A fit and proper person, or not?

Case study

Dr Z worked as an Intern and RMO at a regional hospital. Complaints were made that he breached professional boundaries in relation to three female patients, with whom he had had personal relationships. The allegations included:

• Taking antibiotics from the hospital to give to Patient A to treat recurrent UTIs. Dr Z did not take a history, perform an examination or make any medical records before providing her with the antibiotics


• Taking blood from Patient A, ordering tests in another doctor’s name, discussing the results and incorrectly interpreting the test results.


• Prescribing trimethoprim and amitriptyline to Patient B. Dr Z did not take a history, perform an examination or make any medical records.


• Engaging in sexual activity with Patient B in the hospital recreation room when he was rostered on night shift


• During a night shift, paying Patient C a ‘social’ visit, lying on her hospital bed and watching a movie. Dr Z also charted medication for Patient C when staff had not requested he do so.

Medical-legal issues

The complaints proceeded to a Medical Tribunal hearing in 2018. Dr Z denied many of the allegations, and only admitted to some of the conduct during cross examination. For example, he initially denied having sex with Patient B when he was on duty, but later conceded he did have sex with her at the hospital, but only during his meal breaks which “were my time”.

The Tribunal found Dr Z guilty of professional misconduct. In view of his serious lack of insight, his medical registration was cancelled.

Thirteen months later, Dr Z applied for a review of the cancellation of his registration. The case proceeded to second Tribunal hearing where Dr Z “consistently failed to acknowledge, much less address, his dishonesty in his responses and statement to the original Tribunal”. The Tribunal found Dr Z’s dishonesty was a relevant and important factor to be considered in determining his application.

The Tribunal was confident that if Dr Z returned to medical practice, he would not treat or prescribe drugs for partners or family members, nor would he have sex in a hospital whilst he was on duty or pay social visits to inpatient friends when rostered on. However, the Tribunal remained concerned that the incidents reflected defects in Dr Z’s character or way of thinking which may give rise to him exhibiting different kinds of unsatisfactory professional conduct in the future:

A lack of honesty and frankness in the context of the practice of medicine poses an obvious risk to patients. A medical practitioner must be able to deal with the suggestion that he or she may have made a mistake in an open and forthright manner.

The Tribunal found that Dr Z was not presently a fit and proper person to be registered as a medical practitioner, and his registration remained cancelled.

Summary

• Do not treat friends or family, including prescribing medication
• Never have a sexual relationship with a patient

• Honesty is always the best policy.

Dr Sara Bird
Executive Manager, Professional Services
MDA National