A former Wagga GP has had his registration suspended after he was found to have engaged in "improper and unethical conduct" while working in the city.
The NSW Civil and Administrative Tribunal this week handed down its findings against Phillip James Knowles after two complaints were lodged against him by the Health Care Complaints Commission (HCCC).
Dr Knowles - who worked as a GP in Wagga between 2003 and 2018 but has since left the city - was found guilty of professional misconduct because he did not conduct appropriate assessments, did not adequately record assessments and prescribed drugs of addiction to a drug dependent person without the proper authority.
The 70-year-old was also found guilty of unsatisfactory professional conduct for providing services that were not sought and making false claims for Medicare rebates for services that were not provided.
Both complaints were heard during a four-day hearing in March.
The most recent complaint, lodged in August last year, related to Dr Knowles' inadequate recordings of assessments with patients and his prescription of drugs, which included opioids and benzodiazepines in combination.
Dr Knowles told the tribunal he had since surrendered his right to prescribe drugs of addiction, and said the case had disclosed severe deficiencies in his medical record keeping.
The tribunal heard Dr Knowles reconstructed records, but he denied doing so in order to deceive.
The first complaint, lodged in August 2018, included the provision of counselling that wasn't sought or consented to.
A patient employed by Dr Knowles uncovered the inconsistencies after they accessed their own records to train another employee.
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The patient found Medicare rebate claims for services not provided, including for a care arrangement for a chronic or terminal medical condition when the consultation was for a flu shot.
The Medicare item numbers used attracted higher fees than that for a standard consultation.
Dr Knowles acknowledged he had difficulty complying with the Medicare Benefits Schedule but denied making false claims.
Another patient of Dr Knowles', who knew him as a customer at their restaurant, also complained.
According to documents, the GP accepted payment from the patient for Botox treatments by way of restaurant meals.
He also prepared a false mental health care plan, which wasn't asked for and was done in their absence using information obtained outside the consultation room.
The HCCC submitted the claims for consultations that did not occur were "clear and very concerning examples of improper and unethical conduct".
Coupled with poor record keeping and prescribing issues, it said the case for registration cancellation was "clearly made out".
Dr Knowles was suspended by the Medical Council of NSW in October 2018 but appealed in April last year and had conditions put on his registration.
The GP left Wagga last year and is now working under supervision at a group medical practice on the Mid North Coast. He said his current employment was "radically different".
In fighting a suspension, Dr Knowles submitted the "draconian action" of cancelling his registration was not required to protect the public or the reputation of the medical profession.
He said he wanted to continue working and the COVID-19 crisis meant he could be required should an outbreak occur on the Mid North Coast.
In making its determination, the tribunal said it was satisfied Dr Knowles was now practising medicine "in an appropriate manner and at an appropriate standard".
However, the tribunal stressed the findings in relation to his past conduct "draws him into a category of very unacceptable conduct".
The tribunal said providing counselling to two patients - in circumstances where neither sought it, neither were told a service was being performed and where they provided no consent - was a "fundamental breach of the doctor and patient relationship such that it amounts to the equivalent of performing an operation without consent or authority".
Dr Knowles' registration was suspended until April 16.
After that date, he will be subject to a number of conditions - including that all care plans and certain billings are reviewed monthly.
The suspension will take effect on August 10 to allow him time to hand over his patients.