A psychiatrist who developed a sexual relationship with a vulnerable patient during at-home visits has been barred from working in mental health until 2024 after acknowledging his actions may have been "terribly damaging".
Scot Nicolson Duffton in part blamed the death of his pet for the "huge violation of my professional ethics" more than 30 years into his medical career.
Dr Duffton moved from New Zealand to Tasmania in June 2019 to work as a locum in the state's north-west.
By July, he was working in the newly established Mental Health Hospital in the Home (HITH) unit in Hobart as a career medical officer.
He started treating Kate*, a woman in her early 30s, after she was discharged from hospital following a suicide attempt in October.
According to Kate's submission to the Australian Health Practitioner Regulation Agency (AHPRA), he referred to himself as "Scot", organised appointments in the early evening (5:30pm-7:30pm), and, by December, started contacting her from his personal phone.
Kate wrote that Dr Duffton offered comfort through a break-up — after which her ex-partner had stalked her — and the pair started texting every day.
"Scot began staying after HITH appointments with me if the appointment was at my house for cups of tea at my apartment or for take-away dinners," her submission said.
"I was just so lonely that I felt like I had a friend and confidant in Scot."
Dr Duffton wrote Kate cards and they exchanged gifts, and the relationship became sexual.
Dr Duffton left Tasmania to work in Western Australia in March 2020, and Kate wrote she found it "very hard to cope without him".
In April, she was admitted to hospital after self-harming, and went on to disclose her relationship with Dr Duffton to another psychiatrist.
"I realised that Scot had taken advantage of me when I was at a particularly vulnerable time in my treatment and in my life," Kate wrote.
"I am now working very hard with a new treating team to get help for the devastating impact of Scot's grooming and abuse of me."
Duffton's statements paint a 'complex picture'
The Health Practitioners Tribunal held hearings into Dr Duffton's registration in September last year.
According to findings handed down in December, Dr Duffton was admitted to hospital for psychiatric treatment soon after his relationship with Kate was put to him.
Dr Duffton's statement acknowledged that after his first sexual encounter with Kate, he "immediately knew that what had happened was a huge violation of my professional ethics and potentially a terribly damaging event for [her], although she did not see it in that way".
"There were numerous occasions when I repeated to [Kate] that the relationship was entirely inappropriate, and explained to her that despite her repeating that she was an adult and able to make her own decisions, there were other factors at play, such as the power imbalance, that negated that.
He signed an undertaking not to practise and returned to New Zealand in July 2020.
Submissions from the Medical Board of Australia said Dr Duffton's statements — which were not made public — painted a "complex picture".
"They range between abject apology, self-pity, and self-justification," the board said.
"There is a disconnect between the matters he raises as relevant context for his misconduct (such as the recent death in New Zealand of the family pet) and the actual gravity of the misconduct itself. At times he edges towards victim-blaming."
Accepting Dr Duffton was remorseful, had admitted to the conduct, had no prior disciplinary history, and was a low risk of behaving similarly again, the Health Practitioners Tribunal cancelled his registration with a disqualification period of 2.5 years — after which he can apply to be re-registered.
"It is difficult to conceive of a more serious breach of professional ethics by a medical practitioner engaged to provide acute psychiatric care in the home of a vulnerable patient," the findings said.
"The tribunal finds it is conduct that would reasonably be regarded as disgraceful or dishonourable by members of the health profession of good repute and competency."
The Tasmanian Health Service said on learning of Dr Duffton's actions, the department notified AHPRA and commissioned a review panel.
"A serious incident review panel was commissioned to independently examine the matter and develop recommendations to prevent a similar breach occurring into the future and improve relevant sections of the model of care," Community, Mental Health and Wellbeing Deputy Secretary Dale Webster said in a statement.
"The department is committed to providing safe and high-quality mental health services and providing clients with the very best care and treatment."
*Name has been changed.
