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Tablets fallen out of pill bottle onto note pad

Doctor sanctioned when self-prescribing and prescription forgery revealed after motor vehicle accident

Summary: Doctors are expected to avoid self-prescribing and seek independent objective medical advice when necessary, especially if they know or suspect they have a health condition that could affect their judgement or performance. Self-prescribing and practising with impairment can put the public at risk, as well as having significant personal and professional consequences, as this case illustrates.

Sunday, 6 August 2023

Key messages from the case

Doctors are expected to avoid self-prescribing and seek independent objective medical advice when necessary, especially if they know or suspect they have a health condition that could affect their judgement or performance. Self-prescribing and practising with impairment can put the public at risk, as well as having significant personal and professional consequences, as this case illustrates.

Details of the decision

Self-prescribing and impairment

Dr Z was referred to the Medical Board after he had two motor vehicle accidents while under the influence of sleeping tablets.

Dr Z agreed he had become dependent on the medication, initially prescribed for insomnia and depression. He admitted to self-administering Schedule 4 medications and forging prescriptions on multiple occasions over a six-year period. He pleaded guilty to 40 breaches of the relevant poisons legislation.

Outcome

In disciplinary proceedings, the tribunal found that Dr Z’s conduct amounted to professional misconduct and unprofessional conduct.

At the time of the initial notification to the Medical Board, Dr Z had provided an undertaking not to practise until approved by the Board. Following this, the Medical Board received two further notifications relating to Dr Z continuing to self-prescribe. The Board referred Dr Z’s conduct to the tribunal for disciplinary action.

Dr Z accepted that he had engaged in unprofessional conduct and professional misconduct. The tribunal heard that Dr Z had fully cooperated with the Board, had fully complied with the conditions imposed on his registration and submitted to monthly drug tests. He had participated in clinical training and expressed shame and remorse in relation to this conduct.

In considering what orders to make, the tribunal took into account the doctor’s degree of insight and his success in seeking treatment and addressing his addiction issues.

The tribunal reprimanded Dr Z and imposed conditions in relation to drug-screening, supervision and medical treatment. He was prohibited from prescribing or administering schedule 4 or 8 medications except within his clinical role.

The tribunal also made a non-publication order on the practitioner’s name, because of the adverse impact on his mental health if his name was published.

Key lessons

Avoid self-prescribing and seek independent medical care whenever necessary. All medical practitioners are encouraged to have their own general practitioner.

Doctors who self-prescribe generally lack objectivity, and in most cases their self-prescribing is not appropriate treatment.

Self-prescribing can put the public at risk as well as risking harm to patients through impairment or inappropriate care.

Self-prescribing or self-administering schedule 4 and schedule 8 medications is against the law in some Australian jurisdictions.

Under Australian law it is an offence to forge a prescription, fraudulently alter a prescription, or present a known forged or altered prescription to obtain a drug. Prescription forgery can also put colleagues at risk of being reported for inappropriate prescribing.

References and further reading

Medical Council of New South Wales: Guideline for self-treating and treating family members

Avant factsheet: Treating family members, friends or staff

Avant well-being resources: Substance abuse and the medical profession

For more information or immediate medico-legal advice, call us on 1800 128 268, 24/7 in emergencies.

Download case study

Doctor sanctioned when self-prescribing and prescription forgery revealed after motor vehicle accident (PDF)

Disclaimers

Scenarios in this publication are based on Avant claims experience to date. Certain information has been de-identified to preserve privacy and confidentiality. This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published. © Avant Mutual Group Limited 2023 riskiqcase183 06/23 (DT-3239)

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