An 83-year-old psychiatrist refused re-registration after the Medical Board of Australia said his “rigid thinking” on attention deficit disorder (ADD) made him unfit to practise has had the decision overturned after a tribunal said strong views were not an impairment.
Dr William Orchard decided to retire voluntarily in 2010 after the Victorian Civil and Administrative Tribunal (VCAT) made adverse findings in relation to his communication with one patient and alleged “significant overdiagnosis” of ADD in general, VCAT said.
But before Dr Orchard was due to retire he regretted the decision and started the process of re-registering. He sent 13 “long and intemperately worded” letters to the medical board, VCAT and the Victorian premier alleging criminal abuse of power among other things, VCAT said.
The medical board told Dr Orchard it planned to allow his registration with conditions, to which he wrote back a 13-page letter “strongly reinforcing his views about the way in which ADD should be treated”.
The board ordered Dr Orchard to undertake a health assessment, which “identified a number of concerns about Dr Orchard’s cognitive functioning”.
Based on that, the medical board refused re-registration on the grounds that Dr Orchard had “an impairment which would detrimentally affect the individual’s capacity to practise the profession to such an extent that it would or may place the safety of the public at risk”.
The board’s expert neuropsychiatrist Dr Dennis Velakoulis raised concerns about a range of diagnostic issues, including his cognitive abilities, rigid thinking, lack of insight and inability to view his behaviour as others had seen it, the medical board wrote to Dr Orchard.
Dr Orchard took the matter to VCAT for review. Rigorous health and psychological testing found “no convincing evidence of cognitive impairment” despite the man’s narrow views, VCAT said.
VCAT said it was concerned about Dr Orchard’s “narcissistic insults” to the authorities but found they were “engaged in outside the practise of his profession”.
It added that the behaviour took place while the doctor was under significant stress.
He has since been diagnosed with ADD himself, VCAT added.
VCAT granted Dr Orchard registration under lengthy conditions, including that he work no more than 30 hours per week, between 8am and 6pm on weekdays, undertake supervision, and do additional training.
This article first appeared on Medical Observer on 23 October, 2013.