Background facts
On 2 March 2015, the practitioner was consulted for a medical assessment regarding his suitability to continue to hold, possess and/or use a firearms licence. At this attendance, the patient provided the practitioner with a letter from the Queensland Police Service (QPS) which had advised the patient that his firearms licence had been suspended. The QPS letter indicated that the patient would require a medical report outlining his suitability to continue to possess and/or use firearms held under his licence, and also referenced an information notice stating that concerns had been raised in relation to his state of mind.
The practitioner said he was not shown the QPS letter.
During the consultation on 2 March 2015, the practitioner opened and reviewed past entries on his file. He noted that there were no recent concerns regarding the patient’s suitability to hold, possess and/or use a firearm, nor did the records contain any relevant alerts or warnings.
The practitioner undertook a screening test for cognitive impairment and a mini cog test. He assessed the patient for orientation, enquired about his mood and obtained a psychiatric history. On the basis of these, the practitioner had no cause for suspicion or doubt regarding the patient’s suitability to hold, possess and/or use a firearms licence. Consequently, the practitioner provided a medical certificate stating that he had no psychological or physical problems that would prohibit him from holding a firearms licence.
Following his consultation with the patient, the practitioner received a telephone call from QPS informing him that earlier that day, the patient had attended the Police Station and informed them of his delusions that Romanians were spying on him. Following his conversation with QPS, the practitioner changed his opinion and advised the patient was unsuitable to possess a firearm.
Tribunal findings
The practitioner admitted that in his consultation on 2 March 2015 he failed to have adequate regard to the QPS letter which, if he had reviewed, ought to have put him on notice that there were concerns regarding the patient’s mental health. He accepted his conduct amounted to unprofessional conduct in his assessment of the patient was inadequate and fell below the appropriate standard.
The Board’s Good Medical Practice: A Code of conduct for doctors in Australia relevantly provides:
8.8 Medical reports, certificates and giving evidence
The community places a great deal of trust in doctors. Consequently, doctors have been given the authority to sign a variety of documents, such as death certificates and sickness certificates, on the assumption that they will only sign statements that they know, or reasonably believe, to be true. Good medical practice involves:
8.2.2 Taking reasonable steps to verify the content before you sign a report or certificate ….
The Tribunal found it was inappropriate for the practitioner to rely solely on the medical history as reported by the patient in order to inform clinical observations about the patient’s mental health. The practitioner should have undertaken a more comprehensive medical assessment, or referred the patient to a specialist for further assessment.
The practitioner was reprimanded and had conditions imposed on his registration.
To read the decision in Medical Board of Australia v Kanyowa [2016] QCAT 450, click here.
