‘I was a dead man walking’: The story of a deregistered doctor’s quest for redemption
“You feel like a dead man walking in the street.
“You have a career, you have a job, and then suddenly you are worthless.”
Dr Leimin Chen comes across as positive and hopeful, but there are still moments as he talks to AusDoc where the pain of what he has been through surfaces.
It has been more than five years since he was expunged from the medical register for his entanglements in a series of clinics offering treatment for severe depression.
His story is not exceptional, but the fate of what happens to doctors who fall foul of the regulatory regime and find themselves excommunicated from the profession exists in the shadows.
Maybe it is a sense of shame. It is not something to talk about.
But the subsequent journey for those subject to a very public and confronting judgement is invariably stark.
The clinic Dr Chen joined was based in Sydney and run by the Aura Medical Corporation*.
The company emerged in 2014 with around half a dozen doctors prescribing and administering ketamine injections as off-label treatments.
Clinical respectability came from its clinical director Dr Graham Barrett, a GP who at the time was also an associate professor at the University of Melbourne.
But the treatment protocols he devised were advertised direct to patients via TV and radio adverts. There was no referral mechanism in place.
Sons and Daughters soap star Rowena Wallace fronted some of the commercials, where patients were encouraged to ring 1800 numbers.
AusDoc first reported what was happening — the central accusation being that vulnerable people searching desperately for a resolution to the ills that afflicted them were being asked to part with thousands of dollars for little more than experimental therapy.
Fuelling the concerns was that these clinics had links to Jack Vaisman and his Advanced Medical Institute empire which had recently been through the regulatory mincemeat machine for the way it was flogging high cost, unproven treatments for erectile dysfunction.
After the mainstream media started taking an interest, Dr Barrett resigned as medical director.
Within six months the Aura clinics were shut down.
The bad publicity was blamed.
At this point Dr Chen moved on to a new job at Sydney’s North Shore Private Hospital.
As many doctors would expect, it was not long before he was notified of a complaint against him.
He had failed to properly assess patients he saw, it was alleged, he had failed to exercise responsible medical judgement, and he had failed to inform the patients’ own GPs about what he was doing.
In 2015, Dr Chen went before the Medical Council of NSW, fronting a series of hearings to defend himself.
The council’s panel was not impressed.
Accepting the highly critical expert witness testimony of Dr Harry Nespolon, later to become RACGP president, Dr Chen was found guilty of professional misconduct.
But before sanctions were imposed, Dr Chen agreed to be interviewed by AusDoc.
He admitted mistakes, expressed regrets but tried to explain why he had become involved: “It was exciting to me. It was a new and novel treatment.
“I was aware of some of the research [around ketamine] going on in the US, as well as here in Australia, and the belief was that ketamine could be a revolutionary new treatment for severe depression.”
He also said he was not doing it for the money — the pay was $870 a day and there were no commissions for writing scripts.
“I made it clear to the tribunal that I looked after those depressed patients with my soul and heart. I did not make any financial gain from Aura.”
But as the only Aura doctor to go before a public tribunal, he said had been made a scapegoat.
And that seems to have been the trigger word for the tribunal.
When it reconvened to impose sanctions, it was scathing.
Referring to the article, it said Dr Chen had displayed a “rigidity of thinking”, defensiveness and unwillingness to acknowledge the “deficits” in his care.
It banned him for two years.
At the time he was working as a GP registrar at the Central Australian Aboriginal Congress — an Aboriginal primary healthcare service in Alice Springs.
He had won a place on the GP training program just weeks before the conditions were first placed on his registration.
“I was doing very well; I was just about to finish to do the GP exam,” he tells AusDoc.
“The decision to immediately suspend me came as a surprise to my life.
“How could I be performing very well in Alice Springs and then be suspended by the tribunal immediately?
“How could I be treated this way? It didn’t make any sense to me.”
A graduate of Beijing Medical University and the University of Queensland, who had hoped to make it as an orthopaedic surgeon, Dr Chen returned to Alice Springs to pick up his belongings, his car, and say goodbye to his friends.
It was the end.
He decided to go home to his family in NSW.
