Weight-loss surgeon with licence revoked in Ontario for sex with patients recruiting in Alberta

A weight-loss surgeon whose Ontario medical licence was revoked for sexually abusing four female patients has been recruiting new patients from Fort McMurray to his institute in Mexico.

An Edmonton clinical ethicist said the "egregious" behaviour of Mexican surgeon Dr. Jacobo "Jacob" Joffe while practising in Ontario highlights the potential risks of "medical tourism."

"Would I be worried as a patient? Absolutely," said Brendan Leier, an assistant clinical professor with the University of Alberta's John Dossetor Health Ethics Centre.

"Unfortunately there is no mechanism, when you travel across a border, to protect Canadian patients and it sounds like the Mexican licensing bodies see the issue differently in terms of having a second chance to treat," Leier said.

• Breaching Boundaries: Disciplined physicians often given 2nd chance to practise

A CBC News investigation found that over the last 15 years, at least 250 doctors have been disciplined across the country for a litany of patient boundary offences. Two-thirds were allowed to continue practising, and of those who lost their licences, CBC News discovered three, including Joffe, who moved to other countries to practise medicine.

Joffe is a general surgeon who specializes in weight-loss operations like gastric sleeve and gastric bypass surgery. He practised in Scarborough until December 2008 when the Ontario College of Physicians and Surgeons revoked his medical licence for sexual abusing four female patients over a period of several years.

Joffe did not contest the findings of the college's internal investigation, but those findings only apply to that specific hearing.

The committee found: he hugged and kissed some patients on their lips and told them how sexually attractive they were; had sex with patients regularly at his office, in the hospital and at their homes; and induced one woman to obtain illicit drugs, which he then used with the patient and another female patient.

The college also found Joffe engaged in sexual threesomes with two of his female patients while using drugs.

The college said Joffe knew his behaviour was unprofessional because he actively encouraged the women to conceal their relationships.

"The (disciplinary) committee had particular regard for the poignant description of the effects experienced by patients noted in their respective victim impact statements, which included humiliation, distortion of normal social relationships, fear of hospitals and physicians, destruction of family relationships, depression, psychological problems and employment problems."

The college levied a fine of $40,000 against Joffe to be used for the women's counselling.

The hospital in Scarborough, and Joffe, later settled a $12-million lawsuit with the patients.

"Preyed" upon patients

At his public reprimand hearing in 2013, as reported by The Toronto Star, a committee member excoriated Joffe.

"Your actions were utterly self-serving," Dr. Marc Gabel said. "You preyed upon the vulnerabilities of these patients and misused the trust that they had in you."

Joffe did not respond to interview requests from CBC Edmonton but in a previous discussion with a CBC Manitoba producer he expressed no remorse for his previous behaviour. Instead, he appealed to the producer's sense of humanity while asking that he not be named in a story.

"It has taken me a long time to get over the disaster in how this played in my life, and how much damage, mentally and physically, this had to do with me and in my life," Joffe said. "It has taken me so long. I mean, it is already seven years and it is not easy, okay?"

After the Ontario college revoked his licence in 2008, Joffe moved to Mexico, where he is a citizen and had received his medical degree, and opened the Advanced Metabolic and Bariatric Institute in Guadalajara.

A spokeswoman for the Ontario college said it notified the Mexican regulatory authority of Joffe's licence revocation, including the disciplinary committee's findings.

His website references a recruitment seminar in Fort McMurray in April 2012 and the institute's Facebook site featured a photo of Joffe with more than a dozen patients from there.

The website features many "success stories" of past patients, which praise Dr. Joffe and his care. Eleven of the 22 testimonials are by patients from from Fort McMurray who paid up to $15,000 for surgery, which includes airfare and accommodation costs. There are also video testimonials from Fort McMurray patients posted on YouTube.

Patients praise surgeon

CBC Edmonton contacted seven patients from Fort McMurray; only one responded.

In an email, Ria Ryan said she was "fully aware of Dr. Joffe's situation in Ontario before I booked an appointment with him for my surgery.

"He came highly recommended from a friend," Ryan said. "I received excellent care in Mexico and I came away respecting Dr. Joffe as a surgeon and a person."

In one testimonial, a Fort McMurray man said he was referred to Joffe by his local doctor. He did not respond to interview requests.

Kelly Eby of the College of Physicians and Surgeons of Alberta said she could not comment on a specific case, but she said the college has no specific rules governing the referral of patients to specialists.

"Any time a family physician refers a patient to a specialist, we have an expectation that that family physician knows that the physician they are referring to has a good quality of practice, they will treat the patients well," she said.