Dr BXD graduated in medicine in Ireland in 1978 at the age of 24. She later migrated to Australia. She was first registered in Australia in 1983, and has been continuously registered here since that time. She has no prior disciplinary record, and her registration has never been subject to conditions.
The respondent presently works close to full-time. She splits her work time between the private medical practice in which she has been long involved (at least 13 contact hours per week), and in part-time employment as a community medical officer with a community mental health service (0.37 of a full time position). In both roles she deals only with patients with mental health needs. In the private practice, for example, she does follow-up work with community patients who no longer came under community services.
[2]
The Application
The application, as amended, proceeded to hearing on 29 and 30 September 2015. The primary allegations is wrongful or inappropriate prescription of medications (including Schedule 4D drugs) to family members - the respondent's two adult daughters (Patients A and B), and her husband (Patient C). There is also an allegation of self-prescription relying on false prescriptions issued in the name of her husband. The issue common to all of these matters is failure by the respondent to observe ethical standards the subject of the NSW Medical Council Policy relating to Medical Practitioners treating relatives and self (as it was then entitled).
Many of the particulars refer to her conduct in connection with Patient A. The conduct spanned various dates or periods of time, from as early as February 2007 to February 2013. Patient A has had a significant history of mental health problems as well as significant drug dependence. The allegations include inappropriate prescription over a period of approximately two years (March 2011 to February 2013); failing to inform Patient A's treating practitioners (including a treating psychiatrist) of the nature and extent of her prescribing; failing to ensure safe keeping of her prescription pad; inappropriately or improperly completing a Centrelink medical certificate for Patient A, that failed to disclose her family connection, and made a false or misleading statement as to her treating relationship to Patient A; inappropriately issuing pathology requests for Patient A; inappropriately writing referral letters for Patient A to a psychiatrist; and inappropriately writing a referral letter for admission of Patient A to the care of a psychiatrist in a hospital.
The allegations in relation to her other daughter, Patient B, have similar features. Patient B had concerns over her weight. The allegations include inappropriate prescription over a period of approximately two years (March 2011 to February 2013); inappropriate referral to a plastic surgeon for liposuction; and failure to involve an independent GP in consultation with Patient B to consider weigh loss treatments.
The allegations in relation to Patient C, her husband, are similar in relation to inappropriate prescription, and span a period of about two years (January 2011 to April 2013).
Finally there is an allegation of self prescription against the respondent over the same two year period. She issued prescriptions in the name of her husband and consumed the medications - tramadol; meloxicam; omeprazole; pramipexole; circadin; and valdoxan.
The above matters are the subject of Complaint One. The application is that she be found guilty of unsatisfactory professional conduct under s 139B of the National Law in that the conduct demonstrates that the knowledge or judgment possessed, or care exercised, by the practitioner was significantly below the standard reasonably to be expected of a practitioner of equivalent level of training or experience (s 139B(1)(a)); and/or she engaged in improper or unethical conduct relating to the practice or purported practice of medicine (s 139B(1)(b)).
Complaint Two refers to additional matters, namely, failures to maintain records of the prescriptions to which Complaint One refers, in contravention of Part 4 cl 7 and Schedule 2 of The Health Practitioner Regulation (New South Wales) Regulation 2010; and failures to maintain records of 'prescribed restricted substances' in respect of relevant prescriptions of that kind, in contravention of cl 38 of the Poisons and Therapeutic Goods Regulation 2008. The finding sought is one of unsatisfactory professional conduct because of contravention of applicable laws (s 139B(1)(b)).
Complaint Three relies on the particulars of Complaints One and Two, and seeks a finding that she is guilty of professional misconduct under s 139E of the National Law in that she engaged in unsatisfactory professional conduct of a sufficiently serious nature to justify suspension or cancellation of her registration, or engaged in more than one instance of unsatisfactory professional conduct that, when the instances are considered together, amount to conduct of a sufficiently serious nature to justify the suspension or cancellation of the practitioner's registration.
[3]
Admissions
The respondent admitted all particulars of the three Complaints. She admitted that her conduct constituted unsatisfactory professional conduct within the meaning of the National Law, but questioned whether it amounted to professional misconduct.
