Testosterone prescribing brings professional misconduct verdict

By Michael Woodhead

20 Apr 2021

A doctor who co-founded a ‘peptide clinic’ and prescribed testosterone and supplements for supposed anti-ageing benefits has been found guilty of professional misconduct by a tribunal.

Dr John Hart, a GP and a co-founder of Peptide Clinics Australia, did not have the expertise or qualifications of an endocrinologist needed to prescribe testosterone, synthetic hormones and selective androgen receptor modulators (SARMs), the NSW Civil and Administrative Tribunal ruled.

The tribunal heard that Dr Hart used testosterone to treat patients based on an ‘Andropause questionnaire’ and if their testosterone levels were low according to a benchmark level of 12 nmol/l suggested by the International Society for the Study of the Aging Male.

But experts told the hearing that the this society was not an appropriate body to provide guidelines on testosterone prescribing, and noted that the Endocrine Society of Australia recommended less than 8.0 nmol/l for prescribing testosterone.

A report provided by Professor John Carter, a clinical endocrinologist, found that the assessment of patients prior to prescribing testosterone and other hormone supplements was inadequate, and did not include a detailed history or consideration of the possible effects on diabetes risk.

Some of the peptides provided by Dr Hart were synthetic analogues of growth hormone releasing hormone, but were not backed by any quality research on their efficacy and safety, said Professor Carter.

The multiple peptides and supplements supplied by Dr Hart included HCG, Insulin-like growth factor 1 (IGF-1 LR3), LGD-4033, Melanotan-II, Thymosin Beta 4, Follistatin 315, GHRP-2, GHRP-6, hexarelin and ipamorelin.

In complaints brought in relation to treatment of 29 patients, it was alleged that Dr Hart failed to provide appropriate care and treatment by prescribing certain with peptides and hormones “without an appropriate level of training”.

Professor Carter’s evidence was that the level of training required to prescribe the peptides should be equivalent to that of a clinical endocrinologist.

Other allegations included that Dr Hart kept inadequate clinical patient records, did not ensure adequate monitoring and communication with the patient’s GP, and failed to disclose a conflict of interest, namely that he received a rebate from various pathology and supplement providers he referred patients to.

In its decision dated 8 April 2021 the Tribunal found most of the complaints against Dr Hart proved and that his conduct amounted to professional misconduct.

The Tribunal will determine the appropriate protective orders at a further hearing.

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