Opinion

Do you know your prescribing limits?


Janet Harry


18/12/2018 4:24:40 PM

MDA National medico-legal adviser Janet Harry examines a recent tribunal decision regarding a young doctor’s prescribing methods.

Janet Harry believes the case highlights that doctors in early years of practice must be aware of areas of prescribing considered controversial, and seek advice from senior clinicians or colleagues.
Janet Harry believes the case highlights that doctors in early years of practice must be aware of areas of prescribing considered controversial, and seek advice from senior clinicians or colleagues.

A recent Victorian Civil and Administrative Tribunal decision highlights a number of important issues for doctors in their early years of clinical practice.
 
A doctor, who at the time was in his third year post-graduation, worked part-time at an anti-ageing clinic in 2013 and 2014, where he prescribed testosterone and human growth hormone to patients with test results in the normal range. 
 
The Tribunal found that he had engaged in unprofessional conduct in:

  • prescribing testosterone and human growth hormone to six patients without proper clinical justification
  • failing to appropriately clinically manage certain of his patients by not obtaining specialist input before prescribing testosterone and human growth hormone.
In making a finding of unprofessional conduct, the Tribunal relied on the evidence of three expert medical witnesses who examined the treatment of six patients.  The Tribunal also took into account the doctor’s level of training and expertise, and considered that his conduct was not at the extreme end of irresponsible prescribing.
 
The case highlights the need for doctors to:
 
  • resist pressure to prescribe or provide treatment which is not in accord with accepted professional standards, even if the patient has consented to the treatment
  • not prescribe any medications unless they have taken all reasonable steps to ensure that a therapeutic need exists
  • recognise when they are at the limit of their expertise and seek appropriate specialist input
  • be aware of areas of prescribing considered controversial and seek advice from senior clinicians or other colleagues.
This article contains general information only. MDA National recommends practitioners contact their medical defence organisation or insurer when they require specific advice in relation to medico-legal matters.
 
This article first appeared on MDA National’s Medico-legal Blog (subscribe here) and is reproduced with its permission.



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