[4]
Possible Orders
The disciplinary powers of the Tribunal are conferred by ss 149-149E [NSW] of the National Law (Subdivision 6 of Part 8). The Tribunal may exercise 'any power' if it finds the subject matter of the complaint proven, or it is admitted in writing to the Tribunal: s 149.The Tribunal has a wide range of disciplinary orders available to it, including imposition of conditions of registration. The power to suspend a practitioner's registration or to cancel the registration may only be exercised if the Tribunal finds itself satisfied as to one or more of various circumstances set out in s 149C. One of these circumstances is relevant to this case - 'the practitioner is guilty of professional misconduct' (s 149C(1)(b)). There is no submission that any other of circumstances found in s 149C are applicable to this case.
In this case counsel for both parties advised at the outset of the hearing that they had developed a draft set of orders for the consideration of the Tribunal. Those orders contemplated the imposition of conditions on the respondent's registration, regardless of whether the conduct was ultimately characterised as professional misconduct. Counsel for the applicant confirmed that the applicant did not consider it necessary to the protection of the public in this case that an order of suspension or cancellation be made. He and respondent's counsel acknowledged that ultimately the matter was one for the judgement of the Tribunal in light of the evidence presented.
At the end of the hearing, the Tribunal briefly adjourned. It then returned and advised the parties that it would deal with the question of whether the conduct constituted professional misconduct in its reasons for decision, but, in any case, it was not disposed to make an order of deregistration or suspension. It was content to make orders along the lines submitted.
There is also an issue as to whether the interim non-publication order that has protected the identity of the respondent should be continued once these proceedings conclude. The interim order was granted because of the risk posed by publication of her mother's identity to the health and welfare of Patient A. We deal with that issue in a separate set of reasons: see Health Care Complaints Commission v BXD (No 2) [2015] NSWCATOD 135. We have adopted that course in light of representations made after the close of the hearing by the respondent's advisers, and made known to the applicant (exchange of correspondence 17-23 November 2015).
[5]
The Hearing
At hearing the Tribunal had before it four volumes of documentary evidence in support of the application. The respondent submitted a folder of documents that included a detailed statement by her, together with statements from practitioners from whom she sought treatment or been referred for assessment. They included a general practitioner who works with drug and alcohol dependent patients, a family counsellor, a clinical psychologist, a psychiatrist, and another general practitioner. The material also included references from her present employer, and character references from several people.
Oral evidence was given by the respondent, and she was cross-examined. Expert evidence was given by: Dr Jeannie Ellis, called by the applicant, an experienced general practitioner. Her evidence primarily went to the ethical issues involved for medical practitioners in treating family members, and the gravity of the conduct in this case. The Tribunal expressed interest during day 1 of the hearing in receiving oral evidence from a psychiatrist, Dr Anthony Samuels, who had been treating the respondent in relation to her understanding of the boundary issues this case highlights. The parties arranged for him to participate, which he did by telephone link at the beginning of day 2 of the hearing.
The unusual feature of the case, as compared to many that have reached the Tribunal, is that the conduct in issue was confined to members of the respondent's family - as noted, her two (adult) children, her husband and herself. There is no allegation that the respondent has ever engaged in inappropriate prescribing in her day to day work with non-family patients. Moreover in her prescriptions to family members she issued them in quantities and frequencies that fell within normal parameters, in contrast to the excesses often seen in these regards in many of the cases of improper prescribing that reach the Tribunal.
The respondent did not dispute that she failed to adhere to the ethical standards that apply to doctors in relation to treatment of family, friends and relatives. She accepted the authority of the NSW Medical Council Policy to which the particulars refer. Basically it is improper for a practitioner to treat and prescribe medicines to family members, other than within narrow limits such as emergency or necessity. An example of necessity might be found in country practice where there is no available alternative doctor within reasonable reach of the family member in need.
We will not deal with the particulars in detail here. We are satisfied in light of the material filed, and the respondent's admissions, that all particulars are proven to the requisite degree.
[6]
Respondent's Explanation
The respondent provided the Tribunal with a long and detailed statement dated 19 August 2015 in explanation of her conduct, one of 30 closely typed pages. The applicant formally expressed its gratefulness for the detail of her response and the general admissions made.
The respondent attributed her conduct to the chaos and stress that existed in her home life during the time of her misconduct, and a misplaced sense of duty as a mother to meet the needs of her family during that time. As will emerge, the difficulties of the family were of an extreme kind, and centred on the health and welfare of Patient A. Her explanation for her behaviour is that she felt obligated to assist her children and her husband in whatever way she could in circumstances of a very stressful kind.
