An outback doctor who suggested sex with a patient after examining his genitals, and had sex with a different patient soon after treating his wife and step-daughter has been suspended for three months. General practitioner Dr Biljana Nikolova-Trask, from Broken Hill in NSW, has had her medical registration suspended for three months from January 1 and ordered to study medical ethics, having also provided medical advice and blood test results via Facebook.
The Health Care Complaints Commission (HCCC) heard that Dr Nikolova-Trask, who started working in Broken Hill in 2004, had a “close personal relationship” with a man, known as Patient D, and often sent him text messages early in the morning or late at night. In August 2009, Dr Nikolova-Trask conducted a genital examination on Patient D and, after the appointment, suggested that he transfer to another doctor because there was a possibility they would start a sexual relationship. Despite some evidence that Dr Nikolova-Trask stayed over at Patient D’s house and suggested to friends they had sex, both denied their relationship turned sexual.
A year earlier, the doctor struck up a friendship with a woman known as Patient B and started treating her husband and daughter in late 2009. The doctor often shared personal details of her life with Patient B through private messaging on Facebook and was a regular customer at her local business. While on a beach holiday in early 2010, Dr Nikolova-Trask socialised a few times with Patient B and her husband, Patient A. By April 2010, the doctor was in “regular and frequent” contact with Patient A, shortly before he told his wife their marriage was over. Dr Nikolova-Trask and Patient A said they began a sexual relationship in June 2010, and began living together in September. She continued to treat him and issue prescriptions until February 2011.
The doctor conceded her conduct with Patient A was “unsatisfactory professional conduct” and “professional misconduct” from June 2010. In a judgment handed down last month, the Health Care Complaints Commission agreed with Dr Nikolova-Trask’s admission. It also found she “engaged in improper conduct” with Patient D, in continuing to treat him while they had an intimate personal relationship, even if it was not sexual.
That conduct alone was not serious enough to have justified the doctor’s suspension, the HCCC said. The HCCC said that while Dr Nikolova-Trask’s conduct of concealing her close relationship with Patient A from his wife and her long-term friend, Patient B, may have been morally wrong, it was not misconduct. The judgment referred to a previous case to explain why a sexual relationship between a doctor and a patient is inappropriate. “The position of power occupied by a treating doctor is such that a relationship with a patient can never be truly ‘equal’.
The doctor and not the patient has the ethical and professional obligation to avoid such relationships.” The HCCC ordered that upon the expiry of her suspension, Dr Nikolova-Trask practise under a professional mentor, and complete a medical ethics course.