Medical practitioner suspended for being intimate with patient

04 Sep 2019

A Victorian plastic surgeon has been suspended for three months for having sexual intercourse with a vulnerable patient.

On 11 June 2019, the Victorian Civil and Administrative Tribunal (the tribunal) found that Dr Ian Holten had engaged in professional misconduct in that he had sexual intercourse with a patient. The tribunal reprimanded Dr Holten and suspended his registration for three months.

The tribunal also found that Dr Holten failed to maintain the professional boundaries that exist between a medical practitioner and their patient and so behaved in a way that constituted unprofessional conduct.

Dr Holten, a specialist plastic surgeon, provided cosmetic medical and surgical services to the patient 10 times between 2011 and 2014. The patient was known to Dr Holten before she engaged his professional services as they were in the same friendship group.

The tribunal found that after the doctor-patient relationship started, Dr Holten and the patient contacted each other regularly via telephone calls and text messages. They had met for coffee and had sat in his car together discussing their personal lives, including the patient’s marital difficulties.

Dr Holten and the patient had sexual intercourse in January 2014, and he had subsequently provided professional services to the patient. The tribunal found that Dr Holten should have realised that the patient was vulnerable as he knew that she had been treated for depression.

After receiving a notification, the Medical Board of Australia (the Board) referred Dr Holten to the tribunal alleging he had breached his professional conduct obligations by having sexual intercourse with a patient and by failing to maintain professional boundaries.

The tribunal referred to the Board's Good medical practice: a code of conduct for doctors and to the Board’s guidelines Sexual boundaries in the doctor-patient relationship, pointing out references to the importance of maintaining professional boundaries and that ‘a good doctor-patient partnership requires high standards of professional conduct’ and that ‘this involves … recognising that there is a power imbalance in the doctor-patient relationship, and not exploiting patients physically, emotionally, sexually or financially’. It also provides that professional boundaries are integral to a good doctor-patient relationship.

The tribunal concluded that Dr Holten’s conduct was a serious transgression of the obligations he owed to the patient once he had agreed to treat her and the tribunal found that the patient’s vulnerability was relevant to the seriousness of the conduct.

The tribunal suspended Dr Holten’s registration for three months as a deterrent to other medical practitioners from engaging in sexual intercourse with a patient. It noted that there is an inherent power imbalance in the doctor-patient relationship and that sexualising of the relationship had the ability to erode the public’s trust and faith in the profession.

The tribunal was satisfied Dr Holten was at low or no risk of repeating the conduct, having practised safely for the past five years and for decades before that. Dr Holten’s registration is suspended for three months from 14 October 2019.

The decision is published on the Austlii website.