To be a doctor is to hold a fairly unique position in society, with respectability and trust that almost no other profession can lay claim to.
This trust between a doctor and their patient is essential but it is this trust that is being deliberately abused by a small but deceitful group of criminals.
Across Australia, 1303 people have been reported to the Australian Health Practitioner Regulation Authority (AHPRA), which is responsible for the registration of medical professionals, since 2014.
Sixteen have been convicted, some of whom infiltrated hospitals and treated people who had no idea that their so-called doctor had about as much knowledge as they did.
One of the most disturbing cases is that of Raffaele Di Paolo, who not only pretended to be a doctor and fertility specialist but also performed a range of bizarre ‘treatments’ and tests on 30 victims.
These included using a needle to remove semen from testicles without anaesthetic, injecting unknown substances into women’s’ stomachs and buttocks, and instructing the partners of some female patients seeking IVF to insert ultrasound probes into their vaginas.
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Di Paolo was fined more than $ 28,000 and jailed in 2018 for almost a decade after he pleaded guilty to 51 charges related to fraud, indecent assault and sexual penetration.
Balaji Varatharaju was sentenced to 14 months in prison in 2012 for impersonating a junior doctor in Alice Springs.
He attended to more than 400 patients and even claimed in his defence that he was better than actual qualified doctors.
And in Brisbane in 2017, 25-year-old Nicholas Brett Delaney was fined $ 3000 after he infiltrated Lady Cilento Children’s Hospital and the Ronald McDonald House in South Brisbane.
He didn’t engage with any patients but he spent months at Lady Cilento Children’s Hospital before being caught.
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The question that unites all of these cases is ‘why’? Why did these people pretend to be doctors and potentially put people’s health at risk?
The answer to that question is complex, Professor Phillipa Marty says, but it all comes down to essentially three things.
Prestige, money and power.
“Television and film have a lot to answer for here, especially for its persistent portrayal of the handsome, young male doctor with a string of romantic successes,” Professor Marty explains. “Most medical impersonators are male — the case of ‘Dirty John’ Meehan is at the extreme end of the scale, but the key elements of sexual allure and high status were very clear in his case.
“And in a funny way, perhaps to meet some deep-seated need to be seen as a hero or lifesaver; as someone important and altruistic. This might be something that the person aspires to, but they lack the means to achieve it through the usual pathways.”
Unverified foreign credentials, less scrutiny in regional locations and in a small number cases, a personality disorder may be at the root, Professor Marty said.
An AHPRA spokesman told news.com.au that anyone falsely claiming to be a qualified health practitioner was “unacceptable”.
“Patients can check the online register of practitioners to see if they are seeing a registered practitioner. The register can reassure patients who are considering accessing care from a practitioner, that the practitioner is qualified and required to meet national standards.
“If they cannot find the practitioner on the register — think twice about going to see them and let AHPRA know.”
Queensland Parliament this year passed a new law that increased the severity of fines and jail terms for such crimes, up to three years for each offence.
One of the most serious cases is that of Shyam Acharya, who stole the identity of a real doctor and used it to obtain Australian citizenship and work four hospitals across New South Wales.
His real identity and fraud only became known in 2017 — 11 years after he first faked being a doctor — and he immediately went to ground.
He was eventually brought to justice, convicted and fined $ 30,000.
Dr Chris Moy, chairman of the Australian Medical Association’s ethics and legal committee, said these fakes undermined the integrity of the profession and the “special relationship” that exists between patients and doctors.
“In an already sceptical world, something like this can certainly undermine the trust a patient can have in their doctor,” Dr Moy said.
The ability for someone to fake their profession for that long raises questions about whether more needs to be done to prevent fraudsters infiltrating hospitals and medical centres.
Dr Marty says the answer doesn’t involve installing burly security guards at front doors who check credentials but that those responsible for hiring and registering staff need to ensure they have actually checked and verified their qualifications.
In the meantime, is there anything that patients can do to safeguard themselves? Dr Marty urges people to “trust your gut”.
“If something strikes you as ‘off’, feels wrong or not quite right, that’s a really valuable instinct, and you can and should at least document it for yourself, and then follow it up if you can.
“Countless people often ‘knew’ about a bogus practitioner long before they were finally caught, but they stifled that inner voice, or told themselves they were imagining things.”
While most fake doctors do get caught and either face jail or fines, there is one case that had a surprising conclusion.
Californian man Adam Litwin infiltrated UCLA Medical Center, posing as a surgeon for six months in the late 1990s before he was found out.
But he clearly got a taste for life as a doctor, as he actually went through university and training to become a doctor — a real one, this time.
Alana Schetzer is a freelance journalist. Continue the conversation @schetzer