GP reprimanded and has conditions imposed on registration for inappropriate prescribing

29 Mar 2021

A tribunal has reprimanded a Queensland general practitioner and imposed conditions on his registration for professional misconduct after he inappropriately prescribed performance enhancing medications to nine patients over a seven-year period.

The Medical Board of Australia (the Board) referred Dr Craig McCombe to the Queensland Civil and Administrative Tribunal, alleging he inappropriately prescribed performance enhancing and mitigation medications relating to body building to seven male and two female patients, aged between 21 and 38. Though the allegations dated from 2011 to 2018, they primarily concerned prescribing for four patients between 2016 and 2018. It was alleged Dr McCombe’s record keeping and documentation were also inappropriate.

The tribunal heard Dr McCombe provided a prescription in 2011 for Arimidex, ordinarily prescribed as a treatment for breast cancer but known to be taken by bodybuilders to reduce the side effects of anabolic steroids. The drug lowers estrogen levels in the body. He also issued two prescriptions in 2012 and 2015 for Tamoxifen, another breast cancer medication known to be used by bodybuilders to inhibit estrogen and increase testosterone.

The Board filed an amended referral in June 2020, with the parties largely agreeing on the facts of the matter and the nature of the conduct, but disagreeing on the number of conditions and appropriate period of suspension. The Board sought a six-month suspension while counsel for Dr McCombe argued a shorter suspension period was more appropriate.

In its orders dated 9 December 2020, the tribunal found Dr McCombe had behaved in a way that constituted professional misconduct, noting he inappropriately prescribed the medications in circumstances where he was aware the patients were seeking them for body building or performance enhancing purposes. Further, the tribunal found Dr McCombe did not maintain sufficient patient records. In doing so, Dr McCombe breached a number of sections of Good medical practice: a code of conduct for doctors in Australia.

The tribunal ordered that Dr McCombe be reprimanded and have conditions imposed on his registration. The conditions require Board approval for each place of practice and prohibit his access to certain medications related to those he prescribed inappropriately. The affected medications include but are not limited to androgenic anabolic steroids, human growth hormone and anti-estrogenic medications. The Board will review the conditions after 12 months.

Though the tribunal noted the seriousness of his conduct, it opted not to suspend Dr McCombe’s registration due to the, ‘exceptional efforts made by the respondent to demonstrate his remorse and insight.’ The tribunal took into account Dr McCombe’s early admissions about his inappropriate prescribing and prior to the hearing had undertaken education and mentoring initiatives, altered his practise of medicine to mitigate the risk to patients and had undergone two audits of his medical practice at his own expense.

Each party was required to bear their own costs of the proceedings.

The tribunal's decision was published on the AustLII website on 22 February 2021.