Medical Board of Australia v Jones
[2012] QCAT 362
| CITATION: | Medical Board of Australia v Jones [2012] QCAT 362 |
| PARTIES: | Medical Board of Australia (Applicant) |
| v | |
| John Michael Jones (Respondent) |
| APPLICATION NUMBER: | OCR294-11 |
| MATTER TYPE: | Occupational regulation matters |
| HEARING DATE: | 2 July 2012 |
| HEARD AT: | Brisbane |
| DECISION OF: | Judge Fleur Kingham, Deputy President Assisted by: Dr Sandra Congdon Mr Trevor Jordan Dr David Rosengren |
| DELIVERED ON: | 25 July 2012 |
| DELIVERED AT: | Brisbane |
| ORDERS MADE: | 1. Dr Jones is reprimanded. 2. Dr Jones’ registration is suspended for 6 months. 3. That order to suspend Dr Jones’ registration will operate for 2 months, after which the order will no longer have effect, provided that, for a period of 12 months from the date of these orders, Dr Jones complies with the following conditions and is not subject to disciplinary proceedings: 3.1. Dr Jones must undertake a course of counselling with a clinical psychologist who specialised in boundary violation issues. Dr Jones must nominate and the Board must approve the psychologist in writing. The counselling is to continue for 12 months or such shorter time as the psychologist considers necessary given the circumstances of this case. The Board must provide a copy of these reasons to the psychologist. Dr Jones must authorise the psychologist to provide a report to the Board about the outcomes from the counselling, at the conclusion of the program. 3.2. For a period of 4 months from the date the order is suspended, Dr Jones must practice only at the Garden City Retirement Home, Tricare Mt Gravatt Private Hostel, Tricare Mt Gravatt Nursing Centre and Arcare Warrigal Residential Aged Care on the same terms as applied immediately before the date of the Tribunal’s orders. 4. The suspension referred to in paragraphs 2 and 3 is to take effect from the date on which the original order was served on Dr Jones.[1] 5. Dr Jones must pay the Board’s costs of and incidental to the proceedings, as agreed or assessed on the standard basis against the District Court Scale. 6. Within 7 days of these orders, the parties must each file one copy of any material they have filed, further redacted to remove any details that might identify the wife of Dr Jones. Publication of the name of Dr Jones’ wife or any details that might tend to identify her are prohibited. |
[1] Decision amended by order of the Tribunal on 10 August 2012.
| CATCHWORDS: | OCCUPATIONAL REGULATION – HEALTH PRACTITIONERS – MEDICAL PRACTITIONERS – DISCIPLINARY PROCEEDINGS – where the registrant commenced a sexual relationship with a patient within an inappropriate time after the treating relationship ceased – where the registrant treated the patient’s husband – where the registrant continued to treat the patient’s family members – where the registrant admitted the subject conduct – whether the conduct constitutes professional misconduct OCCUPATIONAL REGULATION – HEALTH PRACTITIONERS – MEDICAL PRACTITIONERS – DISCIPLINARY PROCEEDINGS – NON-PUBLICATION ORDER – whether it is appropriate that the name of the registrant’s wife be disclosed OCCUPATIONAL REGULATION – HEALTH PRACTITIONERS – MEDICAL PRACTITIONERS – DISCIPLINARY PROCEEDINGS – COSTS – where the Tribunal has found the registrant engaged in professional misconduct – where the registrant agrees to pay the Board’s costs of and incidental to the application –whether it is appropriate to make the order proposed by the parties Queensland Civil and Administrative Tribunal Act 2009, ss 32, 114 Health Practitioner Regulation National Law (Queensland), ss 5, 193, 196(2)(a), 196(2)(d), 225 |
APPEARANCES and REPRESENTATION (if any):
This matter was heard and determined on the papers pursuant to s 32 of the Queensland Civil and Administrative Tribunal Act 2009 (QCAT Act).
REASONS FOR DECISION
The Board brought disciplinary proceedings against Dr Jones because of his personal relationship with a patient. The complaint was made to the Board on 1 July 2010, the day the national scheme for regulating medical practitioners commenced. Under that scheme, the Board must refer a matter to the Tribunal if it reasonably believes the practitioner has behaved in a way that constitutes professional misconduct.[2]
[2] Health Practitioner Regulation National Law (Queensland), s 193.
Dr Jones has admitted the relationship with the patient. The Board has proceeded on his admission that the sexual relationship commenced within an inappropriate time after the treating relationship ceased. Dr Jones has also admitted that he continued to treat other members of the patient’s family, when he should have referred them to another practitioner.
The conduct
Dr Jones first encountered the patient when they worked together at a retirement home where he attended various patients and she worked as an endorsed Enrolled Nurse. Although there is some dispute between the patient and Dr Jones about the sequence of events and the degree of their contact at the retirement home, Dr Jones concedes he commenced treating the patient in September 2008, after they had worked together.