She said that her intense sense of her responsibility as a mother can be traced to her childhood and upbringing. She was the oldest child in a family of five. She was raised with strong expectations in relation to work and achievement. There had been some difficulties in the home, and her mother had carried a special burden.
She then referred to the diversity of her medical experience since migrating to Australia with her husband in 1983. She spoke of the pressure of combining work with a young family. Patient A was diagnosed with anorexia nervosa when she was about 16 around 2001.
Patient A had had a very difficult life since then. Patient A had received treatment for a variety of addiction, mental health and other problems. The respondent acknowledged that she had acceded to Patient A's requests for medicines wrongly, and should have left this matter entirely to her treating practitioners, in particular her treating psychiatrist: 'my life was consumed with trying to achieve the best outcome for [Patient A]'.
The respondent acknowledged that when she became aware that her child was stealing prescription blank prescriptions, and using them to obtain medications, she should have acted, and failed to do so. She referred to the drinking, drugs and mental health problems that beset Patient A from about 2008 onwards. She referred to the rehabilitation programs into which Patient A was placed. She acknowledged that she should not have filled in the Centrelink Medical Certificate in which she represented that she was her child's treating practitioner when that was not the case, and that would have been an improper treating relationship in any event. She referred in detail to the downward escalation in Patient A's health, lifestyle and addictions. We will not itemise that here.
She was cross examined closely in relation to her explanation, especially her conduct as it related to Patient A's situation.
We accept that the respondent found herself in an extraordinarily difficult and worsening domestic situation over the years from approximately 2005 until recently.
Patient B had problems with weight control. Again, the respondent said that she sought to respond in the way that she felt she must as a mother. OF particular concern was her prescription of duromine. She said that she had prescribed it because of its weight loss benefits. She also saw her assistance to Patient B as helping to minimise the impact of the disruptions occurring in the family, and the problems besetting Patient A.
In the case of her husband, she said that he had an expectation that his medical needs would be managed within the family. That expectation derived from his childhood in Ireland where he had two uncles who were GPs and they had played that role in his family.
The respondent's evidence in this regard suggested to us that she may have always routinely managed her husband's medical and prescription needs. While our formal finding is confined to the conduct as particularised, this suggestion reinforces the need to ensure that she receive mentoring to allay the possibility of treatment of family members recurring.
She spoke of her shame over engaging in self-prescription and to that end issuing scripts in the name of her husband for her own use.
Finally, she expressed her happiness with the level and quality of care Patient A was now receiving, the general improvement in her health, and the good quality of her relationship with her.
She referred to the intervention of the Pharmaceutical Services Unit (after reports of concerns from local pharmacists) as 'the catalyst for change' on her part. This explanation adds little. Regrettably, it is often only when the offender is found out that her or she thinks of stopping. There is nothing to suggest that the respondent would have stopped had she not been found out.
[7]
Characterisation of Conduct
The respondent accepted that her conduct constituted 'unsatisfactory professional conduct' in the ways asserted in Complaints One and Two. The issue in dispute is whether it is unsatisfactory professional conduct 'of a sufficiently serious nature' to constitute 'professional misconduct'; or alternatively, the number of instances of unsatisfactory professional conduct, when considered together warrant such a finding.
The respondent submitted that the conduct did not constitute professional misconduct. Though the statutory test for professional misconduct that applies today differs from the test that applied then, the following observations of Kirby P (Pillai v Messiter (No 2) (1989) 16 NSWLR 197 at 200) remain apposite:
[T]he statutory test is not met by mere professional incompetence or by deficiencies in the practice of the profession. Something more is required. It includes a deliberate departure from accepted standards or such serious negligence as, although not deliberate, to portray indifference and an abuse of the privileges which accompany registration as a medical practitioner: ….
In this instance the conduct in issue occurred over a wide span of time. It affected the other three members of the respondent's family, and the respondent also engaged in self treatment. The matters proven are diverse in character. They have as their common feature the misuse within the family setting of the privileges that accompany registration. Each of the patients had prescriptions given to them repeatedly. She did the same for herself. She also engaged in a number of acts of a deceptive kind. Her conduct was, for her, driven by the view that a parent should do whatever is needed for family members in distress.
The question of whether the line between 'unsatisfactory professional conduct' and 'professional misconduct' has been crossed is to be answered objectively. This necessarily involves the making a judgment of degree as to seriousness: Sabag v Health Care Complaints Commission [2001] NSWCA 411 at [82].
