On July 7, 2014, the Discipline Committee found that Dr. Rakem committed an act of professional misconduct, in that he engaged in the sexual abuse of a patient, and that 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. Rakem admitted to the allegations.
At the time of the incident, Patient A was eighteen years old and saw Dr. Rakem in 2011 for a sports injury to her knee. He performed an arthroscopy on Patient A, diagnosing and treating a partial ACL tear. Dr. Rakem saw Patient A for follow up in 2012 with her mother. In the course of an appointment, Dr. Rakem offered to have Patient A watch him operate the next time he was on call at the hospital as she had expressed an interest in attending medical school. Patient A and her mother accepted the offer. A few days later, Dr. Rakem called Patient A, inviting her to come watch some surgeries. Patient A observed Dr. Rakem perform a hip replacement surgery and then accompanied him to another floor to see a patient. While mounting the stairs, Dr. Rakem patted Patient A on the buttock and chuckled. Patient A said nothing at the time.
Patient A observed Dr. Rakem perform a second surgery. After this surgery, Dr. Rakem invited Patient A to accompany him to his office across the street from the hospital, where he suggested that he give her an anatomy lesson. In doing so, Dr. Rakem had the patient undress down to her t-shirt and underwear, and then touched and stroked her various body parts, including in her pelvic region, while naming the muscle groups. Patient A states that Dr. Rakem asked her to remove her underwear, which she refused to do. At that point, Patient A got up and dressed and told Dr. Rakem that she felt uncomfortable, that it was getting late and that she wished to go home rather than observe another surgery.
The Discipline Committee ordered and directed that:
the Registrar suspend Dr. Rakem's certificate of registration for a six-month period, to
commence at 12:01 a.m. on July 8, 2014.
the Registrar impose the following terms, conditions and limitations on Dr. Rakem's
certificate of registration:
Practice Monitoring - Office Setting
(i) Dr. Rakem shall not engage in any professional encounters with female patients except in the presence of a monitor who shall be a member of a regulated health profession pursuant to the Regulated Health Professions Act, 1991, S.O. 1991, c. 18 as amended, who is acceptable to the College (the "Practice Monitor") and who has executed an undertaking with the College in the form attached to this Order as Appendix "A";
(ii) The Practice Monitor must be present in the examination or consultation room at all times when professional encounters with female patients occur, and must carefully observe, with an unobstructed view, all physical examinations performed by Dr. Rakem on female patients;
(iii) The Practice Monitor is required to maintain a log of all female patient encounters and the log shall provide the name of the female patient, and the purpose and date of the appointment. The Practice Monitor will sign and date the corresponding entry on the female patient's medical record;
(iv) Dr. Rakem shall post a sign in the form attached to this Order as Appendix "B" in each examination and consultation room, as well as the waiting room, that states as follows: "Dr. Rakem may only have encounters with female patients if a Practice Monitor acceptable to the College of Physicians and Surgeons of Ontario is present in the examination or consultation room."
Practice Monitoring - Hospital Setting
(v) In the case of Dr. Rakem's hospital practice, the Practice Monitor shall be a member of a regulated health profession who is employed by the hospital where Dr. Rakem has privileges;
(vi) The Practice Monitor must be present for all encounters as in (ii) above, which includes all surgeries and post-operative examinations;
(vii) The Practice Monitor must initial the patient's chart at the end of the encounter, whether surgery or otherwise, to confirm her presence. If more than one monitor is present but at different times during a surgery, each monitor shall sign the patient's chart;
(viii) Dr. Rakem shall ensure that the Chief of Staff in all hospitals in which he practises is aware of this restriction on his practice;
(ix) Dr. Rakem shall keep the College updated with respect to all locations where he practises including, but not limited to, hospitals, clinics and offices, in any jurisdiction (collectively his "Practice Location(s)") within 15 days of this Order, and shall inform the College of any and all new Practice Locations within 15 days of commencing practice at that location;
(x) Dr. Rakem shall provide his irrevocable consent to the College to make appropriate enquiries of the Ontario Health Insurance Plan and/or any person or institution who may have relevant information, for the purposes of monitoring and enforcing his compliance with the terms of this Order;
(xi) Dr. Rakem shall submit to, and not interfere with, unannounced inspections of his office(s) and practice(s) and patient charts by a College representative for the purposes of monitoring and enforcing his compliance with the terms of this Order;
Other
(xii) Dr. Rakem shall participate in and successfully complete the next available course regarding boundary issues and risks inherent in the doctor-patient relationship approved by the College; and
(xiii) Dr. Rakem shall be solely responsible for all fees, costs and expenses associated with his compliance with the terms of this Order.
Dr. Rakem appear before the panel to be reprimanded.
Dr. Rakem reimburse the College for any funding provided to Patient A under the program required under section 85.7 of the Code, and shall post an irrevocable letter of credit or other security acceptable to the College to guarantee payment of such amounts, within 30 days of the date of this Order, in the amount of $16,060.
Dr. Rakem shall within 30 days pay the College its costs of this proceeding in the amount of $4,460.00.
Terms and conditions imposed on certificate by: Member