A GP has been reprimanded and his registration suspended for six months after providing medical care to close family in avoidable circumstances
The Medical Board of Australia has published the findings of a Victorian Civil and Administrative Tribunal decision which also found that the doctor’s clinical management of 23 patients was not clinically justified and exposed patients to potential harm.
In November 2014, the Professional Services Review notified the Medical Board that it had completed an investigation into whether the doctor had engaged in inappropriate practice in providing services under the MBS.
This investigation concluded that he had engaged in inappropriate practice.
The doctor was then reprimanded and counselled, disqualified from rendering services under the MBS for two years, and ordered to repay Medicare benefits in the amount of $453,656.75 to the Commonwealth.
The doctor appealed the decision unsuccessfully, before the Federal Court and then before the Full Court of the Federal Court.
He admitted to two allegations which were referred to the Tribunal; the first being that he engaged in professional misconduct in that between 1 December 2011 and 20 November 2012, he failed to demonstrate the standards of professional conduct expected of a registered medical practitioner by providing medical care to one or more close family members in circumstances that were avoidable; and that between 6 December 2011 and 1 November 2012 his clinical management was not clinically justified and/or was not evidenced based and/or exposed patients to potential harm in that the doctor administered to them, treatment with an intravenous injection of the antibiotic Keflin in a residential setting.
He had treated two close family members, avoidably, on 81 occasions and 60 occasions respectfully – a total of 141 occasions in just under 12 months.
He had also treated 23 patients with antibiotics intravenously in a residential setting, in just under 11 months.
It was agreed that the doctor’s clinical management in these latter instances was not clinically justified or evidence-based and exposed patients to potential harm.
The Board submitted two expert opinions to the Tribunal. The first concluded that “taking on the role of GP for his close family member would be regarded by the body of other GPs and the general public to be unacceptable”.
The Tribunal highlighted that the doctor should have realised that his conduct was clearly out of step with clause 3.14 of the Good medical practice: a code of conduct of doctors in Australia, which requires that whenever possible, a doctor should avoid providing medical care to anyone with whom they have a close personal relationship.
The second expert opinion said the doctor’s treatment of the 23 patients was substantially below the standard reasonably expected of a medical practitioner with his level of training and/or experience.
This was because among other issues, the treatment exposed patients to a risk of adverse effects of the intravenous therapy and antibiotic resistance.
The Tribunal added that this was contrary to clause 2.2.2 of the code which states, “Maintaining a high level of medical competence and professional conduct is essential for good patient care. Good medical practice involves…Considering the balance of benefit and harm in all clinical- management decisions”.
The Tribunal also noted that the doctor had repeated the conduct, and the Board had sanctioned him on earlier occasions.
In 2011 he had completed a reflective report about the treatment of family members as a result of a panel hearing. The conduct being heard by the tribunal occurred just months after the doctor completed that report.
Furthermore, in 2001 the doctor had also received training about the administration of intravenous antibiotic treatment, specifically regarding appropriate dosage and indicated use.
The Tribunal agreed both allegations amounted to professional misconduct and reprimanded the doctor.
It also imposed conditions on his registration that require further education on the therapeutic guidelines for the administration of antibiotics, education about ethical decision-making and conflicts of interest.
The doctor will also have to undergo a period of mentoring and submit his clinical records for audit once he returns to practice.