Impairments in training and practice

Health Care Complaints Commission v Quach [2015] NSWCATOD 2 saw the applicant seek findings in the alternative of unsatisfactory professional conduct under section 139B of the Health Practitioner Regulation National Law (“the National Law”) or professional misconduct under section 139E.

The matter was somewhat unusual however in that (amongst other things) the HCCC alleged that the doctor had an impairment as defined in section 5 of the National Law in the nature of a narcissistic personality disorder. Reference was made to peer relationship issues dating back to the time of the respondent’s training, though these were not the direct subject of the HCCC complaints.

Narcissistic personality disorder

The tribunal noted evidence at [10] including that the respondent had a number of difficulties in the course of his training, including interaction with senior personnel within the Department of Psychiatry and complaints had been made by colleagues, medical administrators and patients especially during his intern years.

At [419] the tribunal included reference to relating appropriately with peers when saying:

His ability to practice medicine has been severely compromised, weakened and damaged because of the impact of his narcissistic personality disorder on his ability to diagnose appropriately, create appropriate treatment regimes, relate appropriately to patients, relate appropriately to his peers, and otherwise conduct himself in a manner appropriate to standards of behaviour expected within the community of medical practitioners.

Fees charged / over-servicing

Although not expressly discussing any possible fiduciary relationship, the tribunal at [254] recorded the view that the trust placed in the medical practitioner by the patient creates an obligation on the medical practitioner to restrict his or her services to those which are reasonably necessary in the provision of therapeutic services to patients.