College of Physicians and Surgeons of Ontario v. Costescu, 2026 CanLII 7287

ONTARIO PHYSICIANS AND SURGEONS DISCIPLINE TRIBUNAL

Date: February 4, 2026

Tribunal File No.: 25-019

BETWEEN:

College of Physicians and Surgeons of Ontario

College

• and -

Dustin James Whitby Costescu

Registrant

FINDING AND PENALTY REASONS

Heard: January 7, 2026

Panel:

Raj Anand (panel chair)

Marie-Pierre Carpentier (physician)

Vincent Georgie (public)

Carys Massarella (physician)

Linda Robbins (public)

Appearances:

Elisabeth Widner, for the College

Marc Flisfeder, for the registrant

RESTRICTION ON PUBLICATION

Pursuant to Rule 2.2.2 of the HPDT Rules of Procedure and ss. 45-47 of the Health Professions Procedural Code, no one shall publish or broadcast the names of patients or any information that could identify patients or disclose patients’ personal health information or health records referred to at a hearing or in any documents filed with the Tribunal. There may be significant fines for breaching this restriction.

The Ontario Physicians and Surgeons Discipline Tribunal is the Discipline Committee established under the Health Professions Procedural Code.

Introduction

1Dr. Dustin James Whitby Costescu is a physician who self-identifies as a member of a marginalized community. In addition to his personal involvement in the community, he has provided lengthy service as an obstetrician/gynaecologist. This referral arises out of interactions with another member of his community, Patient A, in which Dr. Costescu failed to maintain appropriate boundaries between his personal communications and his professional contact with Patient A.

2Based on uncontested facts, we found that Dr. Costescu engaged in misconduct through acts that would reasonably be regarded by the profession as disgraceful, dishonourable or unprofessional (DDU). We also accepted the parties’ joint submission on penalty and costs, which included a four month suspension, a reprimand, completion of the PROBE ethics course and payment of the standard tariff rate of $6,000 in costs for a half-day hearing.

3These are our reasons.

Misconduct

4Dr Costescu obtained his certificate of registration authorizing independent practice in Ontario in 2012. Until the end of 2024, he practised at McMaster University Medical Centre, and his practice included the provision of care in the field of transgender medicine. Since then, he has provided other types of services in outpatient facilities.

5On September 30, 2024, Patient A saw Dr. Costescu for a surgical consultation prior to a gender-affirming procedure that would be performed by Dr. Costescu. At the end of the appointment, Patient A was informed that he would be placed on a waiting list for the surgery. The surgical consultation did not involve a physical examination.

6During the appointment, Patient A recognized Dr. Costescu from prior interactions they had had on an online app several months to a year before the appointment. Dr. Costescu did not recognize Patient A during the consultation. In those earlier online interactions, they had exchanged photographs of each other and engaged in communications of a personal nature. Patient A knew at that time that Dr. Costescu worked in health care, but did not know he was a physician.

7After the appointment, Patient A sent a message on the app “liking” Dr. Costescu’s online profile, and Dr. Costescu responded with a message back to him.

8Patient A then sent a message to Dr. Costescu saying “I think that I saw you at my appointment the other day.” Dr. Costescu’s reply confirmed he had been the physician at the appointment. He told Patient A he did not bring up their prior contact on the app and apologized for making Patient A feel uncomfortable. He suggested to Patient A that he might want to have his care transferred to another physician.

9Patient A told Dr. Costescu he was fine continuing as his patient; however, Dr. Costescu’s suggestion that he might want to switch care made Patient A nervous. He began to realize it was not acceptable to continue as Dr. Costescu’s patient.

10After about two weeks of messaging on the app, Dr. Costescu and Patient A exchanged phone numbers and texted each other for several weeks, until Patient A terminated contact around November 2024. In their communications, they continued to share personal information, but they did not discuss any clinical issues and did not meet in person.

11Patient A terminated contact with Dr. Costescu because he was uncomfortable with their conversations, since Dr. Costescu was his physician. When Patient A called the hospital to switch surgeons, he was told Dr. Costescu had closed his hospital practice, but this would not affect Patient A’s wait time for surgery.

12At the hearing we accepted the College’s uncontested position that Dr. Costescu’s actions constituted disgraceful, dishonourable or unprofessional conduct. He communicated with Patient A on personal matters, unconnected with clinical care, through the online app and texts. It was his responsibility as a physician to maintain appropriate boundaries, and he did not do so. When he suggested that Patient A might want to change physicians, he effectively put the responsibility on his patient to end the boundary violation.

13The parties submitted three cases in which the Tribunal has found that personal communications with patients, unconnected with medical issues, resulted in findings of professional misconduct: College of Physicians and Surgeons of Ontario v. Slataroff, 2025 ONPSDT 6; College of Physicians and Surgeons of Ontario v. Stein, 2023 ONPSDT 21; and College of Physicians and Surgeons of Ontario v. Steinberg, 2023 ONPSDT 13.

Penalty and Costs

14As noted, the parties made a joint submission on penalty, which the Tribunal must accept unless it is contrary to the public interest in a way that brings the administration of justice into disrepute: R. v. Anthony-Cook, 2016 SCC 43 at para 34.

