After a pharmacist reported a doctor to AHPRA for inappropriate prescribing, AJP looks into the circumstances that led to her being attacked
In the past few weeks we have covered the story of a pharmacist who was violently attacked by a doctor whom she had reported to AHPRA.
The doctor was a general practitioner at a medical centre in Adelaide, while the pharmacist was based in Port Lincoln, South Australia.
In April 2017, the pharmacist noticed the GP had written scripts for several different individuals for high quantities of diazepam, oxazepam and panadeine forte.
She first tried to telephone the doctor but found his surgery closed.
Later, in May, the pharmacist made a report to AHPRA regarding these prescriptions. The original report was verbal. She was told it was best to put the report in writing.
Following her notification and an AHPRA investigation, the Medical Board of Australia decided to place conditions on the GP’s registration restricting to his ability to prescribe Schedule 4 medicines.
These conditions were confirmed in early October.
A few days later, the GP travelled to the pharmacist’s workplace and stabbed at her with a knife, in an action that a judge found this week was attempted murder.
She survived the attack after she and a customer of the pharmacy fought the doctor off.
During our coverage of the story, our readers asked the following questions:
“How insane!! Firstly how did he get her name?? And secondly, he went in with flowers and stabbed her? Why are pharmacists not protected when reporting prescribers?” – SE
“How would he know that she reported him…good one AHPRA. This is what we get for reporting?? Just going to keep more pharmacists quiet and these doctors will just keep getting away with things.” – EF
“And here I thought that all concerns/complaints reported to AHPRA were meant to be confidential??” – SS
“A big question is how did the doctor realise who reported him to AHPRA. It’s a huge failure on their behalf if they disclosed her name to the prescribing doctor. This has pretty much ensured no one will ever report anything to AHPRA ever again.” – UwS
“Two friends of mine have been on the ‘other’ end of APHRA reports in the last year. In both these circumstances APHRA did disclose who made the report… I don’t think anyone at APHRA could have imagined this happening. But now that it has a review of procedures is necessary.” – GM
Court documents reveal that the pharmacist was told by AHPRA there was scope to indicate whether she was prepared for her name to be disclosed.
AHPRA also told the pharmacist that if she was prepared for her name to be disclosed with her report, this would expedite the referral and it would “carry more weight”.
Accordingly, the pharmacist authorised the release of her name.
Her full name was included on the notification document provided to the GP, and later the name of one of the pharmacies she worked at was also provided to him.
At the time of receiving the notification report, the GP was advised by AHPRA: “It is not appropriate for you to discuss this matter with the notifier”.
However having found out her full name, the doctor went to lengths to find out her home address, instructing and paying a private investigator to ascertain it for him.
During a trial, the judge found that the GP had “formed a profound resentment” towards the pharmacist following the notification, “and carefully formulated a plan over a period of a couple of weeks to attack and kill her with the lethal weapon purchased”.
In her sentencing remarks, Justice Ann Vanstone criticised the process that led to the pharmacist’s name getting into the hands of the doctor.
“Most regrettably, the victim was encouraged by AHPRA to allow her name to be disclosed as the pharmacist notifier and it was provided to you, as was in due course, the name of her pharmacy. This enabled you to locate her. Indeed, you employed a private investigator to ascertain her home address.”
AHPRA has confirmed to the AJP that in the light of this case, it will be reviewing its policies and processes – but also highlights that healthcare practitioners currently have the option to make a notification anonymously.
“We respect people’s right to remain anonymous and we provide the option of making a notification anonymously,” said a spokesperson for AHPRA.
“We also provide the option of making a notification where a notifier’s identity is known to us, but is not disclosed. We will only disclose a notifier’s identity where we have consent to do so.
“We continue to review our policies and processes in light of relevant findings, including this case.”
Its guide for practitioners regarding notifications says that “AHPRA and the National Boards treat all notifications seriously. They are managed according to legal requirements, including confidentiality, privacy and natural justice principles.
“We will usually send the health practitioner a copy of the notification we have received and ask them to respond. Occasionally, we are not able to ask the practitioner for a response at this stage because this would:
- prejudice an investigation;
- place a person’s safety at risk; or
- place a person at risk of intimidation.
“In almost every case, practitioners and students who are being investigated are aware of the investigation, as they are given notice of the investigation and information about what is being investigated. The issues being investigated will be set out in written advice from AHPRA. AHPRA provides practitioners or students being investigated (and notifiers) with three-monthly updates on the progress of the investigation. The only exceptions are when the Board believes that giving notice to the practitioner may:
- seriously prejudice the investigation;
- place someone’s health or safety at risk; or
- place someone at risk of harassment or intimidation.”