Montreal doctor suspended for excusing students from class without proper medical checkup
Dr. Raymond Rezaie, previously disciplined for botched circumcisions, to lose licence for 6 months
A Montreal doctor has been fined $10,000 and will lose his licence for six months for writing notes excusing CEGEP students from school and prescribing them medication for depression or anxiety without thoroughly examining them first.
Dr. Raymond Rezaie pleaded guilty to 13 violations brought before the disciplinary committee of Quebec's College of Physicians earlier this month.
Citing the need to protect the public, the college said it had to mete out a punishment matching the heightened gravity of the complaints.
"The respondent breached the ethical obligations at the core of the practice of professional medicine," reads the decision, released Thursday.
The investigation was launched after the college's investigative branch was asked to look into the cases of a number of Collège de Maisonneuve students.
Rezaie had given them medical notes in December 2015 and January 2016, excusing them from attending one or more of their classes.
The college's investigators went through the doctor's medical file and contracted an outside firm to gather more evidence.
In April 2016, a woman posing as a patient went to Alpha Medic Montréal on Guy Street and saw Rezaie for what she described as burnout.
During the interaction, which was recorded on video, the patient told the doctor that she was attending Collège de Maisonneuve, was stressed out about the end of the term, and she wasn't sure what to do. The doctor asked if she wanted to drop some of her classes.
She told him she had a hard time concentrating, and he then described how to proceed if she wanted a note to drop her courses.
"For Collège de Maisonneuve, this is how we do it. The form costs $65.... If you have anxiety and you have burnout, adjustment disorder — we can take off courses if you want," the doctor says on the video.
He then asked her if she had insomnia, anxiety and a hard time concentrating. He didn't ask about her medical history or whether she was taking any medication before prescribing her an antidepressant.
"It is clear that Dr. Rezaie led the interview by suggesting symptoms to fill in the school form, so that the request to drop out would be accepted," Dr. Sophie Ménard, an expert witness who viewed the video, said in the written decision.
She said the doctor failed to properly diagnose the patient.
"Of particular worry," she said, was the fact that the doctor prescribed the antidepressant Citalopram without conducting any mental health exam.
Took students at their word
In another incident, the doctor was criticized for writing a retroactive medical certificate for a patient who he met once at walk-in clinic and who, according to his notes, he did not fully evaluate.
Rezaie told the disciplinary board that he took students at their word when filling out retroactive notes from the time they reported experiencing anxiety symptoms.
He said the fact that students agreed to pay $65 for a medical note showed they were serious, otherwise, they would save their money for "a new iPhone."
The doctor was also sanctioned for prescribing Propranolol, a beta blocker used to treat high blood pressure, to patients who came to his office for issues related to anxiety and depression.
"I have never seen or heard of a case where Propranolol was used for treating an adaptation disorder," Ménard said. She said the drug is not recommended in the treatment of anxiety, as is clearly stated in the Canadian guidelines for the drug's use.
Banned from doing circumcisions
Rezaie, who obtained a licence to practise medicine in 2006 and opened his downtown clinic in 2010, kept a file of the forms needed to drop out of courses or to obtain a reduced course load from several different colleges and universities.
Rezaie told the college that staff from some education institutions advised students to go see him if they wanted to get a medical note to drop out of one or more courses.
According to the written decision, the doctor has expressed regret and said the cases covered by the complaint represent a very small portion of his 1,500 patients.
A receptionist at Rezaie's Montreal office contacted Thursday said he was not available for comment.
This is not the first time Rezaie has been sanctioned by the College of Physicians' disciplinary arm.
In 2016, Rezaie was banned for life from performing circumcisions after he pleaded guilty to performing botched procedures on 31 children at his clinic — some of which required surgical interventions to repair. He was fined $20,000, and his licence was suspended for a month.
The latest decision notes the "disastrous" financial situation Rezaie's clinic was facing in 2017. The clinic was $45,000 in debt, and two doctors had announced they would be retiring.
Rezaie's six-month licence suspension will start on June 4.