A Toronto plastic surgeon told Ontario's medical regulator Friday he now realizes he acted against a patient's best interest in allowing a television crew to film her breast augmentation surgery despite her objections.
Dr. Martin Jugenburg is facing a disciplinary charge of professional misconduct on several allegations that he violated patients' privacy, including an incident involving a news segment that briefly showed a patient's breast.
The doctor previously told a panel of the College of Physicians and Surgeons of Ontario through his lawyer that he admits to professional misconduct but disputes some of the allegations against him.
Under cross-examination by video conference Friday, the doctor said he understands in hindsight that his behaviour caused a patient's breast to be shown for just over a second during a Global TV segment in 2016.
Jugenburg said the patient, who cannot be identified under a publication ban, declined to be filmed by the TV crew but agreed to let them shoot footage of the doctor during the procedure.
The surgeon said he should have taken greater steps to ensure the patient was not captured on film during the segment, which focused on his use of the social media platform Snapchat to promote his work.
Carolyn Silver, the lawyer representing the regulator, suggested Jugenburg prioritized the benefits to his business over the patient's privacy.
"You rolled the dice and risked exposing her most intimate personal health information, correct? You put her in that risky position...by letting the film crew in the room, correct?" she asked.
"Correct," Jugenburg agreed.
"With no benefit to her," Silver added.
"Correct."
"And the result of this was...her breasts were exposed on national TV, correct?"
"Yes, it happened," he said.
Jugenburg said, however, that he did not intentionally put his own interests before those of the patient, calling it a "mistake."
He also denied pressuring the patient to consent to having the crew in the operating room, though he acknowledged he should not have waited until 20 to 30 minutes before the procedure to seek approval.
"It would have been nice to give her more time to think about it but I disagree with any implication that I was forcing her, suggesting or using my power to get her to agree with me," he said.
When asked whether the patient may have felt pressured given the timing and Jugenburg's position of power, the doctor conceded that was possible.
An agreed statement of fact presented to the committee earlier this week said Jugenburg had mistakenly posted photos of another patient's bare breasts on his Instagram and Snapchat accounts without her consent.
That patient also said she felt pressured to contribute to Jugenburg's social media presence, and that he seemed more focused on his social media than on her recovery, the statement said.
Asked about that incident Friday, Jugenburg said the patient's perception didn't necessarily reflect his behaviour.
"I'm sorry if she felt that way but it was not something that I intentionally did or...that maybe didn't even happen. The fact that she felt that way doesn't mean it actually happened," he said.
The document also said Jugenburg had video cameras installed throughout the downtown Toronto clinic — including inside the operating and examination rooms — over a period of two years, during which thousands of patients would have been recorded.
It said there were only two signs mentioning the cameras, one of which was not easily visible to patients. Jugenburg could access the recordings through an app on his phone, it said.
Jugenburg is also facing a class-action lawsuit in connection with the video cameras at the clinic.