He spent some time bushwalking in Kamay Botany Bay National Park, a beautiful stretch of coastline, rich in Aboriginal culture, where Captain James Cook first set foot on the continent.
Emotionally he was in a dark place.
“I realised why some people can snap and kill themselves because doctors [in these situations] are under pressure and they go from a very high status, respected, down to nothing.
“You walk in the national park, you walk to the cliff, you do think about why you have been treated this way. But I’m not the kind of person to harm myself.”
He says he spent most of the rest of the year travelling, taking his daughter to New Zealand, and returning to China to visit his mother.
But he needed to pay the bills.
What options did he have?
He says very few.
In 2019, he started driving taxis.
“I did enjoy it actually. You don’t have to use your brain power to be dealing with these sorts of hopeless situations. I thought maybe I should have driven taxis when I first came to Australia.
“I told some customers that I used to work in the medical field and a couple of people were very interested.
“One person said, ‘Oh what a great waste to be driving taxis, they need doctors in the bush.’”
He then completed a diploma in bioethics at the University of Sydney — additional training that had been one of the sanctions imposed by the medical council as part of his rehabilitation.
“It was very hard … but I realised that what happened to me was a part of life. If they [the regulator] can jump on me like this then maybe I did something wrong.
“To survive, to work, to have any sense of hope, you have to accept what happened.”
To be clear, Dr Chen says he is not attempting to rewrite history or make claims that his involvement with the Aura clinic was anything other than a mistake.
He says he was naïve, his decisions wrong.
But he says the presence of Professor Barrett had convinced him it was a legitimate operation.
And he maintains that it was “sold to him as a clinical trial”.
“It was not meant to be a backyard clinic but a genuine business, but I found out later it had a bad reputation,” he says.
“That was my mistake, I shouldn’t have got involved in that type of work.”
But he still insists he felt an obligation to help patients and their families who were suffering.
It was about treatments of last resort to those whose lives were being torn apart.
“I’ve never known so many people depressed … so many patients came in, we were inundated,” he says.
“Patients of all ages came to the clinic … most had tried two or three antidepressants and not found them helpful.”
His role at the clinic was to assess patients, take their histories and administer the injections.
He says most people were given a four-week course of treatment.
The costs were significant — reportedly up to $3000.
The tribunal in its findings said that he failed to follow up four patients whom he had supplied ketamine to administer at home.
Looking back now, he still believes no patients were harmed by the treatment he gave them.
“They said to me, ‘Dr Chen, I had the best relief, I’ve never been like that, I was always depressed, I almost wanted to kill myself, but now I can reattach to my family, to my work.’”
“Ketamine is used for depression nowadays,” he adds.
That statement has some truth.
The potential benefits of the S8 drug continue to spark interest.
Earlier this year the Black Dog Institute made an application for an MBS item to fund subcutaneous ketamine injections, after their trials found “promising” remission rates for severe depression.
Sydney’s Royal Prince Alfred Hospital and Gold Coast University Hospital in Queensland are running clinics in the context of clinical trials.
And Victoria’s first public ketamine clinic — which is not a clinical trial — opened at the Royal Melbourne Hospital last month.
Dr Chen stresses this is not offering him backdated justifications for his actions.
“No, I wouldn’t say any of this is a vindication. I did what I thought was best for the patients suffering at the time. Of course, the science develops.
“If you asked me now whether I would get involved in a novel treatment I would say, I’m sorry, I can’t.
“I have learned my lessons.”
This insight was acknowledged by the medical council at the hearing to reinstate his registration in 2021.
It said he had taken “diligent steps” to address its concerns and had “fully accepted responsibility for his actions”.
“The judge said to me ‘Dr Chen I feel for you for the last two years.’ It almost made me cry.”
But remorse is not enough.
There has been no return.
More than two years on from that day, he is struggling to find work as a doctor.
Excommunication feels permanent.
“What does it mean to have been deregistered? It is career wrecking.”
He said it took nine months for AHPRA to reinstate his registration.
After this he was able to find work as a doctor at a GP clinic in Sydney.
But as an IMG without fellowship he was only able to bill private patients.
