A Victorian doctor who allegedly made racist and homophobic comments to patients has had restrictions imposed by the medical regulator paused, due to their “significant financial imposition” on one of the last bulk-billing clinics in his local region.
The Victorian Civil and Administrative Tribunal has suspended the requirement that Dr Tom Crawford be subject to 10 months of supervision at his Bendigo practice, which was imposed by the Medical Board of Australia last month.
He was also required to undertake “one-on-one” education and receive mentorship as a result of comments made during two separate consultations that the board alleged were homophobic and racist.
Vcat heard that Crawford, the sole practitioner at his clinic and who specialises in the treatment of skin cancer and skin issues, denied making homophobic, racist or inappropriate comments to patients. He has also sought a review of the Medical Board’s decision.
The tribunal heard that two notifications about Crawford’s conduct were lodged with the Australia Health Practitioner Regulation Agency last year.
The first involved a same-sex parent family for a consultation for their five-year-old son who had previously been diagnosed with autism spectrum disorder. The mothers alleged Crawford asked who “the natural mother was”, if they “even knew the father” and – when told the child was conceived with an anonymous sperm donor – said: “those people aren’t even screened that well”.
Vcat heard that when the parents were having difficulty getting their child’s consent to pull his pants down for the examination, Crawford allegedly said: “just pull down his clothes, I need to see his skin” and “look, your GP might have time to waste like this, but I don’t, I need to see it”.
The board described Crawford’s conduct as “homophobic” and said he “lacked disability awareness”.
In a written submission to the tribunal, Crawford said his comments were not homophobic, and were made to help him understand the history of a new patient.
He said the parents may have been offended by an “unintended slight” but that no concerns were raised with him.
In a separate incident, a patient with Māori heritage alleged that Crawford made comments about Māori people. That included an alleged comment suggesting New Zealanders with both European and Māori ancestry did not want to acknowledge their former because they want to claim Māori descent for government benefits.
It was also alleged that Crawford had spoken about a Māori friend who had been taken captive overseas, and then released because the captors thought he was native to that country.
But Crawford disputed any suggestion that he made racist remarks, with his saying the discussions were “an attempt to build rapport with the patient”. He said he “has an acute understanding of First Nations people from Australia and New Zealand and believes he is culturally sensitive when he provides care to all patients”.
In asking for the supervision condition to be stayed, Crawford’s solicitor, Russell Ball, told Vcat the cost of an external supervisor would be $6,000 to $6,375 a week, and could increase by $1,000 if they required travel from Melbourne, which he said was not financially viable for the practice.
Ball said Crawford saw 70 to 75 patients a week, including six long-term patients who would be affected if he was unable to practise.
In written reasons published on Wednesday, senior Vcat member Anna Dea said she halted the supervision and education requirements because they would “represent a significant financial imposition on Crawford”.
But she said the mentoring condition remained in placed until the application for review concluded.
“Crawford is one of the few remaining bulk-billing practices in the region,” Dea said. “Ball’s affidavit referred to a number of long-term patients who currently depend on Crawford for the management of their serious medical conditions.
“I accepted that evidence showed Crawford’s inability to practise (due to the challenge of finding and paying a supervisor as required by the supervision condition) may jeopardise the timely and well-informed treatment of those patients for many months and render the practice unviable.”
She said the evidence suggested there were “significant shortcomings” in Crawford’s “communication skills and capacity to understand his patient’s personal circumstances” but said it was in the “greater public interest” to allow him to keep practising.
“I reached that view with an expectation that Crawford would reflect carefully on the matters raised by the notifications, including with his mentor, and ensure his communications hereafter were consistent with what is expected of a practitioner with his experience and training,” she said.
Guardian Australia has contacted Crawford for comment.
A spokesperson for the Medical Board of Australia said it could not comment because the matter was before Vcat for a final review that is not likely to be listed until well into the second half of 2024.
