3. Dr Nandam must continue to be treated by his treating psychiatrist.

4. Dr Nandam's patient contact must not exceed 40 hours per week.

5. Dr Nandam must at his expense, work under the supervision of an experienced colleague who must be registered with the Medical Board of Australia.

6. The name of the experienced colleague must be submitted to the Board for approval prior to Dr Nandam resuming practice.

7. Dr Nandam must at his expense, complete a course on ethical decision-making with a focus on boundary violation counselling within 12 months.

8. Dr Nandam must obtain the Board's approval of the course prior to commencement.

9. The above conditions (except (3)) must be recorded in the public register for 2 years.

10. Dr Nandam must pay the Board's costs fixed at $20,000.

HEALTH PRACTITIONER - DISCIPLINARY PROCEEDINGS - where practitioner commenced and maintained a sexual relationship with a patient while continuing to treat her and other members of her family - where admissions made and practitioner co-operated in proceedings - where underlying factors which contributed to practitioner's conduct were being addressed - where not alleged that practitioner predatory in his conduct

Health Practitioners (Professional Standards) Act 1999 ss 241(2)(a)-(b),(g), (3), (4), 242(1)(a),(c), 247

Medical Board of Queensland v Alroe [2005] QHPT 4

Medical Board of Queensland v Anderson [2003] QHPT 5

Medical Board of Queensland v Chetty Unreported, 12 December 2007

Medical Board of Queensland v Doolan [2001] QHPT 3

Medical Board of Queensland v Hashim [2006] QHPT 1

Medical Board of Queensland v Ibrahim [2005] QHPT 2

Medical Board of Queensland v MRW [2002] QHPT 13

_Medical Board of Queensland v Quan [_2006] QHPT 5

Medical Board of Queensland v Russell, Unreported, No 10 of 1997, 18 December 1997

Medical Board of Queensland v Thurling [2003] QCA 518

**[1] Dr Nandam, an experienced and well regarded general practitioner, maintained a sexual relationship with a patient for about 9 months in 2007 to 2008. Dr Nandam was aware of the patient's personal circumstances which meant she was more vulnerable than another patient might have been. That said, there is no indication of predatory behaviour in Dr Nandam's conduct and it appears to have been aberrant. Although he was not the only doctor from his clinic to do so, he continued to treat the patient and her sons.

[2] The relationship commenced during a period that Dr Nandam was also vulnerable. He was then suffering from medical conditions established by reports the Tribunal received from Dr Prior, Dr Khoo and Dr Apel. He is now being properly treated for those conditions.

[3] At quite an early stage in these proceedings, Dr Nandam admitted the relationship. While he does not accept, entirely, the patient's account of how the relationship commenced or some of the details of events which occurred during it, Dr Nandam concedes his perception may have been affected by his medical conditions. Given his admissions, it has not been necessary to resolve the differences between Dr Nandam's account and that of his former patient. Importantly, his admissions obviated the need, otherwise, for the patient to give evidence about highly personal matters.

[4] At the time the relationship commenced, Dr Nandam was living with his family but had withdrawn from them. In his self imposed isolation he says he craved companionship. Dr Prior considers Dr Nandam's conditions provide a significant degree of explanation for his behaviour. Dr Nandam is now reconciled with his family and he has their support in addressing his conditions and the consequences of his conduct.

[5] He always understood he was violating professional boundaries. He now has insight into his personality and psychiatric vulnerabilities and is actively addressing them.

[6] On reflection Dr Nandam now recognises the potential harm to his patient and accepts she suffered as a consequence of the relationship. The patient was vulnerable and Dr Nandam was aware of health concerns and other personal circumstances which should have indicated to him her particular vulnerability. Dr Nandam breached the significant trust a patient places in her doctor by commencing and maintaining a sexual relationship with her. His conduct falls short of the standards the public or his peers would reasonably expect of him and is discreditable to his profession.

[7] The parties jointly submitted orders imposing a brief suspension from practice and conditions which require a lengthy period of treatment and supervision.[1] The proposed orders also require Dr Nandam to meet considerable costs incurred by the Board in investigating the complaint and bringing these proceedings. Both parties commend the proposed orders as adequate to protect the public and appropriate to deter such conduct, while recognising the circumstances in which it occurred.

[8] After consultation with the assessors, the Tribunal is satisfied that the orders are appropriate. While the period of suspension is short, 3 months suspended for 2 years after 1 month, the structure of the order ensures that Dr Nandam is subject to the certainty of the remaining 2 months being triggered if he transgresses within the next 2 years.[2]

[9] The conditions limit Dr Nandam's working hours to 40 hours of patient contact per week. Given Dr Nandam has, in the past, buried himself in his working life as a means of coping, the Tribunal has a lingering concern that the other duties of general practice might mean Dr Nandam is working considerably longer than 40 hours and that this may present a risk of recurrence of his condition. Dr Nandam's condition will be monitored by his treating psychiatrist,[3] an experienced colleague and his family and the Tribunal is confident that all will be alive to that risk.

[10] The parties have not proposed any restriction relating to the treatment of female patients. Shortly after the complaint was made to the Medical Board, Dr Nandam undertook not to treat female patients without a chaperone. He has not seen a female patient since then. He has placed before the Tribunal a number of references from colleagues, peers, personal friends and patients, all given with knowledge of the allegations made against Dr Nandam and his admissions. His broad exposure of his wrongdoing demonstrates he accepts responsibility for his actions and does not seek to minimise it. It is a positive indication of his rehabilitation.

[11] Many of the references are from patients, including a number given by women whom Dr Nandam did not treat in the last 2 years because of his undertaking. They expressed their ongoing confidence in him and their desire for him to resume treating them. Both Dr Apel and Dr Prior assessed Dr Nandam's conduct was not predatory in the sense that he did not appear to have groomed the patient for the relationship.

[12] Dr Nandam will undertake an ethics course as a condition of his registration. His personal and professional circumstances have changed. Dr Nandam is now being treated and has reconnected with his family. His family and colleagues are willing to actively monitor his treatment and conduct, personally and professionally.

[13] The postponed sanction is within the scope of sanctions imposed for conduct of this nature[4]. The Tribunal is satisfied that the proposed sanction is appropriate to ensure patient safety, to uphold professional standards and to maintain public confidence in the profession.**

[1] Health Practitioners (Professional Standards) Act 1999 ss 241(2)(a)-(b),(g), (3), (4).

[2] Health Practitioners (Professional Standards) Act 1999 s 247.

[3] Health Practitioners (Professional Standards) Act 1999 s 242(1)(a),(c).

[4] Medical Board of Queensland v Alroe [2005] QHPT 4; Medical Board of Queensland v Anderson [2003] QHPT 5; Medical Board of Queensland v Chetty Unreported, 12 December 2007; Medical Board of Queensland v Doolan [2001] QHPT 3; Medical Board of Queensland v Hashim [2006] QHPT 1; Medical Board of Queensland v Ibrahim [2005] QHPT 2; Medical Board of Queensland v MRW [2002] QHPT 13; _Medical Board of Queensland v Quan [_2006] QHPT 5; Medical Board of Queensland v Russell, Unreported, No 10 of 1997, 18 December 1997; Medical Board of Queensland v Thurling [2003] QCA 518; Psychologists Board v Meredith [2004] QHPT 5.