Case descriptions
Referral to a Committee
Dr Mark Mitchelson
General practitioner
Cairns Queensland
Medicare Australia was concerned that Dr Mitchelson’s prescribing under the PBS and his percentage and ratio of level B and level C surgery consultations may have been inappropriate. During the review period Dr Mitchelson rendered 9012 services generating $258,131.10 in Medicare benefits.
Dr Mitchelson was required to produce a sample of medical records for the Director to examine. The records were brief; they showed a high level of prescribing of narcotics with frequent failure to document the rationale and proposed management of patients on long-term narcotic therapy. Given the lack of history and examination findings the Director considered that another practitioner would experience difficulty in providing ongoing care for Dr Mitchelson’s patients.
A Professional Services Review Committee was established. The Committee found that Dr Mitchelson had engaged in inappropriate practice in 73 per cent of his MBS item 23 services and 83 per cent of his MBS item 36 services. The Committee found that Dr Mitchelson failed to satisfy the requirements of the relevant MBS item number, provided insufficient clinical input in connection with managing patients who were prescribed drugs of addiction, and initiated investigations in the absence of relevant clinical indicators.
During the course of its investigation, the Committee formed the opinion that Dr Mitchelson’s conduct had caused, was causing, or was likely to cause a significant threat to the life or health of a person. It therefore made a referral to the Queensland Medical Board in 2006 for further investigation.
The Determining Authority made a determination that Dr Mitchelson be reprimanded and counselled by the Director, repay $188,256.79 of Medicare benefits, be fully disqualified for six months and be suspended from prescribing under the PBS for six months.
Dr Mitchelson filed an appeal in the Federal Court. This motion was dismissed and PSR was awarded indemnity costs.