Synopsis
In the case of Medical Board of Australia v Conron (Review and Regulation) [2023] VCAT 15 (6 January 2023), the Victorian Civil and Administrative Tribunal (the Tribunal) discussed a range of issues relating to a general practitioner’s self-treatment, the treatment of a family member, substandard treatment and inadequate record taking.
Facts
Dr Conron became a member of the Royal Australian College of General Practitioners in 1968 and retired in July 2019, at age 81.
At age 81, Dr Conran had planned to retire from general practice at the end of 2019. His retirement was brought forward to July 2019 following four of his colleagues expressing concerns about the standard of care he provided and the clinic’s management making a notification to the Medical Board of Australia (Board).
The Board brought four separate allegations against Dr Conron:
- Allegation 1: self-treatment over a period of almost 11 years (unprofessional conduct).
- Allegation 2: the treatment of a close family member for 10 years (professional misconduct).
- Allegation 3: substandard treatment of patients in three instances (unprofessional conduct).
- Allegation 4: taking inadequate clinical notes in two circumstances (unprofessional conduct).
Allegations
Allegation 1
Between 11 June 2008 and 30 April 2019, Dr Conran was alleged to have self-prescribed medication to himself on 106 occasions (including a Schedule 4 poison), ordered 5 investigations for himself, recorded a total of 107 surgery consultations with himself, consulted with a doctor other than himself on 25 occasions and sought specialist advice from his urological surgeon on five occasions.
The Board argued that the conduct (in addition to Allegation 2) was of a more serious order of magnitude and should constitute professional misconduct.
The Tribunal did not agree that self-treatment was the same level of gravity as providing long-term treatment to a family member. The Tribunal concluded that Dr Conron’s self-treatment constituted unprofessional conduct under the National Law.1 They found it fell short of professional misconduct, although not by a large margin.
Allegation 2
Dr Conran provided treatment to a close family member, including writing 43 scripts, requesting 7 investigations, conducting 77 surgery consultations, and failing to maintain adequate clinic records of the treatment.
The Tribunal found that although the treatment provided by Dr Conran followed the path of the patients primary GP, the extent and duration of his involvement amounted to shared care or fragmented care, which increased the risk of errors and chance of sub-optimal care being provided. They noted further that putting aside a minor one-off or emergency situation, treatment of a close family member is a deviation from acceptable standards.
Overall, the Tribunal found that Dr Conran provided the treatment in circumstances where it was avoidable and contrary to relevant and applicable standards and codes of conduct for registered medical practitioners.
The Tribunal found that the treatment provided by Dr Conran to a family member constituted professional misconduct under the National Law.
Allegation 3 and 4
It was alleged that Dr Conran:
- erroneously advised a patient in her third trimester of pregnancy against administration of a Boostrix immunisation. Dr Conran conceded that this error occurred as he had not been across the Commonwealth’s immunisation guidelines, which had changed two to three years prior;
- provided substandard treatment to a patient with deep vein thrombosis by failing to provide an active follow up, record inadequate notes without documenting the condition, clinical findings, information provided to patient and other management required in the circumstances; and
- breached section 34C(1) of the Drugs Poisons and Controlled Substances Act 1981, as he had overlooked the fact that a long term patient’s permit to prescribed a Schedule 8 poisons (Endone and Targin) had expired.
The Tribunal found that his record taking was inadequate.
The Tribunal found that the conduct in Allegations 3 and 4 comprised unprofessional conduct under the National Law.2
Determinations
The Board proposed a three-month disqualification, but the Tribunal concluded that Dr Conran should receive a reprimand. The Tribunal found that it was not necessary to impose a disqualification, based on Dr Conran’s decision to retire and relinquish registration in mid-2019. The Tribunal considered that these circumstances operated in a manner akin to an undertaking never to practise again, which had protective consequences.
Lessons
The Tribunals decision reinforces the importance of adapting practice to accord with modern professional requirements for practitioners that have been long standing members of the profession. Such adaptations include upskilling to keep abreast with expected professional standard, regulatory requirements and changing technology.
This article was written by Stephanie Cowley, Solicitor, and reviewed by Rob Muir, Partner.
1s5 of the Health Practitioner Regulation National Law (Victoria): unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience.
2s5 of the Health Practitioner Regulation National Law (Victoria) (National Law): Professional conduct that is of a lesser standard than that which might reasonably be expected of the health practitioner by the public or the practitioner’s professional peers.
