Dear colleagues,
I am sending you my story of dealing with AHPRA.
If this story will get your attention, I will provide more data, including correspondents and email exchanges to you.
I have been communicating with the both the West Australian and National branches of AHPRA for more than a year now, attempting to have my registration renewed – with no result, no clear plan and no proof or evidence of any wrongdoing or error on my part. I have serious concerns about AHPRA independence, decision-making ability, professional judgement and bureaucratic processes and I feel that AHPRA needs a serious reforming process. If you would like, I will share some ideas on the AHPRA reforming.
The details of my case are as follows.
My home residence in in Melbourne, however throughout 2018 and 2019, I regularly flew to Perth to perform cosmetic procedures through the Cosmetique Clinic in Subiaco, owned by Dr Vivek Eranki.
In September 2019 I had a call from a staff member at AHPRA’s Perth office, informing me about the decision to start a formal investigation based on two patient complaints of post-procedure infections/wound breakdown at the Perth clinic I worked at
I was understandably shocked and concerned for my patients and immediately agreed to comply with any and all due investigative processes. However, given that feedback from my patients had been, to date, overwhelmingly positive, I do recall feeling somewhat suspicious about the authenticity of the complaints and I recall asking directly if the complaints had been made by a plastic surgeon – it is well known in medical circles that many plastic surgeons unfortunately consider cosmetic surgeons to be direct competitors for the same or similar business. Some plastic surgeons are in fact openly and even publicly hostile towards cosmetic surgeons under the same tired guise of ‘protecting the public’. This is the reality of working in an increasingly popular and of course potentially lucrative area of medicine and many of my colleagues, in a range of disciplines, are hyper-aware of the ongoing possibility of vexatious complaints from aggressive competitors. For example, I know of several other similar complaints made – by cosmetic doctors about cosmetic registered nurses, by physiotherapists about podiatrists and vice versa – it is tiresome and almost endless.
My question was of course hurriedly brushed aside by the AHPRA staff member at the Perth office. To this day, I still have no idea how AHPRA determines the validity of complaints by private practitioners who are running competing businesses and obviously primarily concerned with their bottom lines – not patient safety or care.
I was advised to organise legal representation for the investigation, which I did. This was extremely expensive however I genuinely believed that a proper and thorough investigation would make it clear that I had not been responsible for any harm nor had I failed in my duty of care to my patients. As requested by AHPRA, I procured the relevant medical records from the clinic for AHPRA and answered everything I was asked, honestly and to the best of my ability, in a timely and cooperative manner.
During this time, I discovered that the investigations arose from complaints made by two patients about post-operative wound infections/wound dehiscence, following the same liposuction and abdominoplasty procedures (colloquially known as a ‘tummy tuck’). Both patients’ clinical notes at their review appointments revealed that their wound complications occurred more than a week following the procedure. Importantly, the clinical notes showed that both patients had been non-compliant with their post-operative instructions. The risks of non-compliance with recommended post-operative care is very carefully discussed with patients at their initial consults and reinforced with them at each review. Additionally, patients also signed a consent, affirming that they agree to comply with these instructions and that they understand the potential consequences if they do not. Wound infections and dehiscence are typical examples of such consequences.
Throughout the investigation, I was forced to spend considerable time and money, trying to comply with AHPRA’s investigation and give them the answers they apparently sought. Unfortunately, it also emerged that both patients had made false allegations about the procedures themselves, namely
- – that the procedures had been done under general anaesthesia
- – that the procedures were done under intravenous (IV) sedation, and
- – that the procedures were done without informed consent.
These allegations were easily proven false by the clinical records however this evidence was apparently completely ignored – despite the complete lack of evidence of any harm caused to the patients, or even any wrongdoing on my part, on the 7th of November 2019, the West Australian state branch of the Medical Board provided notice in writing that it had made a decision to suspend me as a health practitioner with immediate effect, citing ‘concerns’ about my ‘practice as a whole’ and their belief that I represented ‘a serious risk of harm to the public’. No clear reason was given for this – the patient’s post-operative wound issues as well as the abovementioned false allegations were repeatedly cited as ‘reasons’ for the my suspension. Furthermore, no acknowledgement of the fact that the patients’ own actions had contributed to their infections was given.
Furthermore, I was informed by AHPRA that I was banned from communicating with any of my patients. Inexplicably, I was also informed that my suspension included a ban on my PhD work as well as on work with my medical technologies company, Endogene Ltd. This caused enormous problems – I was unable to continue my work with conducting clinical trials, my ongoing research and my development of new technologies. Many, many people were adversely affected by this decision and it will take years to rectify the damage.