The ethical guideline relating to the self treatment and treatment of family members has been in similar terms for many years. It lists the pitfalls involved in directly treating family members, in particular the difficulties that may arise for both parties in traversing sensitive matters or for the patient in making frank disclosures in relation to intimate matters such as private behaviour giving rise to special risks. The practitioner who treats a family member may be affected by subjective emotions and views which hamper his or her ability to undertake a full investigation and give the best and most appropriate treatment. The practitioner may be influenced by a desire to please the family member, and not upset that person. There is a risk that any consent obtained from the patient may not have been given in an informed and unpressured way.
In relation to the characterisation of the conduct, the respondent raised the possibility that her professional judgment at the times in issue had been affected by an impairment. She submitted that this factor should be taken into account in assessing the objective gravity of her conduct.
While we accept that there is a likelihood that much of her conduct was a function, at least to some degree, of a psychological or mental impairment (and Dr Samuels expressed a similar opinion in his evidence at hearing), the proceedings, as conducted, did not squarely place that issue before us. We are not disposed, therefore, to make any finding of that kind.
The Tribunal is firmly of the opinion that the conduct meets the higher threshold required for a finding of professional misconduct. While it was confined primarily to the family circle, it was, as noted earlier, diverse in character, involved deceptive conduct towards third parties such as treating doctors and Centrelink, and was spread over a long time, and only ceased when discovered by Pharmaceutical Services unit investigators.
The seriousness of the conduct is exacerbated by the respondent's length of experience, and the nature of the work she has undertaken over many years within her private practice and with community health service patients. The ethical standards relating to self treatment and treatment of family members would, we think, have been well known to a practitioner of the respondent's experience. In her work in the mental health field she would have had a great deal of exposure in her work to the difficulties that can affect patients in areas such as candour, comprehension and the giving of informed consents; and should have recognised that these difficulties would be magnified in a family setting, especially in the case of Patient A.
[8]
Appropriate Disciplinary Order
As noted earlier in these reasons, the respondent has no adverse disciplinary history. She has had a long career. There is no spread of patients affected by her conduct in the way often seen in cases of improper prescribing. In this case the improper conduct was limited to her immediate family.
We remain concerned over the level of insight that the respondent presently possesses in relation to her conduct. Because of that there remains some risk that she might re-offend in the same way. There is no risk, in our opinion, to the safety of patients who deal with her in her general practice environments.
The material before us included two comprehensive reports from Dr Anthony Samuels, psychiatrist, dated 29 January 2014 and 9 June 2015 and a pre-hearing report dated 10 September 2015. The last report was especially helpful because it provided comments on the respondent's statement of evidence.
Dr Samuels considered that the respondent had, over the course of the last two years, achieved a 'much greater level of insight' into the inappropriateness of treating family members, especially one with such serious health difficulties as Patient A. He considered 'absolutely' that long term therapy was essential.
He commended the value of a condition being included in any order that is made, requiring her to undertake an ethics course. He did not think she needed to be subject to professional oversight in her work as a medical officer with the community health service. We note that in the orders as ultimately proposed and adopted by us, mentoring rather than oversight has been seen as sufficient. He considered that 'it is unlikely' that she will inappropriately treat family members in the future, and similarly it is 'unlikely' that she will again self-prescribe.
Dr Samuels expanded on these conclusions in his oral evidence to the Tribunal. He did express some concern that if personal difficulties of the depth of the past recurred, the respondent may again transgress the appropriate boundaries in relation to treatment of her family. He did feel that the respondent, because of her stoicism, her sense of guilt and feelings of that kind, did have vulnerabilities. For these reason ongoing counselling of a psychotherapeutic kind was desirable.
The respondent has begun a significant program of rehabilitation. We are satisfied that she is deeply ashamed by her conduct. We are satisfied that she is now managing much better the difficult line that will often need to be drawn in relation to pressures from within a family to deploy one's professional abilities and privileges for a family member's benefit.
It remains the case that Patient A is unwell. The evidence is that the independent treatment and support that she is receiving is working well, and the respondent is providing her with strong support. The bond between them is a good one.
Our orders which follow are in line with the orders proposed by the applicant. We have made the following variations of significance to the orders as they were initially proposed, for the following reasons.
