Medical practitioner’s registration suspended for inappropriate prescribing

11 Jul 2016

A medical practitioner who admitted inappropriate prescribing has had her registration suspended by a tribunal for professional misconduct.

The Medical Board of Australia (the Board) started disciplinary proceedings against Dr Michelle Ong in November 2014 about Dr Ong’s treatment of 12 patients. The Board’s referral to the Queensland Civil and Administrative Tribunal (the tribunal) alleged:

• inappropriate prescribing of drugs and poisons containing the active ingredient pseudoephedrine and/or drugs of dependency and/or controlled drugs, including that the prescribing occurred:
  • over protracted periods of time
  • when there was often no therapeutic need
  • for certain medications, without obtaining the relevant approval of Queensland Health’s (then) Drugs of Dependence Unit as required by the Health (Drugs and Poisons) Regulation 1996 (Qld)
  • when Dr Ong should have known that some of the patients were exhibiting signs that they were ‘doctor shopping’
  • where there was a risk that the medications were being used for illegitimate purposes; and
  • when it was otherwise inappropriate because of a patient’s history of drug abuse or dependence
• providing prescriptions to patients for medications which were excessive in quantity and frequency, often resulting in the volume of prescribing exceeding the recommended dosage
• failing to consider differential diagnoses for patient’s medical conditions
• failing to refer patients to specialists for their medical conditions, and
• serious deficiencies in her record keeping.

The Board also alleged that Dr Ong’s performance and conduct was in breach of Queensland’s Drugs and Poisons Regulations and contrary to the Board’s code, Good medical practice: A code of conduct for doctors in Australia.

At a tribunal hearing in April 2016, Dr Ong admitted the alleged conduct, agreed that it constituted professional misconduct and accepted the opinions of the Board’s experts.

The tribunal issued its decision on 20 May 2016 and found that Dr Ong had behaved in a way that constituted professional misconduct. It noted her admissions and stated that:

‘There can be no doubt that in respect of the 12 patients ... Dr Ong provided services that were “excessive, unnecessary or otherwise not reasonably required for the patient’s wellbeing”, and that the clinical record keeping ... was deficient.’

The tribunal ordered that:

• Dr Ong’s registration be suspended for one month (the date of suspension was subsequently amended)
• conditions be put on her registration, including that she meet with a mentor every month for 12 months and that she provide reports of these meetings to the Board
• her practice and patient records be audited
• Dr Ong may not seek a review of the conditions for 12 months, and
• she pay the Board’s costs.

The tribunal made specific reference to the Board’s independent experts, one of whom commented in his report that Dr Ong had a history of prescribing narcotics in excess of approved quantities for patients registered (with the relevant department of Queensland Health).

The other expert commented that, “there was no excuse for a general practitioner not to be aware” of narcotic medication, PSE and benzodiazepines being “abused in the past and diverted for sale to other persons”.

The tribunal referred to the steps Dr Ong had taken since the initial complaints were made which demonstrated she had acknowledged her conduct, had insight and had minimised the risk of future misconduct.

The reasons for the tribunal’s decision are published on the AustLII website.