A junior doctor has been reprimanded for inappropriately prescribing hormones while working in an “anti-ageing clinic”.
Dr Bassam Abi Haila prescribed testosterone and hGH Somatropin to a number of men at a Victorian clinic over approximately nine months to January 2014.
During this time he was in his third year post-graduation working as a medical registrar with no Medicare provider number, the Victorian Civil and Administrative Tribunal heard
He worked at the clinic one day a week, whilst at the same time being a medical registrar at Box Hill Hospital.
The tribunal had considered slapping Dr Haila with “professional misconduct” findings over his failure to properly manage certain patients and his clinically unjustified prescribing.
In several cases he prescribed testosterone to patients whose pathology results did not suggest testosterone deficiency. In others cases he prescribed testosterone where he was aware of a patient’s misuse of anabolic steroids, and another where he could not rule out Klinefelter’s disease.
But in its decision the tribunal ultimately opted for a lesser finding of “unprofessional conduct” taking into that his behaviour was “not at the extreme end of irresponsible prescribing”.
The mitigating factors included that he had not prescribed without seeing patients, had obtained initial blood test results and prescribed low starting doses.
“Despite the pressures he was under from the expectations of the clinic owners and the patients referred to him, he refused to prescribe to a number of patients,” the trio of tribunal members said in their ruling.
“He recognised the pressure he had come under and eventually left the clinic”.
The tribunal ordered Dr Haila undergo education in off-label prescribing and five one-hour mentoring sessions, something which the junior doctor contested.
It also described having lingering concerns about Dr Haila’s attitude, who had demonstrated a “failure to recognise that he was well outside the limits of his training and experience and out of his depth,” the tribunal said.
While he had some experience in endocrinology from his hospital work, this was not sufficient for him to prescribe hormone treatment without obtaining specialist opinion from an endocrinologist or andrologist.
“We were also concerned about Dr Abu Haila’s continued justification of his prescribing practices…which indicated a lack of genuine remorse in our view.”
“He gave us a strong impression of a lack of understanding of the clinical inappropriateness of the prescribing and an apparent inability to properly evaluate the evidence concerning the prescribing of testosterone and human growth hormone to adult patients with hormone levels within the normal range.
The tribunal recommended that mentoring conditions be placed on his registration.