18 JANUARY 2019
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NZT: Doctors, drugs of dependence and discipline: new review out
Only 24 doctors in 20 years have faced disciplinary action for inappropriate prescribing of drugs of dependence in
Aotearoa New Zealand, a new review has revealed. The review’s lead author says the low number probably reflects that
discipline is a last resort, which is fitting since drug dependence should be treated as a health issue rather than a
crime.
The review, which covers the years 1997-2016, is out today in the New Zealand Medical Journal. It also found that cases more commonly come to light via reporting from pharmacists (24 percent), rather than medical
colleagues, who only reported four (16 percent) of the cases.
Lead author Dr Katharine Wallis, from the University of Auckland Faculty of Medical and Health Sciences, says it’s not
surprising that the number of disciplinary decisions is low because, ideally, the majority of drug dependence cases in
health professionals would be handled by The Medical Council’s Health Committee, protecting both the public and the
doctors’ safety.
“Drug dependence is a health issue rather than a crime,” says Dr Wallis, a senior lecturer in the School of Population
Health and practising GP. “The very low number of disciplinary cases involving drugs of dependence suggests that
discipline is used as a last resort, which is the right approach.”
The review, co-authored by medical student Susie Middleton, analysed publically available decisions and found only 26 of
the total 236 disciplinary cases against doctors in the 20-year period involved inappropriate prescribing of drugs of
dependence. It was not clear that the drugs were for self-use, although it is likely the majority were, says Dr Wallis.
Most cases also involved other behaviour, such as sexual relations with patients and forging a colleague’s signature.
Disciplined doctors were mostly men (19, or 76 percent), working in general practice (19, or 76 percent) and older
(averaging 24 years in practice). Discipline often spelled the end of their careers.
Dr Wallis says the fact that pharmacists rather than medical colleagues were more likely to flag suspected problems with
authorities may be because the pharmacists were the ones filling the prescriptions, while medical colleagues were not
aware “perhaps because the doctors kept the issue hidden, or perhaps because they had become isolated in practice, or
because colleagues were unwilling to report”.
Her message to doctors: “By reporting your colleague, you can be helping them rather than harming them. If you think you
have an issue with drug dependence, seek help.”
ends