One, in the case of order 2.3 we have required that the professional mentor be a psychiatrist, and not permitted that be done by a general practitioner. We continue to have some reservations as to the fullness of the respondent's appreciation and acceptance of the inappropriateness of the conduct in which she engaged. There is little doubt, we consider, that she remains deeply affected by the family trauma. She continues, we consider, to experience some difficulty in not seeing it as her duty as a parent to do everything within her power to meet the needs of the other members of the family. She referred on a number of occasions in her oral evidence at hearing to the imprint left on her in relation to the role of the mother by her upbringing, religious beliefs and later socialisation. This is repeated in the professional assessments placed before us, from Dr Samuels in particular.
Two, in our view, it is not necessary to cover at every mentoring meeting the four issues to which draft order 2.3 (a) refers. We think it sufficient to ensure that the first two topics be canvassed at the opening meeting, and that at later meetings that the final two topics be canvassed. As the terms of the order reflect, this does not set the limits of the matters that might be addressed. That is left to the judgement of the mentor. The applicant accepted this amendment.
Three, in order 2.4 we have removed express references to courses offered by the Ethics Centre, formerly known as the St James Ethics Centre, or similar courses offered by Monash University. In our view it is better simply to leave to the Medical Council the working out of the detail as to the appropriate course.
We have not acceded to a number of submissions made by the respondent as to the appropriate order. The respondent submitted that the primary order should be one of caution rather than reprimand. In that regard the respondent also raised the issue of possible impairment at the time of the conduct. For the reasons already given, we do not think it appropriate to make a finding on that issue.
The misconduct that occurred in this case had a wide time span, it had diverse aspects, and included misleading communications with treating practitioners and authorities such as Centrelink. The respondent's interference in the treatment of her daughter could potentially have delayed the daughter receiving appropriate medical care. A caution would not reflect sufficiently the seriousness of the misconduct that occurred.
The respondent also submitted that it was unnecessary to include a condition that she be required to observe the Medical Council guidelines on self-treatment and treatment of relatives, as she was obliged by law to observe these guidelines. It is not uncommon in disciplinary orders of the present kind to draw attention to the area of law that the practitioner has breached, and specifically require the practitioner to adhere to that law in the future.
[9]
Restriction on Disclosure of Names and Addresses
As previously noted, the Tribunal has issued a separate set of reasons in relation to the respondent's application for continuation of a non-publication order in respect of her name and address: Health Care Complaints Commission v BXD (No 2) [2015] NSWCATOD 135. The application has been granted. The usual order protecting the identity the Patients named in the application is continued. Both orders appear on the cover page of these reasons.
[10]
Costs
The applicant has applied for its costs because it has succeeded in its application. The power to award costs is given by cl 13 of Schedule 5D of the National Law. It is a specific provision, applying to the exclusion of the general principle in relation to the award of costs applying elsewhere in the Tribunal. The ordinary Tribunal rules is that each party bear its own costs unless there are special circumstances justifying an award of costs: NCAT Act, s 60.
The discretion to award costs conferred by cl 13 is 'unfettered', but the general rule remains that costs should ordinarily follow the event: Health Care Complaints Commission v Philipiah [2013] NSWCA 342 at [42].
The respondent submitted that each party should bear its own costs.
The respondent referred to features of the case that had exacerbated costs unnecessarily. The first was the applicant's procurement of a report from Dr Andrew Byrne, upon which ultimately it did not rely. The engagement of Dr Byrne had generated costs for the respondent which were wasted, by having to attend upon Dr Byrne, in having her legal representatives consider the report and in seeking to respond to it. As it happened the report was more favourable to the respondent, as to the view to be taken of the gravity of her conduct, than the later report, upon which the applicant did rely, from Dr Ellis. The respondent did seek to rely on the Byrne report as part of her case as to the assessment of the gravity of her conduct. As the respondent did seek to make use of the report, the Tribunal is disinclined to give this matter any great weight.
The respondent also referred to time that had been wasted because of the way the applicant managed its case against her. She said that serious allegations of prescription of benzodiazepines had formed part of the original schedules to the complaint. They were withdrawn after the hearing of the criminal charges against Patient A (in relation to the misuse and forgery of the blank prescription scrips). In that regard she noted that Dr Ellis had to be asked to be reconsider her previous opinion in light of that development, and that had taken place only a month before the hearing was due to commence. This had caused her further expense in having to obtain advice in relation to the revised, somewhat less critical, opinion.
It was argued that had those particulars not been part of the allegations, the matter may never have reached the Tribunal. In reply the applicant noted the variation to the particulars had occurred prior to lodgment of the application in the Tribunal. The concerns raised in that regard belonged to the investigation stage.
