Dr . X , retained as an expert by the College , opined that Dr . Mohan failed to meet the standard of pracdiscipline summaries
DR . RAJESH MOHAN
Practice Location : Toronto Practice Area : General Practice
Hearing Information : Agreed Statement of Facts ; Admission ; Joint Submission on Penalty
On September 22 , 2015 , the Discipline Committee found that Dr . Mohan committed acts of professional misconduct , in that he has failed to maintain the standard of practice of the profession ; and he has engaged in conduct or 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 . Dr . Mohan admitted to the allegations . In February 2010 , the College received information from a patient that she and her family had attended at Dr . Mohan ’ s clinic for travel medicine services , where they had been seen by a man whom they believed to be a physician . On returning home , they viewed Dr . Mohan ’ s website and realized that although they had received a prescription signed by “ Dr . R . Mohan ,” the man whom they had seen was not Dr . Mohan . Dr . Mohan explained to the patient that the man they had seen was not “ licensed ” to practise medicine in Ontario and had signed Dr . Mohan ’ s name on the prescription . As a result , the College began an investigation into Dr . Mohan ’ s practice . When Dr . Mohan was made aware of the investigation , he ceased to employ physician assistants in his general practice , and cooperated with the investigation . The investigation showed that Dr . Mohan had employed two assistants in his general practice , neither of whom was authorized to practise medicine in Ontario . Dr . Mohan failed to familiarize himself with his professional obligations in regard to delegation and supervision of patient care and other issues arising from his employment of assistants . Appropriate delegation , under College policy , requires a number of safeguards , including the establishment of a physician-patient relationship , the existence of a medical directive or direct order , appropriate evaluation of the delegate , informed patient consent , and quality assurance steps , including appropriate supervision . Dr . Mohan screened applicants for assistant positions , provided a period of job shadowing , and subsequently reviewed care provided by his assistants after the fact . However , his supervision , delegation and ongoing quality assurance were inadequate . The following deficiencies in Dr . Mohan ’ s use of physician assistants were identified :
( a ) Dr . Mohan delegated controlled acts in the absence of written medical directives or direct orders , and in fact did not have written medical directives in his office ;
( b ) Dr . Mohan inappropriately had his physician assistants provide care while he was out of the office , including during a period of time while he was on holiday , without ensuring that another physician was on the premises and would supervise them ;
( c ) Dr . Mohan did not ensure that there was a prior physician-patient relationship between himself and any patient seen by his physician assistants ;
( d ) Dr . Mohan did not adequately ensure that there was informed patient consent to care being provided by physician assistants in all cases ;
( e ) When introducing patients to his physician assistants , Dr . Mohan did not adequately ensure that patients were aware in all cases that physician assistants were not certified to practise medicine in Ontario ;
( f ) Dr . Mohan did not adequately ensure that his physician assistants and office staff introduced the physician assistants appropriately to patients when he was not present ;
( g ) Dr . Mohan inappropriately permitted his physician assistants to write prescriptions and test requisitions ; and
( h ) Dr . Mohan inappropriately billed the Ontario Health Insurance Plan for services provided by his assistants in circumstances where it was not permitted for him to do so .
46
Dialogue Issue 2 , 2016