DISCIPLINE SUMMARIES
DR. MOHAN KRISHNAN RAJA
PRACTICE LOCATION: St. Catharines
AREA OF PRACTICE: Family Medicine (Methadone)
HEARING INFORMATION: Contested Hearing; Joint
Submission on Penalty
On November 27, 2017, the Discipline Committee
found that Dr. Raja committed an act of professional
misconduct in that he engaged in conduct or an act
or omission relevant to the practice of medicine that,
having regard to all the circumstances, would reason-
ably be regarded by members as disgraceful, dishon-
ourable or unprofessional.
The allegations arose from the conduct of Dr. Raja
during a number of clinical appointments when
Patient A saw Dr. Raja for methadone treatment. The
Committee found that in at least two examinations of
Patient A, Dr. Raja had her raise her shirt above her
bra, lifted the left side of her bra, and exposed her left
breast. He then listened to her heart sounds in four
areas, which included touching the periphery of her
left breast with his stethoscope and pushing aside her
breast for optimal skin contact. There was no evidence
that Dr. Raja made any comments of a sexual nature.
The Committee found that while he did raise Patient
A’s bra, there was no evidence that Dr. Raja touched
her breast in a sexual manner. The Committee noted
that there was no fondling, massaging of the breast,
squeezing, or touching of the nipple. The Committee
accepted that listening to the heart sounds in the four
areas described by Dr. Raja was an acceptable focused
cardiac examination. Examination of the heart in this
manner with a stethoscope would involve placing the
stethoscope close to the breast or at the periphery of
the breast. In some cases, the breast would need to be
pushed aside for optimal contact between the stetho-
scope and skin. The Committee found there was no
sexual character to the examination as performed in
this fashion. While Dr. Raja may have touched her
breast while carrying out the examination of her heart,
such touching of the breast in this context did not
constitute a violation of sexual integrity. Dr. Raja’s ap-
proach appeared to have a mechanical quality, but was
not of a sexual character.
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DIALOGUE ISSUE 4, 2018
In making a finding of disgraceful, dishonourable and
unprofessional conduct, the Committee considered that:
• Dr. Raja failed to respect the privacy owed to his
patient;
• The unanticipated exposure of her breast on its own
constituted a significant boundary violation;
• Dr. Raja was inconsiderate when he exposed Patient
A’s breast;
• Dr. Raja did not understand or disregarded how his
actions would make Patient A feel;
• Dr. Raja’s explanation to Patient A of why he
needed to repeatedly listen to her heart sounds was
unclear or nonexistent; and
• Patient A was a particularly vulnerable patient,
which makes a lack of respect for her dignity and
privacy more egregious.
The nature of Dr. Raja’s misconduct was held to be
an aggravating factor. The Committee commented
that physicians need to have heightened awareness
with regard to maintaining appropriate boundar-
ies and need to show respect for modesty and body
integrity. It is also necessary to provide sufficient
explanation to patients to meaningfully communi-
cate. Failure to do so results in patients’ confusion
about the possible motive for certain actions and sets
the stage for negative consequences. Both maintain-
ing appropriate boundaries and meaningful com-
munication are integral to a healthy patient-doctor
relationship and are necessary to ensure that public
and patient trust is not eroded.
There were a number of mitigating factors which
the Committee acknowledged. Dr. Raja completed
the course on Understanding Boundaries and Man-
aging the Doctor-Patient Relationship. Dr. Raja co-
operated in coming to an agreement on penalty, thus
shortening the penalty hearing. In addition, Dr. Raja
has no prior discipline history with the College.
ORDER
The Committee ordered: a two-month suspension
of Dr. Raja’s certificate of registration; a reprimand
and payment to the College for the costs in the
amount of $22,000.
For complete details, please see the full decision at
www.cpso.on.ca. Select Find a Doctor and enter the
doctor’s name.