Monday, August 20, 2007

ACCC strikes again

Doctors fined for breaching trading laws from The Australian, July 5 2007.
Doctors fined for breaching trading laws
July 05, 2007
TWO leading Adelaide heart surgeons have been fined a total of $110,000 for trying to stop a third surgeon operating on private patients in South Australian hospitals.
In a judgment handed down in the Federal Court today, John Knight and Iain Ross were each fined $55,000 and ordered to attend a compliance seminar after breaching competition laws.

In action brought by the Australian Competition and Consumer Commission (ACCC), Judge John Mansfield ruled that doctors Knight and Ross had come to an arrangement to hinder or prevent a colleague, Craig Jurisevic, from performing surgical services on private patients unless he underwent further training.

The judge said on six occasions between February 6, 2001 and March 9, 2001, Knight and Ross advised hospitals where Dr Jurisevic had wanted to work or surgeons who had been asked to support his applications, that he was insufficiently trained or had not completed his training.

This was despite Dr Jurisevic having been legally qualified and being admitted as a fellow to the Royal Australian College of Surgeons after completing the advanced surgical training program.

Judge Mansfield said Ross and Knight had also come to an arrangement with another surgeon, James Edwards, not to work at a hospital where he operated provided he did not work at a hospital where they performed surgery.

Judge Mansfield said the admitted conduct of Knight and Ross involving Dr Jurisevic stemmed from a decision by him not to take up an 18-month training position in Boston and to begin performing surgery on private patients in Adelaide instead.

"This upset Messrs Knight and Ross,'' the judge said.

He said it was not possible to determine the extent of loss suffered by Dr Jurisevic.

But he said the actions of Knight and Ross had raised barriers to other surgeons entering the Adelaide market.

"As a result ... newly qualified cardiothoracic surgeons in Adelaide were likely to consider they were, in effect, required to undertake further training, overseas or interstate, in order to practise as a cardiothoracic surgeon,'' Judge Mansfield said.

He said the result of this case should serve to ameliorate the impact of any such ongoing effect.

The judge said he also accepted that both Knight and Ross genuinely believed Dr Jurisevic needed more training and praised the two doctors for cooperating with authorities.

Their admissions had saved both the court's and the ACCC's time, he said.

In a statement Knight and Ross said their actions were motivated by concerns over patient safety.

"At all times, patient safety was very much in our minds,'' the surgeons said.

They also expressed concerns over the operation of competition rules on the medical profession.

"Whilst we recognise the importance of competition rules in the market place, we are concerned that the legislators have had insufficient regard to matters of patient safety in seeking to apply those rules to the medical profession,'' they said.

What bothers me about this case is how close a line we tread to breaking the law.

For example, doctors in Australia are not allowed to advertise their services. But when does marketing become advertising? How big an entry in the Yellow Pages is allowable? Is it OK to have a small sign outside your clinic, or a big sign outside your clinic, or a big billboard down the road?

When we give advice to each other about which areas are underserviced and would be better places to practise, is that inviting someone into a non-compete arrangement?

Judge Mansfield said the admitted conduct of Knight and Ross involving Dr Jurisevic stemmed from a decision by him not to take up an 18-month training position in Boston and to begin performing surgery on private patients in Adelaide instead.

...

But he said the actions of Knight and Ross had raised barriers to other surgeons entering the Adelaide market.

"As a result ... newly qualified cardiothoracic surgeons in Adelaide were likely to consider they were, in effect, required to undertake further training, overseas or interstate, in order to practise as a cardiothoracic surgeon,'' Judge Mansfield said.


Hang on, I thought that there was already an expectation that some form of post-fellowship training or experience was desirable. Perhaps this means I can cancel the PhD and the two unpaid overseas posts I had planned?

4 comments:

Milk & Two Sugars said...

Ah, but 'desirable' is not the same as 'required', is it? Do you think it's possible that the problem stemmed from Ross and Knight's inability to formally take action to prevent a surgeon they considered inexperienced and therefore dangerous from being allowed to take such a position? I'm not familiar enough with the College of Surgeons practices to know whether such an avenue was available.

Anonymous said...

The surgeon in question had several years as a trauma surgeon on top of his cardiothoracic training and had a Masters I Surgery in the field of cardiac surgery, so experience was never an issue, nor was patient safety.

Sheepish said...

You make a good point, M&TS. Ross and Knight may have felt that way for reasons apart from CJ's professional qualifications. There is no practicable means to limit someone's activity in private, as the whole point is that the market decides whether such qualities are a problem.

I have written a further post about my opinions on this.

Thanks for your insight, Anonymous. Please keep reading, and letting me know what you think.

me said...

lets not kid anyone people, JK's and IR's behavoir had nothing to do with patient safety concerns and everything to do with keeping the cash stream running in their direction only. These two have a long and unrelenting history of bad behavoir and greed. Grow up gents.