Doctor found guilty of misconduct, fined after writing 282 prescriptions for herself, friends and family

A Hamilton doctor wrote 282 prescriptions for herself, family and friends - including medicine to help her go without a glass of wine each night.

Other medication included controlled drugs such as codeine, drugs that carried a risk of addiction or misuse such as the opioid tramadol, and psychotropic drugs for pain relief.

These included bimatoprost (for glaucoma), disulfiram (discourages drinking), domperidone (treats nausea and vomiting), fluticasone propionate (relieves nasal allergies), gabapentin (treats seizures and neuropathic pain), rizatriptan (for migraines), sertraline (an antidepressant) and tretinoin (for acne and other skin conditions).

The doctor, who has name suppression, wrote the prescriptions over eight years with the vast majority since 2020.

They included 197 to herself and 81 in her partner's name, despite being warned by the Medical Council in 2014 it was inappropriate.

She also wrote prescriptions for four friends for acne cream, according to an agreed summary of facts heard by a health practitioners disciplinary tribunal in Hamilton on Tuesday.

Doctors cannot prescribe to themselves, nor to family and friends, under Medical Council rules.

Counsel for the Professional Conduct Committee (PCC) Samantha Ward alleged the doctor, who is not a GP, also wrote prescriptions for a sedating antihistamine in her partner's name intended for her infant children.

The medication is not safe for children under the age of two because it has been known to cause hallucinations, convulsions, respiratory depression, coma and, in some cases, death.

It was the only aspect of the charges that the doctor disputed, claiming the liquid promethazine hydrochloride was for her to alleviate nausea in pregnancy.

But Ward said the timing did not match, because the doctor's first pregnancy was over and her eldest child was under one when she began prescribing it.

At the time the doctor was into the second half of her second pregnancy, a stage when it was more common for nausea to have abated, Ward said.

The fact it was a liquid version of the medication instead of tablet was also suggestive it was for the children, Ward said.

However, the tribunal decided while the rest of the disciplinary charge was established, that aspect was not.

The doctor only agreed she wrote a "back-pocket" prescription for antibiotics for the children in case they got sick while on holiday, and for vitamin D.

She told the tribunal she did not know she was not allowed to prescribe to herself and family, but Ward said the Medical Council informed her about this in 2014.

Only a month later she prescribed zopiclone, a medication to treat insomnia, for herself.

PCC counsel Robert Stewart said between 9 September 2014 and 31 January 2023, the doctor prescribed 282 times to herself and to people close to her.

Stewart said the amount of prescribing was not minor or incidental and disregarding the warning showed a cavalier attitude.

Much of the medication was not clinically indicated, meaning it was not needed, and was outside her scope of practice, he said.

"In doing so she exposed herself, and her family, to unnecessary risk to side effects."

The PCC submitted the actions showed a doctor who was struggling. Her health conditions are suppressed.

Stewart said she risked causing harm to herself and her family and the nature of medications prescribed for her partner indicated his health condition was not well-managed because of her involvement.

"She does not appear to appreciate the limits of her own competence, or that she is unable to provide objective assessment of her own condition or that of people close to her.

"She does not appear to understand why there are restrictions on doctors providing this kind of care to themselves or people close to them."

The doctor's early acceptance of wrongdoing the second time was a mitigating factor and there was no evidence she could not prescribe in the scope of her practice, he said.

Her counsel, Samantha Beattie, said the situation was "one of great shame and disappointment" for the doctor who had overcome several personal challenges.

Beattie said the doctor's competence was not in question and she had engaged in the Medical Council process.

Since then the doctor, who sat through the hearing alone and cried at times, had agreed to a voluntary undertaking not to prescribe and had complied with that.

Beattie said specific deterrence was unnecessary and the disciplinary finding would serve as a warning to the profession.

She said the proceeding itself had been significantly punishing and stressful.

"[She] has been so anxious, that she has felt unable to give evidence. She is aware she has let down herself and the profession."

Beattie submitted the doctor had shown insight into her actions, accepted liability and never tried to conceal her prescribing or act dishonestly.

She said the doctor was amenable to rehabilitation.

The doctor was found guilty of professional misconduct and the PCC submitted that protection of the public would be achieved through a censure, conditions on practice, a fine and contribution to costs.

The tribunal adjourned to deliberate penalty and the doctor's interim name suppression continues until publication of the full decision.