Doctor couldn’t say ‘no’


legal medical tribunal doctor overprescribing

A pharmacist tipped off police when presented with a script that raised suspicions – sparking an investigation into a doctor who had been prescribing drugs for sex workers he hired

The Victorian Civil and Administrative Tribunal heard that the medical practitioner and specialist admitted to 11 “serious” allegations, which included the inappropriate prescribing – without conducting an assessment or examination, or maintaining proper clinical records – of diazepam, oxycodone, alprazolam and/or MS Contin to four commercial sex workers on eight occasions.

These allegations also concerned dishonesty, in forging a doctor’s name on a prescription pad and then denying this to the Immediate Action Committee convened by the Medical Board of Australia when immediate action was proposed.

They also concerned the inappropriate prescribing to himself and his former wife – largely without her knowledge – on 16 occasions.

While working as an accredited registrar at a Victorian hospital, the doctor prescribed Viagra to himself in late December 2014 and in February 2015; he also prescribed the drug to his wife on three occasions without her knowledge between July 2015 and March 2016, as well as prescribing the Sandoz generic to her in June 2016.

He also prescribed Proxen 75 and Voltaren 50 to his then wife without a clinical assessment or examination in December 2014.

The Tribunal heard that the doctor engaged the services of a sex worker, “Patient B” in August 2015 and on that date prescribed diazepam for her, hiring her for sexual services again and prescribing the same drug the next month. On neither occasion did he conduct an assessment or record the interaction or prescription.

He also engaged the services of two more sex workers, prescribing them both diazepam without assessment or recording the prescription; in the case of the second, “Patient C,” he also prescribed oxycodone. On a later date he prescribed Patient C diazepam again.

This interaction with Patient C occurred on the same day as one of the occasions he hired and prescribed for Patient B.

In September 2015, the doctor met “Patient D,” a commercial sex worker, while she was soliciting in the St Kilda area.

On that date, he prescribed her an benzodiazepine unnamed by the court transcript at a strength of 2mg and in a quantity of 50 tablets. Again, he conducted no assessment and kept no record of the interaction or prescription.

The next month, Patient D went to the emergency department of the hospital where the specialist worked and informed staff that a doctor working there had prescribed her an addictive substance, while trying to engage her to perform sexual services.

Two days later, the doctor was suspended from duty at the hospital and required to return his prescription pad. The next month he was allowed back – with conditions imposed.

Days later, he notified the Victorian Department of Health that the woman was drug dependent.

When he met Patient D again in February 2018, he used the prescription pad of a colleague to prescribe her 28 tablets, 100mg per tablet of MS Contin.

Patient D took the script to the pharmacy to be dispensed, but the pharmacist became suspicious of the prescription, and queried it with the doctor, who did not take the opportunity to cancel it. The pharmacist then contacted Victoria Police.

When interviewed by police, Patient D said the doctor had given it to her.

After police informed AHPRA about the allegations following their investigation into the doctor, he told the Immediate Action Committee that he did not write the script for Patient D in question.

But several months later, he wrote to the Medical Board and told it he had provided false information, admitting falsely using another doctor’s pad and that he had prescribed the MS Contin.

In March 2019, the doctor pleaded guilty to charges of theft and making a false document to the prejudice of another, and was sentenced to an undertaking to be of good behaviour with conviction.

He appealed this sentence successfully and it was adjusted to be without conviction.

AHPRA took immediate action and suspended the doctor’s registration in May 2018.

The Tribunal heard that the doctor had been seeing a psychologist, who said that he had difficulty saying “no” thanks to his upbringing in a strongly patriarchal culture, and that this could have played a role in the doctor’s inability to “refuse the demands” placed on him by the drug-seeking individuals.

“We were concerned that it neither fully explained the conduct nor reflected a completely accurate portrayal of it,” the Tribunal noted.

The doctor said that Patient D, whose character he denigrated repeatedly, had continued to call and harass him over several years, and that because he was under “cumulative executive stress” and due to his “emotional vulnerable personality,” he used the opportunity she gave him to make his stress “go away”.

He claimed that the sex workers were the ones who had asked him for the scripts, saying he did not have the capacity to say “no” due to his undiagnosed and untreated mental illness.

The Tribunal said it had “difficulty accepting that the women were responsible” for the doctor’s behaviour.

It noted that it had “difficulty unpacking” the explanation that the sex workers had instigated the prescribing, wondering how they knew he was a doctor, and if so, how they knew he would be willing to prescribe drugs outside the confines of a clinical consultation.

Patient D had told AHPRA that the doctor paid for sexual services with the scripts, and alleged that she knew “other street girls” had been paid by him in this way, though the doctor denied this and the Tribunal did not make the finding that this took place.

However, it also said it would not “blindly” accept the explanation that the doctor just had trouble saying “no” when asked.

He also said he was just trying to help the women, another explanation which the Tribunal said it did not “unquestioningly accept”.

The doctor was reprimanded and his registration cancelled.

He is disqualified from reapplying for registration as a registered health practitioner for a further period of 14 months, from the date of the hearing (13 August 2020).

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