A trainee orthopaedic surgeon who shared graphic images of injuries, with commentary, to non-medical friends has been fined $5000 but not publicly reprimanded.
“KGY” committed the offences in 2019 when he was working as a principal house officer in orthopaedics at a major public hospital. Between June and August of that year, 12 times he sent various photos, videos and X-ray images to two women with whom he was in relationships.
A complaint to the Health Ombudsman followed, and in the Queensland Civil and Administrative Tribunal (QCAT) on 20 September, Judicial Member Murphy SC delivered reasons for the decision to fine KGY $5000 and not order a public reprimand.
Both parties agreed the conduct constituted professional misconduct but disagreed on the sanctions to be imposed.
The Health Ombudsman contended a reprimand should be given and recorded on the public register, while KGY argued a caution would suffice, pointing to the five-year-delay between the conduct and the determination, and the negative impact of a reprimand against him on the public register.
The images, sent via WhatsApp and text messages, included:
- an image of an abdominal CT of a person’s rectum with crass comments and two smiley face emojis overlaid;
- an image of a severe trauma injury to a patient’s hand, leaving only two remaining fingers with bony protrusion and blood with the words “Clap clap”; “Haha. Another day. It’s like chopsticks”; “Haha. I have more… But am about to go do something to it”;
- an image of a patient’s foot with trauma, necrosis or some other injury with an admission label affixed to the top of the foot and the message, “that’s my night. A foot that looks like pizza haha”; and
- images and X-rays of what appears to be a compound fracture with bony protrusion through the skin.
The tribunal agreed the conduct should be classified as professional misconduct because it fell below the standard expected of a doctor by the public and the profession.
“The subject conduct exhibits a flippant disregard for the pain and suffering endured by the individuals whose injuries were displayed,” Judicial Member Murphy said.
“It offends the standards of professional behaviour set out in the relevant Codes of Conduct, including, in particular, the obligations of doctors to practice with integrity and compassion.
“The unprofessional conduct is serious and represents a substantial departure from behaviour reasonably expected of a doctor with KGY’s level of training and experience.”
Judicial Member Murphy said the health and safety of the public was the paramount consideration in imposing sanctions, but specific deterrence was not a factor in this case.
He said the evidence showed KGY had no prior disciplinary history, was of good character (reflected in written references), had genuine insight into the appropriateness of his conduct; had co-operated fully with the investigation and made full and early admissions; and his subsequent conduct as a general practitioner had been exemplary.
The delay of five years between the offending and the hearing was due to an overwhelmed tribunal, and not attributable to any act or omission by KGY or those who represent him, he said.
Judicial Member Murphy said the consequences for KGY had been severe and ongoing. Following immediate suspension from his position, a likely future position at another hospital was not offered, and KGY was then unemployed for six months.
“KGY believed his goal of orthopaedic surgery would be shut off as a result of his conduct and the cessation of his contract. The practitioner members of this tribunal confirm that belief was well founded,” he said.
KGY retrained in general practice and has worked as a GP since last year. He also works at a fracture clinic at a public hospital.
“Documents before the Tribunal indicate that KGY has re-established himself as a general practitioner who has earned the respect of his peers and his patients. The Health Ombudsman accepts his “reflection, remorse and regret”,” Judicial Member Murphy said.
“The five years that have elapsed since the conduct can be seen to have been a period of rehabilitation and redemption for KGY.”
Other tribunal considerations included that no patient was capable of being identified, no patient records were accessed, no images were published to the web or wider public, and KGY had no relevant disciplinary history.
Judicial Member Murphy said a reprimand and the recording of it on a public register represented an unjust sanction.
“Delay is said to be punitive and cause an injustice to KGY because a five-year publication period would commence at a time when, had the matter been heard timeously, a then-imposed reprimand and consequent five-year publication period would now be coming to an end,” he said.
“Further, a five-year publication period resulting from a timeous order would see any rehabilitative efforts coincide approximately with the publication period – a circumstance concordant with a purpose of reprimand as a sanction.
“Conversely, the ‘public shaming’ aspect of a reprimand and its concomitant publication occurring now is inconsistent with the picture of a rehabilitated doctor held in high regard by his peers who speak highly of his caring concern for his patients.”
He said word of the conduct spreading quicky throughout the tight-knit medical community and its deleterious impact on KGY’s current and future employment should “be seen as a significant deterrent to other medical practitioners who might be tempted into conduct of a similar type”.
“The public can have confidence that misconduct is treated seriously, and the standards of the profession maintained, by reference to the dire consequences suffered because of juvenile conduct being treated properly as serious and judged to be professional misconduct,” he said.
“The tribunal is of the view, however, that the seriousness of the conduct and its disregard for the circumstances of the patients concerned should be underscored by the imposition of a fine.
“That, too, sends a general deterrent message to other practitioners and a message to the community at large as to the maintenance of standards. Unlike a reprimand, a fine, does not appear on the national register.”
No order was made as to costs.
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