Goyer v Medical Council of New South Wales [2022] NSWCATOD 102

Civil and Administrative Tribunal New South Wales Medium Neutral Citation: Goyer v Medical Council of New South Wales [2022] NSWCATOD 102 Hearing dates: 11 - 12 May 2022 Date of orders: 7 September 2022 Decision date: 07 September 2022 Jurisdiction: Occupational Division Before: Cole DCJ, Deputy President Dr A Reid, Senior Member Dr G Yeo, Senior Member J Houen, General Member Decision: (1) A reinstatement order under s 163B(1)(c) of the Health Practitioner Regulation National Law (NSW) is made in respect of Thomas Clement Goyer ('the practitioner'), subject to the following conditions being imposed upon his registration: (a) The practitioner must obtain the approval of the Medical Council of NSW ('the Council') prior to changing the nature or place of his practice. (b) The practitioner must restrict his practice to minor (non-surgical) cosmetic medical procedures as defined in the Medical Board of Australia's 'Guidelines for registered medical practitioners who perform cosmetic medical and surgical procedures'. (c) The practitioner must submit to an audit of his practice, by a random selection of his medical records by a person or persons nominated by the Medical Council of NSW and: (i) the audit is to be held within 6 months from his recommencement of medical practice and subsequently from time to time as may be required by the Medical Council of NSW. (ii) the auditor is to assess the practitioner's compliance with good medical record keeping standards, legislative requirements and compliance with the conditions to which the practitioner's registration is subject, (iii) the practitioner is to authorise the auditor to provide the Medical Council of NSW with a report on the auditor's findings. (iv) the practitioner is to pay all costs associated with the audits and any reports of the audits. (d) The practitioner may conduct consultations with patients in person only. The practitioner may not conduct any telephone or video consultations with any patient. (e) The practitioner is not to supervise or train any medical practitioner or medical student in any context. (f) The practitioner is not to possess, supply, administer or prescribe: (i) phentermine, (ii) diethylpropion, (iii) human chorionic gonadotropin, (iv) hormone replacement therapy and androgen modifiers. (g) The practitioner will practise under Category C supervision in accordance with the Medical Council of NSW's Compliance Policy – Supervision (as varied from time to time) and as subsequently determined by the relevant review body. (i) The terms of the Medical Council of NSW's Compliance Policy – Supervision are varied so that: (A) the practitioner is required to meet with his Council approved supervisor fortnightly; (B) the practitioner must authorise the Council approved supervisor to forward a report to the Council (in a Council approved format) every month. (ii) At each supervision meeting the practitioner is to review and discuss his practice with his approved supervisor with particular focus on: (A) clinical management and patient outcomes, (B) appropriate prescribing practices, (C) medical record documentation, (D) compliance with conditions, (E) progress with return to practice, (F) ethics in medical practice. (iii) the practitioner must authorise the Medical Council of NSW to provide the nominated and approved supervisor with copies of the conditions on the practitioner's registration, and of the decision of the Civil and Administrative Tribunal of New South Wales which resulted in the imposition of this condition. (iv) The practitioner must not practise unless and until a supervisor has been approved in writing by the Medical Council of NSW. (h) The practitioner must complete within 12 months of 7 September 2022 the Ethics Counsel Program for Health Professionals organised by the Ethics Centre and: (i) within two months of 7 September 2022, the practitioner must provide evidence to the Medical Council of NSW of his enrolment in the Ethics Counsel Program for Health Professionals. (ii) within one month of completing the Ethics Counsel Program for Health Professionals, the practitioner must provide to the Medical Council of NSW documentary evidence that he has satisfactorily completed the Program, (iii) the practitioner is to pay all costs incurred in meeting this condition, provided that, in the event that the Ethics Counsel Program for Health Professionals is unavailable, the practitioner must, within two months of 7 September 2022 propose to the Medical Council of NSW a similar Ethics course as an alternative course and, in the event that the Medical Council of NSW approves the proposed alternative course, the practitioner may undertake that proposed alternative course in accordance with the provisions of this condition, in fulfilment of this condition. (i) The practitioner must, at his own expense, within one year of 7 September 2022 undertake both a course in relation to allergies and a course in relation to diabetes. Within one month of completing each of those courses, the practitioner must provide to the Medical Council of NSW documentary evidence that he has satisfactorily completed both courses. (j) Within 6 months of being approved by the Medical Council of NSW to commence employment, the practitioner is to spend a total of 4 observation sessions with his approved supervisor. A session is a period of at least 2 hours. (i) Initially, the practitioner is to spend a total of 2 sessions directly observing the supervisor conduct consultations with