The power to award costs relates to the proceedings as that have taken place in the Tribunal.
We are not satisfied, viewed overall, that the two matters raised warrant any moderation of the usual order.
Orders
(a) Finding
The Tribunal finds the respondent guilty of professional misconduct.
(b) Disciplinary Orders
The practitioner is reprimanded.
The practitioner's registration is subject to the following conditions:
2.1 To practise in accordance with the Medical Council of NSW Guidelines, entitled Guidelines for Self-Treatment and Treating Relatives, as notified and varied from time to time.
2.2 [This is a private health condition].
2.3 To nominate a psychiatrist to act as her professional mentor for approval by the Medical Council of NSW in accordance with Medical Council of NSW's Compliance Policy - Mentor, as varied from time to time, and as subsequently determined by the appropriate review body.
(a) At the initial mentoring meeting the practitioner is to include discussion of the following:
(i) the nature of the practitioner's current practice including work hours, practice hours, practice demands and engagement in CPD activities;
(ii) ethics around prescribing and issuing of medical certificates;
and thereafter, the practitioner is to include discussion of the following:
(iii) other ethical dilemmas and issues arising in the practitioner's practice, and
(iv) the practitioner's general wellbeing.
(b) to authorise the mentor to report, in an approved format, to the Council every month about the fact of contact, and to inform the Council if there is any concern about her professional conduct or well being.
(c) to authorise the Medical Council of NSW to provide proposed and approved mentors with a copy of the decision upon which these conditions are based.
(d) to be mentored for a minimum period of 12 months and as subsequently determined by the Council.
2.4 To complete within 12 months of the date of the decision a formal Medical Ethics course acceptable to the Medical Council, or by any later date approved by the Medical Council:
(a) Within 3 months of the date of the decision she must provide evidence to the Medical Council of NSW of her enrolment in the abovementioned course.
(b) Within 30 days of completing the abovementioned course, she is to provide documentary evidence to the Council that she has satisfactorily completed the course.
(c) To bear responsibility for any costs incurred in meeting this condition.
2.5 To advise the Medical Council in writing at least seven days prior to changing the nature of place of her practice; and
2.6 To authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia and Pharmaceutical Services for the purpose of monitoring compliance with these conditions.
The Medical Council of NSW is the appropriate review body for the purposes of Part 8 of the Health Practitioner Regulation National Law (NSW).
Sections 125 and 127 of the Health Practitioner Regulation National Law (NSW) are to apply while the practitioner's place of practice is anywhere in Australia other than New South Wales so that a review of those conditions can be conducted by the Medical Board of Australia.
(c) Costs Order
The Tribunal orders the respondent to pay the applicant's costs of the proceedings.
[11]
I hereby certify that this is a true and accurate record of the reasons for decision of the Civil and Administrative Tribunal of New South Wales.
Registrar
DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated.
Decision last updated: 11 December 2015
Parties
Applicant/Plaintiff:
Health Care Complaints Commission
Respondent/Defendant:
BXD
Cases Cited (4)
5 and 127 of the Health Practitioner Regulation National Law (NSW) are to apply while the practitioner's place of practice is anywhere in Australia other than New South Wales so that a review of those conditions can be conducted by the Medical Board of Australia.
(c) Costs Order
The Tribunal orders the respondent to pay the applicant's costs of the proceedings.
Catchwords: PROFESSIONAL DISCIPLINE - Medical Practitioner - Disciplinary Findings and Orders - Treatment of Family Members - Self Treatment - Breach of applicable ethical standards - other matters - Unsatisfactory professional conduct admitted - Whether constituted professional misconduct - So held - Appropriate order - Reprimand - conditions imposed on registration.
Legislation Cited: Health Practitioner Regulation National Law, no 86a (NSW)
Health Practitioner Regulation (New South Wales) Regulation 2010
Poisons and Therapeutic Goods Regulation 2008
Cases Cited: Health Care Complaints Commission v Philipiah [2013] NSWCA 342
Pillai v Messiter (No 2) (1989) 16 NSWLR 197
Sabag v Health Care Complaints Commission [2001] NSWCA 411
Texts Cited: -
Category: Principal judgment
Parties: Health Care Complaints Commission (Applicant)
BXD (Respondent)
Representation: Counsel:
W Hunt (Applicant)
M Lynch (Respondent)