The NSW medical practitioner has appealed his suspension following a complaint of excessive prescribing of opiates and benzodiazepines
The Medical Council of NSW suspended a GP’s registration from 13 May this year, after alleging his current practice “poses a risk to the health and safety of the public”.
While the GP has appealed this suspension, with this hearing still forthcoming, he has recently been unsuccessful in applying for a stay on it.
Legal documents reveal that the main complaint against his practice is related to alleged excessive prescribing of opiates and benzodiazepines to one of his patients.
Except for a brief time, the GP prescribed the patient Endone from 2015 until March 2019. He initially prescribed 5 mg three times a day for pain, however by late 2018, he was prescribing 10 tablets of Endone with 5 tablets of Serapax (oxycodone) 30 mg and 5 tablets of Mogadon (mitrazepam) 5 mg every day.
The Council concluded that, based on information the patient provided at a visit on 4 March 2019, the GP should have realised she had taken at least 16 tablets of Endone and 13 tablets of Serapax in the previous 48 hours.
It alleges the doctor inappropriately prescribed opiates and benzodiazepines and failed to call the Prescription Shoppers line or refer the patient to a pain specialist.
The doctor has been practising as a GP since 1984, and has been an accredited prescriber for the Opioid Treatment Program (OTP) since 2010. At the time he was suspended, he was seeing 151 patients on that program.
The NSW Civil and Administrative Tribunal heard the doctor was remorseful and accepted that his prescribing and management of the patient was not appropriate.
He told assessors it did not occur to him that the patient may be drug dependent or a doctor shopper.
Council assessors also reviewed the GP’s prescribing for 10 patients between 26 April 2019 and 30 October 2019, which included prescribing high levels of Schedule 4 Appendix D and Schedule 8 drugs, even to patients who were not on an OTP.
They concluded that his prescribing practices put many patients at significant risk of dependence and overdose.
The GP accepted the Council’s criticism of his prescribing.
According to legal documents, “he felt at the time that he had put in place sufficient mechanisms to limit harm and risk”. In the meantime, he had successfully completed an education course in relation to prescribing.
The GP told the Tribunal that if the stay of the suspension was granted, he would consent to surrendering his Schedule 4D and Schedule 8 prescribing rights.
However Deputy President of the Tribunal Nancy Hennessy found his submission that supervision is neither warranted or necessary “reveals his insight into and understanding of his failures is alarmingly limited”.
“The assessment of [his] practice has exposed unsatisfactory performance in every domain,” said the Tribunal.
Balancing the GP’s financial and emotional distress and the effect on his patients against the evidence of the expert witness about his past prescribing and other practices, the Tribunal found that protection of the health and safety of the public required that the stay be refused.
The GP was ordered to pay costs to the Medical Council of NSW. A hearing for the appeal of his suspension is forthcoming.