Doctor suspended for inappropriate prescribing, failing to maintain professional boundaries

05 Jul 2024

A Victorian general practitioner has been reprimanded, had his registration suspended for three months and had conditions placed on his registration for failing to safely prescribe scheduled medications and failing to maintain professional boundaries with a patient.

The Medical Board of Australia (the Board) referred general practitioner Dr Phuc Nhan Pham to the Victorian Civil and Administrative Tribunal (the tribunal) for professional misconduct and providing substandard care to his patient (Mr P).

Mr P attended consultations with Dr Pham 21 times between May 2019 and March 2020. Dr Pham prescribed both Schedule 4 and Schedule 8 medications during these consultations, which are restricted medicines due to their potential for patient harm.

On eight of those occasions, Dr Pham failed to record any clinical notes relating to the consultations. On the other 13 occasions, he recorded minimal notes, which provided no clinical indication of the need for the prescription.

Dr Pham also failed to seek and obtain a permit required to prescribe a person with any Schedule 8 medication for longer that eight weeks, despite prescribing Mr P with Schedule 8 medications on seven occasions between October 2019 and March 2020. On each occasion, Dr Pham recorded that he had an ‘in-date’ permit to prescribe Schedule 8 medications to Mr P.

Dr Pham also failed to acknowledge, respect or take advice appropriately from nursing staff who raised concerns relating to errors in medication prescribing in his treatment of Mr P.

The nurse was particularly concerned about the prescribing due to Mr P’s history which included alcohol abuse, mental illness, chronic back pain and overdosing on medications.

When his nursing colleague made a notification to Ahpra regarding his conduct, Dr Pham failed to maintain professional boundaries with Mr P by discussing the notification and the care he provided to the patient.

Two days later, Mr P wrote a letter of support (addressed to Dr Pham) in which he said, among other things, that he had no complaints about Dr Pham and that he was upset about what Dr Pham had told him. On the same day Mr P wrote to Ahpra confirming that he had no complaints about Dr Pham and saying that he was very happy to be his patient.

At a hearing on 10 April 2024, the tribunal found Dr Pham’s actions amounted to professional misconduct.

‘[Dr Pham’s conduct] was substantially below the standard reasonably expected of a registered health practitioner of an equivalent level of training or experience,’ the tribunal stated.

‘[His] conduct exposed the patient to risk of harm. His conduct cannot be excused by his workload or the complexity of the law regarding Schedule 4 and Schedule 8 drugs.’

Dr Pham admitted the allegations, and has since completed education and a reflective practice report. Dr Pham said he accepted all his mistakes and that they have made him ‘really regretful and sad’.

On 29 April 2024, the tribunal ordered that Dr Pham:

• be reprimanded,
• have his registration suspended for a period of three months,
• undertake and successfully complete a Board-approved program of education on maintaining professional boundaries and communicating effectively and respectfully with other medical and healthcare professionals,
• attend mentoring, and
• undertake periodic audits of his practice.

Read the full decision on AustLII.