All this over two cases of now-resolved infection.
Every time I tried to understand this decision and asked repeatedly why the evidence I had provided had led them to this conclusion, no explanation was given.
By this stage, I was extremely concerned about the independence of the process and the likelihood of a fair outcome. I was also fielding a number of queries from my clinics about when my patients would be able to see me and continue with their treatment plans. I was advised by my lawyer that offering concessions and restrictions to my medical practice would help to expedite what could be as much as a 6-9 month process.
The issue progressed to mediations and hearings where the same false allegations were repeated as were the ‘concerns’ from both the Board and AHPRA. No evidence was ever given for these ‘concerns’.
Nonetheless, throughout this period, I made constant attempts to offer any sort of concession that would allow me to get my registration back – for example, early on, I noted that the initial complaint arose from two cases of post-operative wound infection following the same procedure colloquially known as a ‘tummy tuck’. Despite the clear evidence that
both patients had been non-compliant with their post-operative instructions, I offered to stop undertaking any tummy tuck procedures, anywhere in Australia, pending the Board’s full review of the two patient complaints.
I even offered to cease performing any substantial cosmetic surgical procedures, including procedures that I had undertaken without issue and had never once been the subject of the complaints on which I have been summarily suspended. I offered to only undertake minor procedures, such as those undertaken by cosmetic nurses, ie ‘injectables’. pending the Board’s review of the complaints.
The Board never engaged with my proposed terms, other than to simply reject them. No counter-offer nor any alternative proposed terms were ever received from the Board in response to my proposals.
At this point, it was hard to avoid the conclusion that there was no intention whatsoever to return my registration at any time in the future. I find it interesting that in a court of law, lack of evidence, such as false allegations, would be taken seriously and seen as grounds to dismiss a case. AHPRA and the Board appear to believe they can operate outside the law and with complete disregard for its well established standards, such as ‘innocent until proven guilty’. I was treated as automatically guilty – the evidence provided during the investigation and the ensuing hearing and mediation sessions was completely ignored. It was as if something now had to be found, to justify the investigation in the first place.
Notably, at the hearing, my original suspicions were confirmed – ie, that the complaint had been solicited and actively encouraged by a
plastic surgeon who operated a practice less than 400 metres from my own workplace in Perth Again this was not seen as concerning
At this point, it was hard to avoid the conclusion that there was no intention whatsoever to return my registration at any time in the future. I find it interesting that in a court of law, lack of evidence, such as false allegations, would be taken seriously and seen as grounds to dismiss a case. AHPRA and the Board appear to believe they can operate outside the law and with complete disregard for its well established standards, such as ‘innocent until proven guilty’. I was treated as automatically guilty – the evidence provided during the investigation and the ensuing hearing and mediation sessions was completely ignored. It was as if something now had to be found, to justify the investigation in the first place.
Notably, at the hearing, my original suspicions were confirmed – ie, that the complaint had been solicited and actively encouraged by a plastic surgeon who operated a practice less than 400 metres from my own workplace in Perth. Again, this was not seen as concerning or even remarkable by AHPRA or the Board. This suggests that vexatious complaints must happen constantly and/or that AHPRA does not think them worthy of consideration.
One of the worst consequences of the hearings was a sensationalist, highly critical and completely inaccurate article, written by journalist Josh Zimmerman that appeared in the West Australian newspaper on 17th December 2019. Mr Zimmerman never once bothered to contact me, as is required by law, for a fair and balanced article – his intention all along was clearly to write a hit piece. I am unsure why or how he even got wind of the proceedings in the first place and I am unfamiliar with whether similar slanderous articles are par for the course with these situations. If so, that is extremely concerning. If not, why was I singled out?
This article was then repeated in a number of other publications, versions of which are still almost the first thing to appear when anyone does an internet search for my name. In it, my income was reported (falsely), my Russian nationality was mentioned disparagingly and it was strongly implied that I was a dangerous, incompetent and money-obsessed doctor. I have practiced medicine and surgery without issue for over 30 years, 20 of which have been in Australia and I have never ever been the subject of such scurrilous treatment.
Predictably, the article completely decimated my professional and personal reputation. Several of my colleagues in Melbourne were sent threatening anonymous emails and my young children were teased and bullied at school. Most outrageously, I was informed that there could be no legal recourse for the utterly devastating effect of the article on my life – the journalist had just been ‘doing his job’ and reporting on the hearing. Perhaps he too thought he was ‘protecting the public’.
