Case descriptions
Referral to a Committee
John Frederick McKenzie
General practitioner
Matraville New South Wales
Medicare Australia asked PSR to review Dr McKenzie’s provision of services in relation to level C and level D surgery consultations, initiation of pathology, initiation of diagnostic imaging, and prescribing under the PBS.
During the review period Dr McKenzie rendered 3673 services to 782 patients for $160,372.95 in Medicare benefits.
The Director considered that the medical records he examined were brief and lacking in clinical detail. They did not contain adequate health summary sheets and the brevity of the clinical notes would create difficulties in providing ongoing care of the patient by another practitioner. The records also reflected frequent prescribing of oral steroids and nandrolone decanoate with frequent failure to document the diagnosis, rationale and proposed management.
Dr McKenzie was referred to a Committee for further investigation. The Committee found Dr McKenzie engaged in inappropriate practice in connection to 73 per cent of MBS item 36 services and 73 per cent of MBS item 44 services. The nature of the Committee’s findings and views were that Dr McKenzie:
- failed to provide an appropriate level of clinical input to the services because he failed to perform adequate examination or assessments with respect to presenting complaints, failed to implement adequate management plans and failed to take detailed patient histories to explain the reasons the patient presented for treatment
- did not satisfy MBS requirements for the rendered services
- used MBS item 36 and 44 in circumstances when the clinical content and the time required to address patients’ presenting complaints did not warrant their use
- on some occasions did not satisfy the requirements for prescribing pharmaceutical benefits under the PBS
- on some occasions provided pathology services that were not necessary
- failed to keep adequate and contemporaneous records as required by section 82(3) of the Act.
During the course of its investigation the Committee formed the opinion that Dr McKenzie’s conduct had caused, was causing, or was likely to cause a significant threat to the life or health of a person. Dr McKenzie’s conduct was therefore referred to the New South Wales Medical Board in 2005.
The Determining Authority directed that Dr McKenzie be reprimanded and counselled by the Director, repay $36,831.83 in Medicare benefits and be fully disqualified for one month.