As you expect, his employment did not last long.
“Also, because I was on conditions, a senior doctor was supposed to spend 10 hours looking at my consultations and they couldn’t do that, the patient numbers were minimal.”
Dr Chen applied again for the GP training program and last year in November he received the RACGP letter accepting him into the medical fold.
But he hit another roadblock.
To satisfy the terms of the training he was required to complete a hospital term.
Despite 20 years of clinical practice in Australia, much of this in hospitals, no hospital it seems is willing to employ him.
“I’ve applied for 41 jobs and only got three interviews. That’s just in NSW.
“I’ve tried to talk to so many doctors, no-one is interested.
“I’m a graduate from Queensland so I thought perhaps I would have some advantage there, but there is no mercy. Even at a hospital I worked at before, it was an outright no.”
When asked if he feels ostracised by the medical community, he says, “In some ways, yes.”
There are a few exceptions.
They include Dr Sam Heard, a well-respected doctor in the NT, a one-time AusDoc columnist and Dr Chen’s old supervisor.
“He was very open and absolutely professional in his disclosure of everything to me,” Dr Heard said when we approached him last week.
“He operated at a high level — he is a competent, bright, worldly fella and contributed well.”
He added that the fact Dr Chen has twice been accepted onto the GP training program, which is competitive, shows others “appreciate him too”.
“He did his time and got back into the program and then just couldn’t get a [hospital] placement.
“I thought that was very sad especially as we would be very happy to have him, and in an area where we are really struggling to get registrars.”
Dr Heard added: “All I can say is from my professional interaction with him the decision [to deregister] was too harsh.
“But that’s only based on his competence, commitment, his energy, his clinical sense — that’s just a professional view of him operating in my environment.
“I got to work with him and that counts for something doesn’t it? I was his supervisor.”
Dr Chen says he no longer sees himself as a scapegoat.
But he does talk of feeling “persecuted”.
This seems to be his view of the disparity between the stated purpose of the regulatory regime governing doctors and the actual effects of its actions.
It is meant to be the first and last there to protect patients from harm.
A tribunal will often go to some lengths in its judgements to make it clear that its role is not to punish doctors.
It is not a criminal court distributing criminal justice.
For Dr Chen, given his experiences, you sense he would find that ludicrous.
And he does remain aggrieved in his perception that the regulator had “double standards” in its punishment of him.
“They showed so much hatred towards me.
“If you treat me like this, you should be treating other people like this.”
“Other people” — his reference to the other people involved with Aura.
He was the only doctor involved who was struck off.
In June 2015, AHPRA banned Professor Graham Barrett from prescribing ketamine to patients, amid allegations that he had administered the drug from his Melbourne home.
At a tribunal four years later he was then reprimanded, and conditions were imposed on his registration not to possess, prescribe, dispense or administer ketamine.
But these conditions were only to remain in place until he had “successfully completed education” on providing medical care to patients at home and prescribing and administering ketamine.
Dr Chen talks about existential harms resulting from the regulatory system.
“The same year as me another doctor got a complaint. I had a coffee with him on the Gold Coast.”
The doctor was Dr Yen-Yung Yap, an obstetrician from Adelaide.
According to media reports, he had been banned by AHPRA from performing vaginal births due to a complaint over his alleged use of vacuum extraction instead of forceps to deliver two babies.
“He killed himself,” Dr Chen says.
“It was about three years ago.”
“His wife told me it was so hard for him. He had three kids.”
He continues: “My medical career is perhaps already gone. I’m 61-years-old. But I just want [what happened to me] to never happen to the younger generation of doctors.
“There are lots of Dr Chens in the health profession, they look different, but they work very hard.
“They shouldn’t be treated this way. That’s my purpose for [speaking out] today.”
He says he remains hopeful.
He is currently working to try and transfer his GP training to the NT.
“I hope I will be able to go to there again, do very well and be a much-loved doctor.
“I’m still in very good health and I can contribute. But if they keep kicking me around and don’t give me a chance then I might have to give up.
“Hopefully one day I will be in a better position and proud to talk to you.”
*Aura Medical Corporation is not related to Aura Medical Group.
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