July 19, 2012
Dr. sanctioned for steroid prescriptions
An official investigation into anabolic steroid use on the Gold Coast has netted a long-standing GP, who inappropriately prescribed the drugs to 14 patients over more than nine years. Peter Grant, who faces sanctions, has practised as a GP in Queensland since 1985. In late 2009, Queensland Health cancelled his power to prescribe some classes of restricted drugs after the department investigated the GP’s practice of writing scripts for medications “for body building rather than therapeutic purposes”. Dr Grant’s activities came to light when the department conducted a state-wide audit of the dispensing of pseudoephedrine. At the same time, the department was conducting an ongoing investigation into anabolic steroid use in the Gold Coast area. Dr Grant agreed he had inappropriately prescribed medications to 14 patients at the Mermaid Beach Medical Centre, according to Queensland Civil and Administrative Tribunal deputy president Judge Fleur Kingham’s recent ruling. The earliest allegation dated back to February 2000, when Dr Grant took on a new patient. “In all he treated him for more than nine years, until April 2009,” according to Judge Kingham. “So (a patient) could improve his body physique [for body building purposes ] and his energy levels, Dr Grant prescribed a combination of drugs: Halotestin, Sustanon, Scitropin, Andriol Testocaps, Testosterone implants, Deca-Durabolin and Proviron [which are types of steroids]. “There was no therapeutic basis for prescribing these drugs to him. “In July 2007, he established the patient had low testosterone, which Dr Grant said was a well known side-effect of prolonged steroid use. He thereafter prescribed Sustanon on a weekly basis.” By February 2009, Dr Grant was prescribing steroids for 11 of those 14 patients. “By then, it is reasonable to expect that Dr Grant would have been known by members of the body building community as a doctor who was willing to prescribe steroids for body building purposes,” Judge Kingham wrote. In his affidavit sworn last month, Dr Grant believed he was not prescribing excessively. In response to a question from his counsel, he said he originally thought it was acceptable to prescribe what he did. Judge Kingham said Dr Grant was a reader of body building publications and preferred these as sources of guidance to “professional sources of information and guidance”. “He had a number of clients who competed. He also treated a cage fighter,” she said in her decision. “He told the tribunal he knew these drugs could be obtained via the internet. There was a risk that products bought this way might be impure, while those he prescribed were pure. “By prescribing to his patients, he was able to keep an eye on their physical health.” Dr Grant believed his patients were seeking the drugs for personal use. “Certainly, if Dr Grant prescribed these drugs with actual knowledge that he was contributing to a trade in steroids, the tribunal would view his conduct more seriously,” Judge Kingham stated. Dr Grant conceded a pharmacist had raised concerns that one of the GP’s patients was excessively using the drugs. The doctor’s explanation was that he was “too weak to say no” to the long-standing patient, which Judge Kingham believed demonstrated his “unprofessional attitude to his responsibilities as a medical practitioner”. Dr Grant and the medical board jointly proposed sanctions including a reprimand and conditions that would prevent the GP from dealing with these drugs. QCAT expressed its concerns about the adequacy of the penalty and declared it was “not appropriate” after taking several factors into account including that the conduct occurred over a “very lengthy period”. Judge Kingham made five orders. Dr Grant would be reprimanded and his registration would be suspended for 12 months. But the suspension would not take effect if Dr Grant fully complied with conditions imposed on his registration and was not the subject of further disciplinary action for two years. Dr Grant would be required to take a tertiary-level course on prescribing practices, and must not deal with the relevant drugs in any way or “seek the return of his endorsement to do so”. He must allow and pay for the board to audit his patient records, nominate a mentor to meet with monthly and provide a copy of the tribunal’s orders and reasons to his employer and mentor. Dr Grant would not apply to review the conditions within three years and would pay the board’s costs associated with these proceedings.