legislation and regulations, along with policies that the College has
developed, which reflect the College’s professional expectations for physicians practising in
Ontario. Current versions of these documents are available on the College’s website at
www.cpso.on.ca, under the heading “Policies & Publications.”

4. Committee’s Analysis

The Committee noted that the MI’s report was very troubling in that it outlined concerns about
the integrity of Dr. Bowler’s charting (there were many discrepancies between the electronic
medical record and handwritten, almost illegible “crib notes” Dr. Bowler later produced for the
College upon request). In addition, some patient encounters contained no notes at all. The MI
noted significant deficiencies in documentation (whether inaccurate, delayed, or non-existent)
in all charts reviewed. The MI also opined that many charts had inadequacies with respect to:
care not in keeping with current guidelines; inadequate documentation for OHIP codes billed;
and inadequate test management, and that Dr. Bowler demonstrated a broad lack of
knowledge of current guidelines, management, and billing.

In his response to the MI’s report, Dr. Bowler acknowledged shortcomings in his medical
records and recognized his responsibility to ensure an organized system is in place to ensure
timely follow-up of laboratory results. Dr. Bowler stated he was prepared to engage in
remediation to address shortcomings in his practice.

In ordinary circumstances the Committee would consider referring a matter demonstrating

such global deficiencies in practice to the attention of the Discipline Committee. The
Committee also noted, however, that Dr. Bowler has remediation pending imposed through
another College process. The Committee did not think it would be fair or reasonable to refer Dr.
Bowler to the Discipline Committee before he had been given a chance to complete the
outstanding remediation. The Committee indicated that it would provide the MI’s report to Dr.
Bowler’s clinical supervisor in order to guide the supervision process and focus on the practice
deficiencies the MI identified once Dr. Bowler is in a position to engage in the clinical
supervision component of his remediation program.
Given the many deficiencies identified with respect to Dr. Bowler’s practice, and considering
that he has a remediation program pending, the Committee decided to caution him.