15In the recent Slataroff decision, the Tribunal translated the Anthony-Cook standard into the professional regulation context at para 11:

A penalty is contrary to the public interest when it fails to protect the public and/or impairs the ability of the College, and by extension the Tribunal, to regulate the profession of medicine and govern physicians. If the proposed penalty violates the public interest, the administration of justice is brought into disrepute. In the professional regulation context, this means the proper functioning of the College’s professional discipline system has broken down.

16Based on this criterion, we concluded at the hearing that there was no basis on which to reject the parties’ joint submission.

17The four month suspension, and the requirement to complete the PROBE Ethics and Boundaries Program before he returns to practice, address the primary purpose of penalties, which is public protection, as well as the maintenance of confidence in the profession and its regulation in the public interest.

18Mandatory ethics training also contributes to Dr. Costescu’s rehabilitation, to better enable him to serve a vulnerable population upon his return to practice. In that context, his counsel pointed out that Dr. Costescu self-identifies as a queer person. He has taken pride in his advocacy for the trans community and has published on gender affirming care.

19A significant suspension contributes to specific and general deterrence by signalling to Dr. Costescu and the profession at large that boundary violations will not be tolerated. We recognize at the same time that Patient A did not lose his place in the surgical waitlist, which avoided more significant harm to the patient.

20There are relevant mitigating factors in Dr. Costescu’s case. He has no prior disciplinary record. In terms of his actions since the misconduct, he did not contest the evidence that was put before us, which facilitated the holding of a short hearing, without stress or inconvenience for potential witnesses. He recognizes that he has let down his community, and that he needs to rebuild trust and demonstrate that this sort of conduct will not happen again.

21The three cases on boundary violations cited earlier in these reasons provide a sense of the range of penalties that the Tribunal has imposed. The Tribunal generally seeks to achieve consistency in its penalty decisions, but the jurisprudence must be applied with care. Tribunal decisions are not binding on subsequent panels, and the specific penalties resulting from joint submissions (as in all three cases) generally carry less weight, because of the limited review that takes place under the Anthony-Cook principles. In addition, every decision is fact-specific, and, as we have done, panels must consider many different and often divergent factors in penalty decisions. At the same time, the prior decisions follow similar principles and suggest the appropriate range of penalties in boundary cases like this one.

22In Slataroff, the Tribunal described the “suspension range” for boundary violations arising from inappropriate comments as two to six months. The misconduct in that case was more serious than Dr. Costescu’s; it included inappropriate comments to three patients about sexual issues, as well as inappropriate physical contact. In addition, the registrant had a history of similar concerns about putting intrusive questions of a sexual nature to patients. He had previously given the Inquiries, Complaints and Reports Committee (ICRC) an undertaking and had been cautioned by the ICRC about sensitive communications with patients. On a joint submission, a five month suspension was imposed, in addition to a reprimand and the completion of a PROBE ethics program.

23Stein involved the violation of boundaries outside the clinical setting. The registrant made telephone calls and inappropriate flirtatious remarks to the patient, took her to a concert, and touched her inappropriately. He also tried to mislead the College during its investigation by seeking an acquaintance’s assistance to fabricate an alibi for the concert attendance. The parties provided cases that imposed suspensions in the two to six month range for boundary violations and interference with a College investigation. On a joint submission, the Tribunal ordered a six month suspension, delivered a reprimand and required completion of the PROBE ethics program.

24In the Steinberg case, the registrant’s misconduct was at a similar level to Dr. Costescu’s case. Dr. Steinberg hugged a patient on one occasion, and sent her a single text to invite her to the registrant’s house, but did not make her feel uncomfortable. Physical touching was not present in our case, but Dr. Costescu’s communications took place over several weeks. Again, the panel accepted the parties’ joint submission, awarding a three month suspension, imposing a reprimand and requiring the completion of the PROBE ethics program.

25Taking all of the above considerations into account, we accepted the parties’ joint penalty submission and ordered a four month suspension, completion of the PROBE ethics course, and delivery of a reprimand.

26We also accepted the parties’ joint submission that costs should be awarded to the College at the half-day tariff rate.

Order

27At the conclusion of the hearing, we ordered:

Finding

The Tribunal finds that the registrant committed the following act(s) of professional misconduct:

1. under paragraph 1(1)33 of Ontario Regulation 856/93 made under the Medicine Act, 1991 (“O. Reg. 856/93”), in that the member has engaged in an act or omission relevant to the practice of medicine that, having regard to all the circumstances, would reasonably be regarded by members as disgraceful, dishonourable or unprofessional.

All other allegations of misconduct were withdrawn.

Penalty

1. The Tribunal requires the registrant to appear before the panel to be reprimanded.

2. The Tribunal directs the Registrar to:

a. suspend the registrant’s certificate of registration for four (4) months commencing on January 8, 2026 at 12:01 a.m.

b. place the following terms, conditions and limitations on the registrant’s certificate of registration effective immediately:

i. Dr. Costescu shall participate in and successfully complete, without condition or qualification and at his own expense, the PROBE Ethics & Boundaries Program offered by the Centre for Personalized Education for Professionals. Dr. Costescu will complete the PROBE program within six (6) months of the date of this Order or, if it is not available within that timeframe, at the earliest available opportunity. Dr. Costescu will provide proof of his successful completion to the College, including proof of registration and attendance and participant assessment reports, within one (1) month of completing it.

Costs

3. The Tribunal requires the registrant to pay the College costs of $6,000.00 by February 7, 2026.