Drug addict GP still working

A drug addict doctor is still treating patients, despite twice having forged prescriptions to feed his addiction.

The public is not allowed to know the name of the doctor, who was allowed to keep practising in the rural North Island town after being convicted in court of similar drugs charges in 1999.

On that occasion, he lied to investigators, claiming the drugs were for his mother who had cancer.

Seven years later, the doctor pleaded guilty to charges of forgery before the Health Practitioners Disciplinary Tribunal, where last week he admitted professional misconduct. On Friday, he will hear if he is allowed to carry on working as a doctor.

His addiction in the town of 20,000 is an open secret, but he has once again applied for permanent name suppression to protect the identity of his wife and teenage children, who live in a nearby city.

Despite his drug habit, the doctor's competence has been cleared by an investigation, and he may keep his job because he is one of only two doctors in the area.

On February 3, 2005, the doctor wrote a prescription for himself for the drug dihydrocodeine tartrate continus, a controlled painkiller with a potency between morphine and codeine.

He wrote the prescription on his colleague's pad with a forged signature, before travelling to a nearby city to collect the drugs from a pharmacy two days later.

On February 8, a Medsafe control officer called the doctor's colleague about the prescription.

It is the second time the doctor has been caught forging signatures to get drugs, but the Medical Council of New Zealand has been aware of the problem since 1987.

The 50-year-old doctor has a history of drug abuse.

He immigrated to New Zealand in the 1980s and started using opiates when he became depressed.

Soon after he started practising in New Zealand, the Medical Council suspended his registration for four months after they discovered he was abusing drugs.

When he returned to work, he voluntarily restricted his right to prescribe controlled drugs.

In 1999, the GP became depressed and stole 26 prescription forms, and then forged a colleague's signature to get morphine and pethidine from a nearby city.

He used his mother's name on the prescriptions and told chemists that the opiates were to dull the pain of her cancer.

Convicted in a district court in 1999 and found guilty of professional misconduct by the health tribunal in 2000, the doctor kept practising in the town under more than 20 strict conditions that included:

* Consulting a limited number of patients each day.

* Seeing a psychiatrist on a regular basis.

* A ban on prescribing class B drugs.

* Attending Alcoholics Anonymous or Narcotics Anonymous.

* Total abstinence from alcohol and any other mood-changing drugs.

* Random urine and blood tests for three years.

However, the conditions were relaxed after three years, and the doctor fell back into old drug habits without the support network.

As one of only two doctors in the rural area, the doctor carried a heavy workload, and it is thought that stress of the job drove him to drugs.

His lawyer presented submissions from other doctors to the tribunal which stated that the area is "deprived" and does not have enough practitioners to cope with demand.

"Most of our patients are from lower socio-economic categories," said a doctor in a written reference.

"Their medical needs are enormous, but we have great difficulties servicing their needs, as we are very short of doctors."

Other submissions stated that no complaints had ever been made against the doctor, and his competence was not questioned after a thorough investigation.

However, there is only one other case in which a medical practitioner appeared more than once for the same offence - and that Christchurch doctor was struck off the medical register.

The doctor's lawyer argued that striking her client off was "an option of last resort", and the doctor could be rehabilitated.

She argued for a fine and for strict conditions to be imposed, and the tribunal is likely to make a decision on the penalty - and on name suppression - next week.

Of the 11,029 doctors registered with the New Zealand Medical Council, 168 have health problems, and 39 of those doctors have drug or alcohol problems. That number is up from 29 five years ago.

Professor John Campbell, the council chairman, said the public's right to know whether a doctor was struggling with an addiction conflicted with the doctor's right to privacy. In fact, Professor Campbell argued that the patients were more at risk if doctors feared being "named and shamed" because they would be more reluctant to seek help, putting themselves and their patients at further risk.

"Anything which impedes the council being advised of concerns about a doctor's fitness to practise has the potential to compromise public safety," he said.

Dr Jonathan Fox, president of the Royal College of General Practitioners, said that if patients had any doubts about their doctor, they should call the Medical Council.

Doctors working under imposed conditions are supposed to tell patients, but anyone can call the council or check an online register to make sure. If a doctor is found guilty of misconduct, Dr Fox said, the severity of the mistake and the circumstances should determine whether their identity is kept secret.

"We're a small country, we can't afford to lose them if we can rehabilitate them."

However, Dr Fox agreed that most studies showed that performance would be impaired by drug abuse. "Whether they're dangerous or not is a moot point," he said.