Tasmanian Board of the Medical Board of Australia v Dr Wojtek Majchrzak (Ref No. 1/2014) [2016] TASHPT 2
Introduction
The Health Practitioners Tribunal of Tasmania has reprimanded a local GP for prescribing testosterone to help a man overcome “embarrassment” and feelings of physical inadequacy after he landed a job in a gym.
Recent changes to PBS criteria for testosterone prescribing
The regulator AHPRA pursued the complaint against Dr Wojtek Majchrzak in line with a renewed national focus on prescribing testosterone in line with recommendations of the Pharmaceutical Benefits Advisory Committee (PBAC). The recommendations include new criteria for patient eligibility and follow concerns about an increase in testosterone prescriptions in circumstances where it is not for therapeutic purposes.
One of the major changes to the criteria, and of specific relevance to the complaint against Dr Majchrzak, is that doctors are no longer authorised to prescribe testosterone in the absence of a diagnosis validated by a specialist (endocrinologist, urologist, or member of the Australian Chapter of Sexual Health Medicine).
Determination
AHPRA sought a determination that Dr Majchrzak was guilty of professional misconduct in supplying testosterone to two patients in circumstances where it was not medically indicated.
The particulars disclose that the Dr Majchrzak prescribed or otherwise supplied testosterone to one patient on at least 8 occasions between June 2006 and July 2012, and to another patient on at least 16 occasions between June 2003 and March 2013. Both patients had indicated that they required this medication for body building or body development purposes.
The Tribunal found that there was no therapeutic justification for the prescribing or supply of testosterone to either patient. It was also found that the use of this drug in the circumstances of both patients exposed them to the risk of serious side effects and harm.
The Tribunal confirmed that prescribing a pharmaceutical product on numerous occasions over a number of years where the purpose was other than therapeutic and where such conduct exposed the patients to a real risk of harm will be found to be professional misconduct.
Dr Majchrzak argued it was his belief was that it was permissible to prescribe in this manner as a private prescription. The Tribunal found the Dr conformed to the wishes or demands of his patients in these cases rather than exercising the professional judgement required. They noted that insistent patients can be challenging but that is no excuse to act otherwise than in accordance with accepted clinical practice.
Consequences for the practitioner
The Tribunal ordered that:
- The respondent is reprimanded;
- The respondent’s registration is to be subject to a condition that he not prescribe anabolic steroids; and
- The dr is also required to undertake training in dealing with “demanding and aggressive” patients.
This article was written by Sarah Sealy, Partner and Emily Page, Senior Associate.