Providing care to yourself and those close to you
Council has received an increasing number of notifications regarding self-treatment or providing of care to family members. We strongly encourage you to read this statement.
You may only provide treatment to yourself or those close to you in exceptional circumstances, such as when someone has an illness or injury that requires immediate attention.
There are certain situations in which you must never provide treatment or care to yourself or those close to you. These include the issuing of certificates or the prescribing of medication with a risk of addiction or misuse, psychotropic medication or controlled drugs.
Notifications to Council involving serious and/or sustained breaches of Council’s Statement often result in Professional Conduct Committee (PCC) investigations and may result in charges being laid in the Health Practitioners Disciplinary Tribunal. Two cases recently before the Tribunal highlight how serious the Tribunal considers breaches of this statement to be.
Dr A, a GP, self-prescribed 15 tablets of Zopiclone after running out of her usual supply whilst on holiday. When this was reported to Council by a pharmacist, Dr A explained that it was a “one-off” to assist with sleep and that she had been unable to see her own GP whilst on holiday. Two years later, concerns were raised by her employer after a different pharmacist reported her writing her own prescriptions for Zopiclone. This prescribing was referred by Council to a PCC, and during its investigation it was found that she had prescribed multiple medications, including medications classified as carrying a risk of addiction or misuse, psychotropic medications and Class C controlled drugs to herself and to family members.
All medications obtained under these prescriptions were intended for her own use. Dr A also prescribed using Medical Practitioner Supply Order (MPSO) forms to obtain the same medications for her own use. At the time, Dr A was experiencing significant stress, and was regularly seeing her own GP who was prescribing the same medications to her. The Tribunal took into account her significant mental health issues when considering penalty. The Tribunal considered Dr A’s prescribing to be an abuse of the privilege and responsibility doctors are given, and in respect of the prescriptions in the names of her family members, commented that it could affect their future treatment. In addition to formally expressing its disappointment in Dr A’s conduct, the Tribunal fined Dr A $5000 and ordered that she contribute to the costs of the PCC investigation and Tribunal hearing. The Tribunal also imposed conditions on her practice for three years. These required Dr A to; undertake an educational programme, advise present and future employers of the Tribunal’s decision and its orders, advise the Health Committee of the decision and any background detail requested by them, to abide by all the Health Committee’s directions and requirements, and to not write or be involved with MPSO prescriptions in any way.
Dr M, a GP, provided medical care to her husband over a period of six years. He had a range of serious health issues and refused to attend another GP despite Dr M’s reluctance to provide treatment to him. Throughout this period, she was under considerable pressure and suffered her own health issues. The treatment provided to her husband included ordering of blood tests, prescribing over-the counter and pharmacist only medications including Class C controlled drugs, psychotropic medication and drugs with a risk of addiction or misuse. She also provided treatment for a knee sprain, a burn and a foot injury.
The treatment she was providing was discovered when her husband was admitted to hospital, in part for his dependence, overuse and subsequent withdrawal symptoms from the medications she had prescribed to him. The Tribunal found that her extensive prescribing to her husband was a “significant failure”, and a “serious neglect of professional duty”. The Tribunal expressed formal disapproval of her conduct, ordered a fine of $5000 and placed conditions on her practice for three years. These conditions required her to disclose the Tribunal’s decision to future employers, and to not provide treatment to family members (which would be monitored by Council every three months). Dr M was also required to make a contribution to the costs of the PCC investigation and Tribunal hearing.
Doctors are often asked for input by their family and friends. This may include requests for medical advice or a prescription, or more substantial involvement such as performing a procedure. This statement explains why doctors must avoid treating themselves and those they have a close personal relationship with.