The New South Wales Medical Board policy on treating self and family

To the Editor: The most recent newsletter of the New South Wales Medical Board1 opens with a plea by the president for better understanding of the Board's initiatives, inspired by the "public interest".

We hope that the board recognises the gulf between legitimate public interest and unrealistic, illegitimate public expectation.

The newsletter goes on to justify the Board's policy against doctors self-prescribing, with six examples (hardly significant from a register of 25 000).

The first, Dr A, aged 70 (the only one whose age was given) was referred to the Board by colleagues for mental impairment, and was not self-prescribing. He was prescribed warfarin by his cardiologist, but also took aspirin. The other five were all involved with drugs of addiction, earning whatever sanctions the Board applied.

The newsletter then states that these were "ordinary doctors providing ordinary services in the community" (p. 3).1 They were certainly not, and it is this patronising assessment of the behaviour of ordinary doctors that is objectionable.

We are next told that "these dramatic examples represent the tip of an alarming iceberg" (p. 3).1 The Board has enough to do without plumbing the depths for imagined "icebergs", and should reconsider their policy on the alleged dangers of self-prescribing, a policy both unwarranted and unwanted.

The mocking adage that "doctors who treat themselves have a fool for a physician" is not made correct by repetitive quotation. There are not many fools in our profession, and sanctions applied to them should not affect the Board's assessment of the whole profession.

Although not mentioned in this newsletter, similar motives are apparent in the Board's disapproval of self-referral, where we are not credited with sufficient wit to discover for ourselves appropriate specialists for clinical referral.

All medical boards are currently seized with similar agenda. The Victorian Medical Board ponders the "problem" of retired doctors, with the comment in their newsletter on doctors affected by "increasing age and commensurate reduction in cognitive ability", another gratuitous observation without supporting evidence. They could as correctly, and more kindly, have referred to the accretion of clinical wisdom commensurate with age, but respect for seniors seems to have declining value in current professional ethics.