The prosecution of a fake doctor this week raises the question: what makes impersonators tick? Health editor Adam Cresswell reports
JULIANNE Radley knows exactly what it feels like to find out the person you looked up to as ‘‘ Doctor Mark’’ — a man who heard her most intimate details, and treated her children’s ill nesses — was nothing of the sort. Even with her own health training, Radley — an acute care nurse — hadn’t seen it coming. She and her children had been going to see ‘‘ Dr Mark’’ Dallas on and off for six or seven years. He was so convincing, it never occurred to her there was anything wrong when he prescribed medicines, vaccinated her children, treated a rash or palpated a breast lump. He even conducted an internal vaginal examination, using a speculum.
So it was only when she opened Sydney’s Sunday Telegraph that she realised ‘‘ Dr Mark’’ in fact possessed no medical qualifications beyond a first-aid certificate.
‘‘ On the day it was in the Sunday Tele I was working in the emergency department, and everyone was talking about it in the tearoom,’’ she recalls. ‘‘ I said I had been seeing him, and they all said, ‘ How could you not know?’. I felt so humiliated — I didn’t know why I didn’t know either, but I didn’t.
‘‘ I felt totally violated, and there was very little support. They (others I spoke to) couldn’t see how psychologically devastated I felt — that I had trusted this man, that I had trusted him with my children’s health and my own health.’’
Mark Dallas, together with his brother Rick, a genuine medical doctor, had been seeing patients together at their surgery in Sydney’s west for up to six years, before the practice was raided in 1998.
Each of the brothers was fined $45,000 in 1999 for defrauding Medicare, and the following year Rick — the one entitled to call himself a doctor — was struck off the medical register for aiding and abetting his brother’s deception. In 2003 Mark Dallas, who provided ‘‘ treatments’’ to an unsuspecting Julianne Radley, was jailed for 18 months in connection with the case.
Even several years later, Radley is feeling the consequences.
‘‘ I didn’t go to a GP for a long while,’’ she says. ‘‘ I would go into surgeries and if they didn’t have their certificates (of qualification) on the wall, I would want to know where they were.’’
The conundrum of medical fakers and what motivates them was in the news again this week, after a traditional Chinese medicine practitioner, Yao Guo Lin, also known as David Lin, pleaded guilty in the NSW Supreme Court to 31 breaches of the NSW
still Medical Practice Act, including holding himself out as a doctor and providing false medical certificates.
The court heard Lin was trapped by two NSW Medical Board investigators, who secretly filmed him telling the woman he could perform an abortion and supplying the abortion drug RU-486 — which can currently only be lawfully imported by one doctor in Queensland, the only one who has so far successfully applied for permission to do so.
Next week, another fake doctor, Lorraine Brooke-Smith, will appear for sentence before Sydney’s Downing Centre Local Court in relation to a string of similar offences.
She was convicted of 27 counts in 2003, including one in which she made herself out to be a cardiologist and advised a patient of another cardiologist to stop taking a number of medicines.
That specialist doctor later testified that had his patient taken the advice, it could have killed the patient by triggering angina and a heart attack.
Following her conviction she was made subject to a two-year good behaviour bond — but later admitted committing further offences during the bond period.
These related to her successfully applying in 2004 for a job with Life Without Barriers, a charity that provides support to people with intellectual disabilities. She was hired partly on the basis that her medical experience would allow her to cope with scenarios beyond the skill of other carers, including a client who experienced about 17 ‘‘ grand mal’’ seizures per day.
Patients have come to very real harm in plenty of other similar cases. And patients who have suffered harm at the hands of impostors may be left without recourse to compensation, as fake doctors will not be members of a medical insurance company that usually foots the bill in negligence suits.
In another case just last year, Nancy Xiao was found guilty of breaching the Medical Practice Act after trying to remove haemorrhoids from a patient who believed she was a doctor. The patient ended up in Concord Hospital after the area became infected and necrotic, and required surgery to remove the dead and infected tissue.
The magistrate fined Xiao $3000 and ordered her to enter into a good behaviour for three years, saying she was ‘‘ careless and indifferent’’ as to whether she obeyed the legislation or not.
NSW Medical Board registrar Andrew Dix says part of the problem in pursuing suspected impostors is that under the legislation, it has to be proved beyond reasonable doubt that the accused falsely represented themselves as a doctor, either directly or by their conduct.
This was the point that stymied the board’s attempted prosecution 10 years ago of kinesiologist Ian Yde, following the death of 22-year-old Robert Romero, who had testicular cancer. It was alleged Yde persuaded Romero to eschew cancer treatments recommended by his doctors in favour of alternative practices, including jumping on a trampoline. But a magistrate threw out all charges in 1997 after accepting that Yde had not promised he could cure cancer.
But of those who are guilty of passing themselves off as doctors, what makes them tick?
Sydney forensic psychiatrist Stephen Allnutt says ‘‘ not much is known’’ about the motivations of people who pass themselves off as doctors. Far from being a phenomenon that is peculiar to medicine, people have also been known to pass themselves off as lawyers and other professionals who are ‘‘ seen by society as having some status’’.
Without referring to any particular case, Allnutt says people who impersonate doctors ‘‘ keep popping up’’ and probably fall into one of four categories.
One would be the delusional mentally ill person, who might believe themselves to be a doctor in the same way as another delusional patient might think they are Jesus Christ. Allnutt believes this category is rare and easily spotted.
The next two categories he thinks are less easily detected, particularly if they have some medical knowledge that can camouflage their deceit. One is the ‘‘ fragile personality’’ who wants to be more than they are, and convinces themselves they are a doctor in order to get the respect and status they crave. Although deep down they are not truly delusional, their adopted persona is often cemented in with years of lies, which can prove difficult to penetrate — and be difficult for the perpetrator to reverse.
The third category would what he calls ‘‘ the true charlatans’’ who know perfectly well they are not doctors, but pretend to be for financial or other gain. The fourth category would be someone who misrepresents himself as a doctor through some misunderstanding of what is permitted, either because they have an intellectual problem or some other reason.
‘‘ The professions that are regulated are the ones (in which cases) will come to the Continued inside, Page 19
Prosecuted: Yao Guo Lin pleaded guilty to 31 breaches of the NSW Medical Practice. Insets, material produced in evidence