Medicopolitical

Skin cancer doctor in hot water over ‘unseemly shouting match’ with patient


A GP skin cancer clinic practitioner has been ordered to undertake classes in anger management and conflict resolution after he engaged in an “unseemly shouting match” with a patient over the result of a skin cancer removal.

The row apparently broke out after the GP performed a series of skin excisions last March to remove suspect cancers from the patient’s scalp and back.

Unhappy with their experience of the operation and the cosmetic outcome, the patient was booked a follow-up consultation several months later.

“Unfortunately… this appointment degenerated into an unseemly shouting match”, and the patient complained to AHPRA later the same day, the Victorian Civil and Administrative Tribunal said in a verdict handed down last week.

The tribunal said it wasn’t the first time.

In one incident back in 2013, he allegedly began “shouting and ranting and raving” at a patient, who had brought her 94-year-old father to have skin lesions removed and had raised the issue of him experiencing pain in a previous consultation.

The second four years later also involved an alleged inappropriate emotional reaction by the GP, triggered by the complainant’s husband taking a phone call during the consultation.

A third, also in 2021, concerned the GP’s response to a patient who presented for a skin biopsy on her forehead wearing make-up.

Conditions

Now with four AHPRA notifications under his belt, the GP finally had conditions placed on his registration by the Medical Board of Australia in April this year. These required him to undertake a course on “de-escalation techniques in response emotional and aggressive behaviours” and to prepare a reflective report.

But he took his case to VCAT, arguing he should instead be allowed to make a voluntary undertaking to engage an education provider to address the concerns.

This would have the same legal effect as conditions being imposed in terms of requiring a course of education, but would have less of an impact on his reputation, the GP argued.

He also claimed the board’s decision had been unfair because the patient had sworn at him, had behaved in a threatening manner during their argument, and had breached COVID-19 protocols.

“This is an unreasonably punitive decision by the board which effectively affirms and appeases the abusive behaviour of the complainant whilst humiliating and demoralising the medical practitioner,” he said.

“This goes against campaigns by multiple health professional bodies that abuse of medical staff is unacceptable.”

However, ultimately the tribunal sided with the medical board, which had argued the GP had failed to show the remorse and insight necessary to justify anything other than conditions being placed on his registration.

“Despite ultimately outwardly accepting that he needs to improve his patient communication skills, [the GP’s] written responses have tended to emphasise the unacceptable behaviour of his patients, inferring that they were really at fault in each instance,” it said.

“They tended to be dominated by commentary which was strongly critical of the patient, with the reflective content being brief and muted.”

It added that swapping the imposition of conditions with a voluntary undertaking would be “somewhat contrived”, given the late stage in the process and the similarity between the wording of each outcome.

“The circumstances tell against the undertaking being truly voluntary, the board said.

“In our view, his agreement to provide a voluntary undertaking is not reflective of an actual acknowledgement that he needs to undergo such education, but rather a desire to avoid what he sees as the significant adverse reputational impacts from conditions being imposed.”

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