his or her patients. (ii) The supervisor is then to spend a total of 2 sessions directly observing the practitioner conduct consultations with his patients. (iii) When observing these consultations, the practitioner and supervisor are to consider such matters as: clinical performance, clinical decision making and judgement, treatment and referral of patients with mental health disorders, appropriate prescribing practices, patient follow-up and clinical outcomes. (iv) Within 4 weeks of the completion of the observation sessions, the practitioner is to provide a report to the Medical Council of NSW detailing the dates of attendance, what he learnt and how this will impact on his practice. (v) Once the practitioner's report is written and before it is returned to the Medical Council of NSW, he is to ensure that the supervisor reviews the practitioner's report and that the supervisor provides his or her own report to the Medical Council in which he or she comments on the content and authenticity of the practitioner's report, confirming the dates of attendance and setting out any concerns or other observations. The supervisor's report is to be provided to the Medical Council of NSW within 4 weeks of the completion of the observation period. (vi) The practitioner is responsible for any costs incurred in relation to the period of observation and any subsequent reports. (k) The practitioner must not prescribe for self-medication. (l) The practitioner must consult with a registered General Practitioner of his choice. The frequency of the consultations is to be determined by the treating General Practitioner. The practitioner: (i) is to authorise his General Practitioner to inform the Medical Council of NSW of any of the following: (A) any failure by the practitioner to attend a scheduled consultation, (B) termination of the doctor/patient relationship, (C) a significant change in the practitioner's health status (including a significant temporary change). (ii) must inform the Medical Council of NSW of the name of the General Practitioner and the address at which the General Practitioner practises. (m) The practitioner must attend for treatment by a registered psychologist of his choice. The frequency of the treatment is to be determined by the treating psychologist. The practitioner: (i) must authorise the treating practitioner to inform the Medical Council of NSW of each of the following: (A) any failure to attend for treatment, (B) the termination of treatment, (C) a significant change in the practitioner's health status (including a significant temporary change). (n) The practitioner must attend for review by a psychiatrist appointed by the Medical Council of NSW on a three monthly basis or as otherwise directed by the Medical Council of NSW. (o) The practitioner must attend a Review Interview arranged by the Medical Council of NSW on a three monthly basis or as directed otherwise by the Medical Council of NSW. (p) The practitioner must authorise and consent to any exchange of information between the Medical Council of NSW and Medicare Australia for the purpose of the monitoring of compliance with these conditions. (q) The practitioner must provide evidence to the Medical Council of NSW, within 14 days of recommencing medical practise or changing his place of practice, that he has provided any practice or organisation in Australia at which he works with a copy of the full set of conditions to which his registration is subject at the relevant time. (r) The practitioner must authorise the Medical Council of NSW to notify any practice or organisation at which the practitioner works as a medical practitioner of any issues which arise in relation to the practitioner's compliance with these conditions. (s) In the event that the practitioner practises at any practice or organisation of which he is an owner, or the director of an owner, or of which his wife, or any first degree relative of his, is an owner or the director of an owner, the practitioner shall ensure that, within six months of him beginning to practise at that practice or organisation, the practice or organisation purchases, instals and uses for the generation and storage of all electronic medical records and the issuing of all prescriptions, software capable of recording and retaining the medical records of patients, with the appropriate measures to safeguard patient confidentiality, and capable of printing and recording prescriptions. (2) The Medical Council of NSW is the appropriate review body for the purposes of Part 8, Division 8 of the Health Practitioner Regulation National Law (NSW). (3) Sections 125, 126 and 127 of the Health Practitioner Regulation National Law (NSW) are to apply whilst the practitioner's place of residence is anywhere in Australia other than New South Wales, so that a review of these conditions can be conducted by the Medical Board of Australia. (4) The practitioner must pay the legal costs of the Medical Council of New South Wales in this matter, to be agreed or assessed. Catchwords: OCCUPATIONS — Medical practitioners — application for reinstatement of registration Legislation Cited: Health Practitioner Regulation National Law (NSW) Cases Cited: Health Care Complaints Commission v Goyer [2019] NSWCATOD 121 Health Care Complaints Commission v Goyer (No 2) [2019] NSWCATOD 195 Qasim v Medical Council of New South Wales [2021] NSWCA 173 Category: Principal judgment Parties: Thomas Clement Goyer (applicant) Medical Council of NSW (respondent) Representation: Counsel: P Dwyer (applicant) A Petrie (respondent)