NEWS 7
Trimbow streamlined management : 2 † COPD ( 100 / 6 / 10 ) + severe asthma ( 200 / 6 / 10 )
ausdoc . com . au 12 JULY 2024
NEWS 7
GP in $ 24m inheritance case avoids suspension
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* Trimbow 100 / 6 / 10 & 200 / 6 / 10 are indicated for maintenance treatment ; in adults with asthma not adequately controlled with a maintenance combination of medium dose or high dose ICS / LABA respectively , and who experienced ≥1 exacerbation ( s ) in the previous year . Trimbow 100 / 6 / 10 is indicated in adults with moderate to severe COPD who are not adequately treated by ICS / LABA or LABA / LAMA . 1
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Dr Peter Alexakis pursued by reporter Pippa Bradshaw for
A Current Affair .
Dr Peter Alexakis argued no-one had been harmed by his conduct .
Heather Saxena “ TWENTY-four million inherited from a patient ? You must have one hell of a bedside manner .”
As Dr Peter Alexakis left his Sydney practice recently , a reporter from A Current Affair was waiting for him .
A few weeks earlier , Dr Alexakis had overcome — for the second time — legal claims by the Salvation Army that he had exploited his professional relationship with Raymond McClure , 84 , who left Dr Alexakis his house and 90 % of his residual $ 27 million estate .
As he was pursued down the street , the GP told the reporter to read the court judgements .
When the reporter referred to the Salvos , Dr Alexakis responded : “ Do you support child sex abuse within institutions ?”
This was a reference to the fact that Mr McClure had cited allegations of child sex abuse within the Salvation Army as his reason for cutting the charity from the will and favouring Dr Alexakis instead .
However , there was one more chapter in Dr Alexakis ’ seven-year legal battle .
Last month , he was found guilty of professional misconduct by the NSW Civil and Administrative Tribunal .
The tribunal reprimanded him and opted to place conditions on his practice , including a ban on nursing home visits and prescribing controlled drugs , as well as limiting him to seeing 36 patients a day .
Like the Supreme Court of NSW , the tribunal said it was not convinced that Dr Alexakis had exploited his professional relationship with Mr McClure for financial gain .
But it criticised his “ discourteous ” conduct towards Mr McClure ’ s hospital doctors and his failure to document “ important ” aspects of the millionaire ’ s treatment before he died from colorectal cancer in 2017 .
This included telling a geriatrician that it would be better if Mr McClure was moved to Concord Hospital .
He also “ assertively ” told a palliative care doctor to speed up a temporary discharge for Mr McClure .
The tribunal said the behaviour stemmed from his “ misguided concern ” for Mr McClure ’ s welfare .
It also found Dr Alexakis guilty over his prescribing of controlled medications for a different patient between 2008 and 2017 — the main basis for the professional misconduct finding .
Over 22 months , he had written 152 scripts for fentanyl or oxycodone for the patient , who had been shot in Afghanistan and had PTSD .
He also failed to refer the patient to a pain specialist during their nine-year therapeutic relationship .
The Health Care Complaints Commission argued that Dr Alexakis should be suspended because he had ignored red flags , such as other doctors in his practice refusing to prescribe controlled drugs to this patient .
It also argued that Dr Alexakis ’ inappropriate billing of 33 long consultations with Mr McClure of “ low-level clinical complexity ” pointed to a “ character defect ” that warranted suspension .
However , the tribunal rejected these arguments .
On the flip side , it rejected Dr Alexakis ’ argument that the impact of media coverage on him and his family meant it should impose lesser conditions , as well as his argument that no patients were harmed by his conduct .
‘ His remorse was palpable . There is no rational basis for doubting that it was genuine .’
It took him two months to act when Mr McClure ’ s haemoglobin levels dropped significantly , leading to the delayed diagnosis of his bowel cancer , the tribunal said .
“ Although there is no evidence that the practitioner ’ s delay adversely impacted [ Mr McClure ’ s fate ], the course of his illness may have been different if the practitioner had observed his stated usual practice .”
But it concluded that “ appropriate ” conditions would be enough to protect public health and safety .
“ His remorse was palpable . There is no rational basis for doubting that it was genuine ,” the tribunal said .
Dr Alexakis must work in a group practice with at least two other doctors and complete courses in palliative care and “ safe professional boundaries ”, among his other conditions .
He was ordered to pay 60 % of the commission ’ s costs .
Trimbow streamlined management : 2 † COPD ( 100 / 6 / 10 ) + severe asthma ( 200 / 6 / 10 )
†
The only pMDI PBS-listed for both COPD ( 100 / 6 / 10 ) + severe asthma ( 200 / 6 / 10 ) 2
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PBS Information : Authority required ( STREAMLINED ). Severe Asthma ( 200 / 6 / 10 mcg presentation only ). Chronic Obstructive Pulmonary Disease ( 100 / 6 / 10 mcg presentation only ). Criteria Apply . Refer to PBS for full information .
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Abbreviations : COPD : chronic obstructive pulmonary disease ; ICS : inhaled corticosteroid ; LABA : long-acting beta 2 agonist ; LAMA : long-acting muscarinic antagonist ; PBS : Pharmaceutical Benefits Scheme ; pMDI : pressurised metered dose inhaler . References : 1 . Trimbow Approved Product Information . 2 . Pharmaceutical Benefits Scheme ( PBS ). www . pbs . gov . au . Chiesi Australia Pty Ltd , Hawthorn East , VIC . 3123 , Australia . Tel : + 61 3 9077 4486 ; Fax : + 61 3 8672 0792 ; Email : medinfo . au @ chiesi . com . Copyright © Chiesi 2024 . All rights reserved . Date of preparation : May 2024 . AU-TRI-2400081 . CHIE00185C .