A Perth neurologist has been found guilty of professional misconduct after he financially exploited an elderly patient with dementia and Parkinson's disease under his care.
Professor Peter Panegyres worked as a neurologist at his private clinic at Subiaco, the Neurosciences Unit of the Western Australian Department of Health and the Mid-West Country Neurology Service.
In 2009, he began treating a Paraburdoo man, aged in his 70s, for tremors.
As the Paraburdoo man's condition worsened, the patient was admitted to Joondalup Health Campus for ongoing hospital care in late-2012.
In a three-month period between November 2012 and February 2013, over 87 days, Professor Panegyres conducted 78 consultations with the patient, and charged him $25,265 - more than twice the recommended Australian Medical Association guidance fees ($11,135) for the services provided.
Each consultation, on average, cost $350, although limited records were kept about the nature of, or the reasons for, the consults.
During his time as a patient at Joondalup Health Campus, it was determined the man had become incapable of making reasonable decisions in relation to his medical care and financial affairs, and, because the man had no family members in WA, a public trustee was appointed in January.
The public trustee, Stephen Dennis, received the invoice for $25,265 around March 2013, and noticed Professor Panegyres had charged his client for every day of his hospital admission, except a two-week period over Christmas and New Year.
"Mr Dennis considered this to be unusual and excessive... he says he considered that (the patient) may have been taken advantage of and therefore he did not authorise the payment," a State Administrative Tribunal decision stated.
Mr Dennis subsequently submitted a complaint to the Health and Disability Services Complaints Office which led to the Medical Board of Australia alleging Professor Panegyres behaved in a way that constituted professional misconduct.
The board and Professor Panegyres were unable to agree on the misconduct allegations, and the matter was referred to the State Administrative Tribunal, which found the doctor guilty of professional misconduct on Tuesday.
The tribunal found the doctor had exploited the patient financially, provided and charged the patient for medical services which were not clinically indicated and were not all reasonably required for his well being, failed to obtain consent for the treatment arrangements from the patient's administrator, failed to keep adequate records of the services he provided the man and charged Medicare Australia for services he was not entitled to or that were not clinically required.
During the tribunal hearing, evidence was given by Victorian neurologist Professor David Williams, who described the number of consultations Professor Panegyres carried out during a three-month period as "excessive and unreasonable".
The consultations included cognitive assessments, ward rounds, phone consultations and family meetings and consultations.
The consultations were in addition to the everyday care of the patient by nurses and junior medical staff.
"There was so little change in the clinical status as documented daily by the junior neurology team during the admission that a consultation attendance every day was not needed," Professor Williams said.
"There is virtually no written evidence of the 81 consultations by the practitioner and an almost complete lack of documentation of changes in management of (the patient) made as a result of those attendances.
"There is little rational for repeating cognitive tests five days apart in order to guide therapy, given the nature of the presentation."
The tribunal will hear from both Professor Panegyres and the Medical Board of Australia before deciding on a penalty.
