Age, deterioration & medical practice

Health Care Complaints Commission v Khan [2016] NSWCATOD 32 is a rather sad report on an action following the death of an 8 year old boy who died following delayed diagnosis of appendicitis.

The general practitioner was aged 77 at the time of the decision.Following an investigation into the circumstances of the practitioner’s involvement in the child’s death, and notification to him of a complaint by the HCCC about his treatment of the child and his records of the consultation, a Professional Standards Committee (the PSC) was convened. The members of the PSC were concerned about the practitioner’s presentation including the manner in which he answered questions. The PSC concluded they should adjourn their inquiry with a recommendation that the practitioner be assessed for impairment and for consideration of his capacity to practise medicine. The practitioner’s registration was suspended, and remained suspended at the date of the hearing: (see [5])

The impairment testing conclusions included that the cognitive trajectory with age and the cognitive reserve evident on present testing rendered the doctor very poorly equipped to competently perform the duties expected of a general practitioner: [105].

The practitioner conceded the various complaints were proven, and that an order could be made removing his name from the register: [12].

The tribunal commented at [111]:

We recognise that it is sometimes difficult for a health practitioner, particularly a doctor, who may be self-employed or an independent contractor, to objectively assess that the time has arrived when the health and safety of the practitioner’s patients dictates that he or she should retire from practice. But practitioners have a duty to put the health and safety of the public before their own needs and desires. This case is a poignant example of the need for support for practitioners facing competing priorities at the end of a long and often highly successful career.



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