A GP has fought off strict conditions that prevented him from practising after a tribunal found hundreds of patients on opioid agonist therapy were at risk of relapse without him.
The solo GP in Brisbane was providing 14% of Queensland’s opioid agonist therapy until conditions were slapped on his registration in December 2022, the Queensland Civil and Administrative Tribunal heard.
The Medical Board of Australia said it acted after receiving four complaints from former patients, as well as one anonymous complaint, about the GP’s care.
It ordered a performance assessment, which concluded the “kind and caring” GP made “extensive use” of investigations that had no obvious clinical rationale.
The tribunal heard the 64-year-old regularly prescribed buprenorphine/naloxone but grew “defensive and combative” when questioned about his clinical reasoning for specific patients.
In response, the board decided the GP required an onsite supervisor who would share responsibility for his patients’ care.
However, the GP told the tribunal he asked five different doctors to supervise him, but they all ignored or rejected his request.
He requested a ‘stay’ until a full hearing to review the conditions, arguing that his patients had no alternative GP and were at risk of relapse or overdose without him.
The local public alcohol and drug service supported the GP’s claims.
The service received an influx of 400 calls from “increasingly desperate” patients after the GP’s practice was restricted, its clinical director told the tribunal.
More than 200 of the GP’s patients were now sitting on wait lists for addiction treatment, he said.
The medical board did not object to the stay.
The tribunal concluded the GP’s argument for overthrowing the conditions had potential and it was important his patients had ongoing care until his case was heard in full.
“There is a significant element of public protection in these vulnerable people being able to continue to access services to address their addiction,” said the tribunal judgement published last week.
“The evidence presently before the tribunal is that this cannot occur as long as [the GP] is unable to practise.”
The GP presented several “glowing” references from patients and other doctors, it added.
“This material … suggest[s] at a basal level that there are different views by professionally qualified people about the matters dealt with in the performance assessment report,” the judgement said.
“The tribunal is satisfied that [the GP] has demonstrated an arguable case.”
More information: Queensland Civil and Administrative Tribunal findings; 22 Mar 2023.