Mentoring and education conditions for practitioner who dismissed patient’s request for a second opinion

27 Jan 2021

A tribunal has imposed education and mentoring conditions on the registration of a medical practitioner who discharged a patient from hospital despite the patient’s concerns regarding his health and request for a second opinion.

The Queensland Civil and Administrative Tribunal (the tribunal) upheld a decision by the Medical Board of Australia (the Board), to impose education and mentoring conditions on the registration of Dr Amira Mahboub.

In November 2018, Dr Mahboub discharged a patient under her care from hospital despite the patient’s request for a second opinion and concerns by the patient and his family about his condition and treatment. In the notification, made by the patient’s son, Dr Mahboub behaviour was described as ‘extremely abrupt’ and that she dismissed concerns that the patient may have a deep vein thrombosis (DVT), and a request for an ultrasound despite rising pain levels.

In November 2019, the Board imposed conditions on the registration of Dr Mahboub after forming a reasonable belief that the way that she practises the medical profession is or may be unsatisfactory.

In December 2019, Dr Mahboub filed an application to review the Board’s decision.  In December 2020 the tribunal delivered its decision and upheld the Board’s decision.

In summary, the tribunal found:

• Dr Mahoub’s versions on the crucial matter of whether she discharged the relevant patient from the hospital, or merely from her care, changed as events unfolded. She was prepared to change her account according to what she perceived might best assist her case;

• Dr Mahboub did not consider and respect the patient’s views in relation to the management of his health, as she made the decision to discharge him, despite being informed of the patient’s request for a second opinion. This constituted a failure to comply with the relevant provisions of the Board’s Code of Conduct, which state the importance of acknowledging and respecting a patient’s right to make their own decisions about their health and seek a second opinion, and to facilitate the coordination and continuity of care of the patient. Further, Dr Mahboub’s persistence in proceeding with a discharge of the patient from hospital, notwithstanding his request for a second opinion, demonstrated a stubborn refusal by her to acknowledge the possibility that her clinical judgement that the patient was fit for discharge from the hospital might be wrong;

• Dr Mahoub’s contention that she was discharging the patient from her care, rather than from the hospital, is not accepted. Such a contention is inconsistent with her notes, as well as the submissions she made to the Board in March 2019;

• on the basis of the information before it, the tribunal reasonably believes that the way Dr Mahboub practises the health profession, or her professional conduct, is or may be unsatisfactory; and the conditions imposed on Dr Mahboub’s registration by the Board are apt to address the specific risks with her professional practice and are not more onerous than required to properly address such risk.

Broadly, these conditions required Dr Mahboub to successfully complete an approved program of education in relation to patient rights and effective communication with patients, as well as be mentored by another registered medical practitioner in relation to  listening and responding to patient concerns, respecting a patient’s right to make his/her own decisions about his/her health treatment and seek a second opinion, and facilitating the coordination and continuity of patient care.

The full decision is published on the tribunal website.