I also find it astonishing that there seems to be no insight into or awareness of the real life consequences of AHPRA’s decisions. All I’ve had to date is some fairly pointless and patronizing assurances from Michelle Quilty – my assigned case manager – that she ‘appreciates how difficult this is’.
Michelle Quilty has also admitted in writing that she accepted false evidence that the Perth clinic I worked at did not keep copies of their patients’ clinical records. She genuinely seemed to believe that I somehow kept the patient notes with me at all times and that the clinic had no access to these notes (I can produce these communications from her on request). This represents not only a serious lack of judgement on her part but a complete unfamiliarity with standard clinic practices – I don’t know of any clinic that doesn’t maintain their patient records. Furthermore, it is a legal requirement for clinics to maintain patient records for several years after the fact. How on earth could an apparently senior AHPRA staff member be so ignorant as to not know this and worse, make decisions about my case that are based on false evidence? Completely unsurprisingly by this stage, there has been no acknowledgement of this error by Michelle or indeed any of her colleagues. I was however sent an earnest letter by another West Australian AHPRA staff member, trying to reinforce to me how hard she was working and what a great job she was doing.
My ban on contacting patients coupled with the negative press publicity led to the perfect storm. Patients who were unable to contact me started doing internet searches for my name – and of course were confronted by various versions of the original West Australian article. Unsurprisingly, there followed a number of other complaints, all requiring their own investigation period of ‘six to nine months’, according to AHPRA.
It became clear to me that this would be an impossible situation for me. Hence, despite eventually achieving a stay of the suspension, by this stage, my capacity to work within Australian clinics or obtain professional indemnity insurance was gone. The expense of the proceedings had crippled me financially and the damage to my professional reputation was absolute.
Furthermore, I was told that in future, I would need to organize a particular practice software all my workplaces, at my own expense, so that AHPRA could scrutinize my patient records. No timeframe was put in place for this, nor for the remainder of the investigation. I was even told I would be liable for the Board’s expenses.
In light of the above, I made the decision to leave Australia in December last year to accept a position as a plastic surgeon in Russia, where I am currently working until such time as I can return home to my family in Australia and attempt to rebuild my life and career. Bizarrely, in March I received an email from AHPRA, asking for my assistance as a doctor during the impending the Covid 19 crisis. I started writing emails, reaffirming my willingness to assist in any way possible – with no luck. There are clearly serious issues with communication between different AHPRA branches and staff.
Even more frustratingly, it was reported in the ABC news on April 1st that AHPRA had put out the call to retired nurses, doctors and pharmacists to assist with the Covid 19. Newly-qualified health care professionals were even having their registration fast-tracked. https://www.abc.net.au/news/2020-04-01/retired-nurses-doctors-pharmacists-recalled-to-fight-coronavirus/12109608
My registration was not returned.
All this from two cases of infection. I respectfully submit that if the AHPRA and the Board were to suspend cosmetic surgeons on the basis of post-operative infections, there would be no cosmetic surgeons left. Perhaps that’s what plastic surgeons are hoping for.
It is respectfully submitted that whilst it’s obviously essential to have a national regulatory body to protect patients from unprofessional and dangerous medical practitioners, AHPRA and the Board’s power in these situations is absolute and, as such, should be exercised with extreme care.
Throughout this entire fiasco, there has been no real insight from AHPRA or the Board into
how much their decisions can directly impact the lives and reputations of individual professionals, as well as lives of their
patients. Instead, AHPRA have simply constantly reaffirmed their independence and their position that they are’ protecting the public’. If you honestly believe you are ‘protecting the public’, I suppose no amount of investigation would be too much. What a broad, overarching and utterly corruption-inducing objective that is. I despair when I think of how much money, from both the public purse and practitioners’ annual fees, must be wasted in AHPRA’s overzealous crusades to ‘protect the public’.
In conclusion, I can only reiterate that this whole situation resulted from two cases of infection. I wouldn’t believe it if it hadn’t happened to me.
I have repeatedly asked (and in some cases, demanded) that AHPRA staff return my registration to me immediately so that I can return to Australia and start rebuilding my life. I genuinely believe they are now deliberately taking as long as possible to complete their ‘investigations’ as punishment for this. Worse still, they appear to believe it is acceptable for them to do so.
I am currently receiving legal advice about this catastrophic situation and have been advised that, should I choose to pursue it, I have a very strong case for compensation – this of course, will take several years.
In desperation, I wrote to the CEO almost 5 months ago and was referred to their internal complaints department. Since then, there have been several delays and requests for ‘more time’ to review my situation and now, no further communications. It is clear that they have no interest in self-regulation or criticisms of their own processes.