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[3] Such medications have the potential for misuse and abuse. It is well known in the profession that there is an illicit market in their trade.

[4] Mr Smith conceded, and the Tribunal finds, that he engaged in unsatisfactory professional conduct in the following respects:

1. His conduct fell below the standard that might reasonably be expected of him by the public and his professional peers;

2. His conduct demonstrated incompetence or lack of adequate knowledge, skill, judgment or care in the practise of his profession; and

3. He provided a person with health services of a kind that was excessive, unnecessary or not reasonably required for that person's wellbeing.

[5] A pharmacist's primary concern must be the health and wellbeing of the consumer and the community.[1] Pharmacists must promote judicious, appropriate, safe and effective use of medicine and be aware of the trends and patterns of use of commonly misused substances.[2]

[6] This requires pharmacists to exercise professional judgment to prevent the supply of products likely to constitute an unacceptable hazard to health or to supply unnecessary or excessive quantities of medicines with the potential for abuse or dependency.[3]

[7] It is unusual for a doctor to prescribe two or more different preparations of steroids of similar use and outcome to a patient at the same time. The volume dispensed exceeded the quantities usually prescribed for each medication. The frequency of dispensing was far in excess of normal dosage ranges, by reference to MIMS On-Line, an online medical reference source.

[8] In one period, Mr Smith dispensed steroids to the customer on three consecutive days. On another occasion, he dispensed multiple steroids in the knowledge that the pharmacy had supplied the customer with those medications by the pharmacy only four days earlier.

[9] Mr Smith was one of three pharmacists at the practice dispensing to the same customer. This suggests a failure in the pharmacy's procedures for monitoring dispensing practices. However, an audit conducted by Queensland Health concluded the problem was confined to a single customer. He also obtained such medications from a pharmacy at a different practice. Those other pharmacists are subject of separate disciplinary proceedings.

[10] All the scripts filled by Mr Smith were valid and under the hand of a doctor known to him. He did not question the doctor's prescriptions, although he had sufficient information to do so. Mr Smith conceded that he ought to have known that the quantity and combinations of restricted drugs he dispensed to the customer were not necessary for a therapeutic purpose.

[11] He agreed he should have been alert to the possibility that the customer was diverting or abusing steroids and ceased dispensing until he had discussed the matter with the prescribing doctor and discussed a policy for dispensing to the customer with the other pharmacists.

[12] Mr Smith is a very experienced pharmacist. It might be discomforting, particularly in a regional centre, for one professional to question the practises of another. Nevertheless, pharmacists must exercise independent judgment in dispensing to a customer, even if this appears disrespectful to another practitioner.

[13] Mr Smith says he was told by the pharmacist who then owned the practice, Mr Paul Kent, that the customer was travelling to a place in which he would have no access to the medications. Presumably, this is put forward to explain why he dispensed in quantities that exceeded legitimate therapeutic needs. Again, Mr Smith accepted information he should have queried and failed to exercise his independent judgment.

[14] Mr Smith has demonstrated insight about the deficit in his response to the situation. He has not obtained, dispensed, sold or possessed Testosterone, Nandrolone or Somatropin since told of the investigation in March 2009.

[15] He is now more vigilant in his dispensing procedures. If a prescription appears out of the ordinary, he checks doses in MIMS or discusses the matter with the prescribing doctor. He notes when a customer presents earlier than expected for repeat prescriptions and enquires if he suspects a customer is seeking to stockpile medications.

[16] He has since bought the practice involved and has attained accreditation by the Pharmacy Guild of Australia's Quality Care Pharmacy Program. The Tribunal accepts Mr Smith is genuine when he says he is embarrassed about his lack of judgment in relation to this customer and that he is committed to maintaining the high standards required for accreditation.

[17] The parties have jointly proposed orders that the Tribunal accepts are adequate to ensure the public is protected and that professional standards are maintained, through a combination of training, assessment and mentoring. Those orders are in near identical terms to the orders imposed on another pharmacist involved in dispensing to this customer, Ms Donnelly.[4]

[18] Although she is a junior pharmacist, she showed less insight about her conduct than has Mr Smith. He has, since, changed his dispensing practises.

[19] The Tribunal's orders suspend Mr Smith's registration for six months. This serves to denounce his conduct and deter others from similar practices. In Mr Smith's case, that order is, itself, suspended. The decision to suspend recognises that he has insight into his responsibilities, has demonstrated his intention to run the practice, which he now owns, on best practice principles, has derived no personal benefit, and is otherwise of good character. During the next 12 months, Mr Smith is at risk of the Tribunal activating the suspension order if he is subject to further disciplinary proceedings in the Tribunal. This would have significant financial implications for him as the owner of the pharmacy.

[20] Mr Smith has agreed to pay the Board's legal costs as agreed or assessed. Given the findings made against him, it is appropriate that he bear those costs.

[21] Although not a matter that bears upon the sanction in this case, it is appropriate to observe that each of the pharmacists involved with this customer have been subject to disciplinary proceedings. To date, however, it seems no proceedings have commenced in the Tribunal in relation to the prescribing doctor. Guarding against inappropriate access to drugs with the potential for misuse and abuse is a shared professional responsibility. The Tribunal would expect that the relevant practitioner boards would take a consistent approach to dealing with practitioners who fail in their professional responsibilities in this regard.