GP who treated patient without checking her records guilty of poor professional performance
Seán McCárthaigh
A Kildare-based GP who treated a patient diagnosed with a long-standing overactive thyroid condition with medication for an underactive thyroid without checking with her former GP and consultants has been found guilty of poor professional performance.
A fitness-to-practise committee of the Medical Council found three allegations proven against Neville Wilson of the Harbour Medical Centre, Kilcock, Co Kildare in relation to his consultation with the patient on June 24th 2021.
It followed a separate medical inquiry in 2024 where the 84-year-old South African native was found guilty of professional misconduct over his failure to follow public health guidelines at his clinic during the Covid-19 pandemic and displaying posters containing false and misleading information about vaccines.
In the latest case, the patient had been diagnosed almost a decade earlier with Graves’ disease – an autoimmune disorder that results in an overactive thyroid or hyperthyroidism, which can cause anxiety, tremor, heat intolerance and weight loss.
A fitness-to-practice inquiry in April, which arose following a complaint from the woman, heard Dr Wilson had changed her medication after he had diagnosed her with an underactive thyroid or hypothyroidism.
The woman subsequently required further specialist intervention and increased medication.
Announcing the committee’s findings on Friday, the chairperson of the inquiry, Mary O’Sullivan, said it had been proven beyond a reasonable doubt that Dr Wilson had not engaged at all with the patient’s previous GP and her specialist endocrinology team as well as failing to obtain appropriate medical records prior to changing her treatment.
Prof O’Sullivan said the committee was satisfied that Dr Wilson had disregarded her long-standing diagnosis of hyperthyroidism and Graves’ disease and had instead suggested that the woman had an underactive thyroid and advised her to stop taking her existing medication at the time.
Although Dr Wilson did not attend the inquiry and was not legally represented, he did not deny in written correspondence with the Medical Council that he had implemented a new treatment regime for the patient.
Dr Wilson also stated that it was correct that he had not consulted with her previous doctors whom he claimed were “responsible for her failed treatment over a period of 10 years.”
He claimed his actions were solely to provide the patient with an alternative treatment without “creating a conflicting situation between the doctors involved.”
Prof O’Sullivan observed that the only medical records Dr Wilson had at the time were laboratory reports which related to a period where the patient’s thyroid disorder was being controlled by medication.
She said such records were neither sufficient nor an appropriate basis for the diagnosis made by the GP to implement a new treatment plan for the woman.
While Dr Wilson had claimed the new treatment regime, in which he had prescribed a hormone replacement, was tentative, Prof O’Sullivan noted he had written a prescription for six months.
She said the proven allegations individually and cumulatively showed Dr Wilson had failed to meet the standard of competence that could reasonably be expected of medical practitioners.
Prof O’Sullivan said the committee accepted the evidence of an expert witness that the GP’s failure to consult with the patient’s previous doctors was “a serious omission”, while his clinical decision making was “a bit illogical.”
She said he had also diagnosed hypothyroidism based on limited and potentially misleading laboratory results, while his implementation of a new treatment plan was “a significant and unjustified change.”
The patient gave evidence that she had attended Dr Wilson’s clinic on the recommendation of two people as she wished to try the functional medicine route before considering surgery to remove her thyroid.
However, her symptoms of an overactive thyroid returned a few months later which she explained to Dr Wilson at a further consultation in November 2021 when he reduced her dose of hypothyroid medication.
The inquiry heard the patient returned to her previous GP after her symptoms continued to worsen.
On the issue of sanction, counsel for the Medical Council, Eoghan O’Sullivan, said aggravating factors in the case including Dr Wilson’s “complete and total lack of insight” because he had remained “steadfast” in maintaining that what he did was correct despite all the evidence to the contrary.
O’Sullivan said the GP’s disciplinary history should also be considered and he noted that Dr Wilson had not complied with conditions attached to his continuing registration with the Medical Council within a 12-month deadline after he was censured when findings of professional misconduct were made against him.
He said the committee should consider that there was an adverse outcome with the patient in the latest case, although it had been controlled quickly by her former GP.
O’Sullivan also noted Dr Wilson’s age and his claim that he had retired from the clinic in Kilcock and intended to leave Ireland.
Although the GP had signalled that he had resigned from the Medical Council, the barrister noted that he can only voluntarily come off the register once the fitness-to-practise inquiry process has been completed.
Prof O’Sullivan said the committee would convey its recommendations on sanction to the Medical Council in due course.
