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Director of Proceedings v Dr Sean Parker - Chiropractor
Health Practitioners Disciplinary Tribunal, Chiro09/121D
and Chiro09/1331D
The Health Practitioners Disciplinary Tribunal found Dr Sean
Parker (chiropractor) guilty of two charges of professional
misconduct in relation to the care and treatment he provided two
consumers. The two matters were heard together and both proceeded
by way of an agreed summary of facts, with the prosecution calling
additional expert evidence in each case.
Dr Parker was promoting a "Deep Treatment programme" with an
upfront fee of $3,700. The contract he offered clients was contrary
to the NZ Chiropractic Board's Code of Ethics as it was not
tailored to meet the client's needs and not specific about the
number of treatments per week, how the cost was calculated, the
reasons for the treatment, the ability of a consumer to withdraw,
or the clinical necessity of the treatment. In both cases the
treatment he provided or recommended was clinically unjustified or
inappropriate to the client's condition.
In the first case Dr Parker faced five particulars with a number
of sub particulars all of which were upheld, including:
- failing to assess his client's presenting injury;
- failing to document his assessments;
- recommending that his client undertake a radiograph without any
supporting clinical reason;
- misrepresenting the seriousness of his client's condition;
- recommending his client enter into a prolonged course of
treatment that was not clinically justified and was contrary to the
Chiropractic Board Code of Ethics;
- failing to provide his client with sufficient information about
the prolonged course of treatment; and
- placing undue pressure on his client to continue with and pay
for treatment that was not supported by clinical findings and that
she did not want.
This case involved a woman who went to see Dr Parker for "tennis
elbow". She had no concerns about her back and had no history of
back pain or problems. However, rather than examine and treat her
tennis elbow Dr Parker sent her to have full spinal x-rays without
examining her. He then reviewed the x-rays and told her that she
had very serious back problems, needed immediate treatment and that
she had a "greater than 70% (severe) decrease in spinal curvatures
and decreased stability". Prosecution expert evidence, which was
accepted by the Tribunal, was that there was nothing wrong with her
back and that the proposed long term treatment was not clinically
necessary. The Tribunal considered Dr Parker's misrepresentation of
her condition to be the most serious allegation and a "gross
departure" from accepted standards.
When the client decided not to continue with treatment Dr Parker
put her under undue pressure to pay, attempting to appeal to her
fears and anxieties and emotions, and when this was ultimately
unsuccessful he commenced legal action to enforce the unethical
contract. The Tribunal considered that Dr Parker's conduct would be
viewed with "severe disapproval by peers".
The second case involved Mr E who entered into a finance
agreement promoted by Dr Parker, paying the $3,700 over a four year
period at 18.5% interest. Mr E had a serious neck and upper back
problem and surgery had been recommended by an orthopaedic surgeon.
Mr E wanted a second opinion as he was particularly fearful of the
potential risks associated with neck surgery. Dr Parker persuaded
him that surgery was not necessary and that he could fix his
problems.
In addition to finding that the treatment provided to the
consumer was not clinically appropriate and that the contract for
the prepaid treatment was unethical, the Tribunal also expressed
concern that the long term treatment plan raised safety issues, and
the longer it continued the greater the risk of Dr Parker
exacerbating the consumer's condition and delaying the receipt of
medical care. They also expressed concern about the financial
consequences of the programme on the consumer.
The Tribunal imposed a significant penalty on Dr Parker
including:
- 18 months suspension to be followed by 18 months supervision
with regular reports being provided to the Board followed by a
further 18 months of case load supervision - effectively imposing a
total of three years supervision on top of the 18 months
suspension.
- Conditions including that prior to recommencing practice he
undertake training and demonstrate competency to the satisfaction
of the Chiropractic Board in:
- fundamental chiropractic assessments and examinations;
- risks associated with the routine use of x-rays and the
appropriate assessments needed prior to ordering them;
- informed consent ethics and the provision of information to
clients;
- client-centred practice;
- ethical business practice for chiropractors; and
- ethics generally.
- He is also to provide a mental health assessment to the
Board.
- He was censured.
No fine was imposed due to Dr Parker's financial situation;
however, a small cost award of $5,000 was made ($3,000 for the
Director, $2,000 for the Tribunal).
The Tribunal's full decision can be found at: http://www.hpdt.org.nz/Default.aspx?tabid=266