GMC's full verdict

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                                    Dr Sarah Barbara MYHILL (2734668)
                                  Interim Orders Panel – 29 April 2010

Dr Myhill: The Panel has considered all the information presented. It has taken account of the submissions made on behalf of the GMC and those made on your behalf. On behalf of the GMC, Mr Summers referred to two complaints. The first complaint was made by a group of general practitioners regarding your suggested management of a patient with a neurological disease. The second complaint related to the content of your website. Mr Summers submitted that an order for interim conditions was necessary in all the circumstances.

Mr Macdonald, on your behalf, submitted that no order was necessary and that the concerns raised were unfounded, particularly in light of the large number of testimonials, supportive of your practice. It has noted your evidence to the Panel that you deny the allegations, and has taken into account your concerns raised regarding the accuracy of the GMC’s case.

The circumstances surrounding this case relate to concerns regarding your clinical and professional practice, and concerns regarding your website, your promotion of treatments and consequently your potential failure to recognise and work within the limits of your competence. At all times, a doctor is responsible for ensuring their own good medical practice, and it is their responsibility to practise safely and in accordance with the requisite guidance.

The Panel has determined that in accordance with Section 41A of the Medical Act 1983, as amended, it is necessary for the protection of members of the public and in the public interest to make an order imposing the following interim conditions on your registration for a period of 18 months, with effect from today.

1. You must not prescribe any prescription only medication, as detailed in the British National Formulary;
2. Within 14 days of today’s hearing you must ensure that in relation to your website, or any website relating to your medical practice or business, all pages, downloadable content, including documents, forum or discussion board content, or other references or online media relating to the following subjects must be removed:
a/ The medical management of cases relating to cardiology, or cardiovascular disease including; chest pain due to ischaemic heart disease; acute coronary syndrome; heart failure; or pulmonary embolus.
b/ The treatment of asthma;
c/ The treatment, testing, identification, diagnosis or management of breast cancer;
d/ The use of hormonal contraceptive medication;
e/ The pharmacological management of primary or secondary prevention of vascular disease;
f/ Any immunisation or vaccination;
3. You must obtain the approval of the GMC before accepting any post for which registration with the GMC is required;
4. You must inform the GMC if you apply for medical employment outside the UK;
5. You must inform the following parties that your registration is subject to the conditions, listed at 1 to 4 above:
a/ Any organisation or person employing or contracting with you to undertake medical work; and
b/ Any prospective employer or contracting body (at the time of application).

In reaching its decision the Panel first considered whether it was necessary for the protection of members of the public, in the public interest, or in your own interests to impose any interim order. It is not the Panel’s purpose to test the veracity of any information put before it. It has reminded itself of the test it must apply and of its nature, function and powers, as well as its duty to consider each case on its individual merits. The Panel’s function is not one of fact finding and the Panel must impose the order it determines necessary notwithstanding any potential for loss or hardship.

In considering the protection of members of the public and the public interest, the Panel is concerned by the allegations made and is satisfied that, if substantiated, your actions could indicate a potentially serious limitation on your insight into your fitness to practise and the consequences of your actions, particularly for vulnerable people who may be accessing your website. As a consequence if the allegations are proven your behaviour could have an adverse effect on the confidence and trust that the members of the public are entitled to place in the profession and its practitioners.

The Panel was concerned that some of the information contained within your website may indicate that you are practising outwith your area of expertise and therefore are potentially putting patients at risk by providing misleading or inaccurate information. The Panel was also troubled that on the basis of your statement and evidence today, you may lack insight into the issues raised by the GMC. In considering the GMC’s document Good Medical Practice the Panel has borne in mind that it is a fundamental Duty of a Doctor to recognise and work within the limits of your competence. Furthermore, the Panel notes that, as a doctor, if you publish information about your medical services you must make sure the information is factual and verifiable.

Accordingly, the Panel is satisfied that there is sufficient information before it to indicate that there may be impairment of your fitness to practise and that such impairment may pose a real risk to members of the public, and may adversely affect the public interest. You are a registered medical practitioner and are expected to behave in a manner that justifies the public trust in the profession and its practitioners at all times.

Having determined that an interim order is necessary, the Panel then went on to consider if an interim order for conditions would be workable, practicable, sufficient and appropriate. In all the circumstances, the Panel is satisfied that a restriction, by way of interim conditions, is appropriate and sufficient, to guard against the risk that your actions potentially have for patients, the public, and the public interest. The public interest includes not only upholding and declaring the appropriate standards of professional behaviour, but also maintaining trust in the profession. Trust is crucial to the doctor/patient relationship.

The Panel is required to consider for what duration an interim order is necessary. The Panel notes that there are a number of issues to investigate and that the GMC’s final consideration of your case may take some time. Therefore, it is necessary to impose the above conditions on your registration for a period of 18 months. In doing so the Panel notes that the order will be reviewed within six months, or earlier should circumstances surrounding your case change.

The Panel has taken account of the issue of proportionality in that it must act in a way which is fair and reasonable. Whilst it notes that its order restricts your ability to practise medicine, the Panel has determined that, given the nature of this case, imosing conditions on your registration, at this time, is a necessary and proportionate response to the risks posed by you practicing medicine unrestricted.

Notification of this decision will be served upon you in accordance with the Medical Act 1983, as amended.