Dr Jones treated the patient over the next 18 months and the personal relationship developed towards the end of that period, when Dr Jones agreed to assist the patient with her nursing studies.
Engaging in a sexual relationship with a patient is always a breach of professional boundaries, involving a breach of the trust and power imbalance inherent in the doctor patient relationship.
This case is made more serious by the particular vulnerabilities of both the patient and her husband.
Early in the therapeutic relationship, she disclosed to Dr Jones that she and her husband faced marital pressures. Dr Jones came to treat other members of the patient’s family, including her husband. Both the patient and her husband revealed personal details about her husband’s circumstances.
Dr Jones treated both the patient and her husband for conditions arising from the stress and anxiety they were experiencing from work and personal issues, including some traumatic incidents in the husband’s family. He was well aware of their vulnerabilities. In the case of the husband, he knew there was a risk of self harm.
In those circumstances, it was reprehensible that he entered into a relationship with the patient. In doing so, he failed in his professional responsibilities to each of them.
The relationship was reported to the Board as a result of a complaint by the patient’s husband to the Health Quality Complaints Commission. His distress about the matter is palpable in his written complaint. The patient has also been affected. She says her trust in medical practitioners has been affected and she now feels that Dr Jones manipulated his position of authority, through his intimate knowledge of their personal circumstances.
The patient reported comments made to her by Dr Jones over time that could be seen to be grooming the patient for the subsequent relationship. However, the Tribunal accepts Dr Jones had genuine feelings for the patient. He disclosed the relationship to his wife. He lived with the patient for a short time. These features suggest Dr Jones was seriously contemplating a future with the patient.
That does not detract from his exploitation of the confidence that both the patient and her husband had placed in him as their treating practitioner. He has engaged in professional misconduct, because his conduct fell substantially below the standard reasonably expected of a registered health practitioner.[3]
[3] Health Practitioner Regulation National Law (Queensland), ss 5, 193.
The sanction
The purposes of disciplinary proceedings are to maintain professional standards and public confidence in the profession and protect the public.
Dr Jones will be reprimanded.[4] This is not a trivial sanction. It is a public denunciation of his conduct, which is recorded on the public register of practitioners.[5]
[4] Health Practitioner Regulation National Law (Queensland), s 196(2)(a).
[5] Health Practitioner Regulation National Law (Queensland), s 225.
An order suspending Dr Jones’ registration will serve to deter others from breaching professional boundaries.[6] The period of suspension reflects the aggravating circumstances that he knew of and exploited the vulnerabilities of the patient and her husband and his conduct has had adverse impacts on both of them.
[6] Health Practitioner Regulation National Law (Queensland), s 196(2)(d).
There are encouraging signs that Dr Jones has some insight about his conduct. He made admissions at an early stage of these proceedings. That has saved the patient and, perhaps also, her husband from the ordeal of having to give evidence about intensely personal matters. That is consistent with the remorse he has expressed about his conduct.
Dr Jones has provided many references that attest to his otherwise good conduct and the valuable contributions he makes as a general practitioner in a number of roles he fulfils, including in the retirement home.
Those matters have been taken into account in the Tribunal’s decision to lift the suspension after 2 months, provided that, within 12 months from the date of these orders, Dr Jones complies with a number of conditions and is not subject to further disciplinary action. These are not conditions imposed on his registration, but conditions under which the order to suspend does not have effect.
The first condition requires Dr Jones to undertake 12 months of counselling in boundary violation issues with a psychologist or psychiatrist approved by the Board. This will assist Dr Jones to develop further insight about his conduct.
The other condition provides that, for the first 4 months after the suspension order is lifted, Dr Jones may only practise medicine at the Garden City Retirement Home, Tricare Mt Gravatt Private Hostel, Tricare Mt Gravatt Nursing Centre and Arcare Warrigal Residential Aged Care, on the same terms, including number of hours, as he performed prior to the order taking effect.[7] This is a substantial restriction on Dr Jones’ scope of practice. It means that he will not be able to work at the medical centre which currently employs him; in Emergency at the QEII hospital; or in any other capacity as a medical practitioner, for a period of 6 months from the date of these orders.
[7] Queensland Civil and Administrative Tribunal Act 2009, s 114.
Dr Jones has agreed to pay the Board’s costs. This order is appropriate given the Board established its case against him.
The Tribunal is satisfied the orders made will deter Dr Jones from re-offending, will deter others from doing so and are adequate to protect the public, in particular potential patients of Dr Jones.
Non-publication orders
The material filed by the parties has been redacted to preserve the identity of the patient and her husband, but discloses the name and other identifying details of Dr Jones’ wife, a professional woman who has not assumed her husband’s surname. There is no public interest in identifying her. The parties are required to file a redacted version of all material filed in these proceedings within 14 days. The original versions will be retained on file but are not to be inspected without further order of the Tribunal.
26
0
0