Page Section: Centre Content Column
Inappropriate prescription of medication to partner (06HDC14100)
Download Inappropriate prescription of medication to partner (06HDC14100) (PDF 141Kb)
(06HDC14100, 28 June 2007)
General practitioner ~ Prescription for partner ~
Self-prescription ~ Documentation ~ Referral for second opinion ~
Depression ~ Right 4(2)
A woman began a friendship with a locum general practitioner,
which eventually became a de facto relationship when they bought a
property and moved in together. He was not her doctor at the time.
Soon after moving in with the GP, he diagnosed her with depression
and prescribed Aropax, Paradex and other medication. The de facto
relationship lasted for about three and a half years. During that
time she consulted no other GP and consulted a psychologist once
only. The psychologist did not prescribe any medication.
The GP did not keep any record of his reasons for the diagnosis,
the drugs prescribed, discussion about side effects, his reasons
for increasing the dosage, or consultations with other health
professionals. The woman claimed that the Paradex and other
medication was for the GP rather than her, and that he added the
drugs to her scripts.
It was held that the GP breached professional and ethical
standards. By diagnosing and treating the woman for depression and
other conditions, and not referring her to an independent
practitioner for an objective assessment, and by not keeping any
record of the services he provided, the GP breached Right 4(2). The
matter was referred to the Director of Proceedings.
On 7 November 2007 the Health Practitioners Disciplinary
Tribunal upheld a charge of professional misconduct in relation to
the diagnosis of depression, prescription of Aropax, failure to
keep records, and his prescription of other medications including
Paradex (an analgaesic), Trisequens (hormone replacement) and Losec
(a treatment for digestive disorders). The Tribunal ordered the GP
to undertake education with regard to professional boundaries, and
recommended that the Medical Council of New Zealand undertake a
competence review of his practice with regard to women's health,
mental health and record-keeping.
The GP was censured, fined $7,500 and ordered to pay $3,000
towards the cost of the investigation and prosecution. He appealed
the finding of professional misconduct as well as penalty.
The High Court upheld the finding of professional misconduct on all
matters except for the prescription of the medications (other than
Aropax). This conclusion was quashed because the Tribunal had not
put to the doctor its conclusions about the seriousness of
prescribing Paradex at the same time as an antidepressant, and
prescribing Trisequens without clear monitoring. The Court
also reduced the fine to $5,000, but upheld the other penalties
imposed.
Link to Health Practitioners
Disciplinary Tribunal decision:
http://www.hpdt.org.nz/portals/0/med0776dfindings.pdf