Disciplinary Action against
Dr. John Warren Piesse

Stephen Barrett, M.D.

In 2000 and 2001, Medicare Australia became concerned about the billing patterns of Dr. John W. Piesse a general practitioner who practices at the Natural Healing Centre in Mitcham, Victoria. As noted below, the resultant Professional Services Review (PSR) committee concluded that he had (a) billed for too many long and prolonged consultations, (b) ordered inappropriate laboratory tests, and endangered patients by failing to appropriately investigate patient symptoms of possibly serious conditions (such as cancer, meningitis, depression, anemia), and (c) using multiple doses of B-vitamin injections from vials intended for single use. In 2004, the Medical Practitioners Board of Victoria directed that Piesse receive a reprimanded, be counseled, repay Medicare benefits totaling A$18,179, and be disqualified for 18 months from all group A1 services. The order took effect in 2006 after the appeals process ended.

In 2017, the Australian Health Practitioner Registration Agency notified Piesse that it was proposing to revoke his registration for providing unjustified vaccine-exemption letters to parents who request them. The agency's concern was aroused by reports that Piesse had boasted at anti-vaccination group meetings that he can help parents jump through hoops to get their children exempted from Victoria's "no jab, no play" legislation. [Davey M. Doctor investigated over helping unvaccinated children avoid 'no jab, no play' law—reports. The Guardian, Aug 23, 2017] Piesse was given four days to state why his license should not be revoked.

Dr. John Warren Piesse
Director's Report to the Professions, 2005-06
Professional Services Review

Medicare Australia referred Dr Piesse on 18 December 2001 because it was concerned about his level of long and prolonged consultations and of pathology requests during 2000. That year he rendered 2,137 services to 707 patients at a total Medicare benefit of $87,570. His 1127 level C and long consultations (items 36 and 54) were 53 per cent of his total consultations, compared with 9.94 per cent for all active general practitioners in Australia. His 530 level D and prolonged consultations (items 44 and 57) were 25 per cent of his total consultations, compared with 0.95 per cent for all active general practitioners in Australia. His 134 pathology requests for leucocyte antigens (item 71139) and his 42 requests for quantitation of metals (item 66668) were both above the 99th percentile (seven and eight such requests, respectively) for all active general practitioners in Australia.

A committee was established on 4 June 2002 and held hearings on 4-5 December 2002 and 9-10 and 21-22 January 2003, during which Dr Piesse initiated (ultimately unsuccessfully) interlocutory proceedings in the Federal Court seeking free transcript of the hearings. The committee's fi nal report on 23 March 2004 was that Dr Piesse had engaged in inappropriate practice in connection with item 44, 71139 and 66668 services. Further details are on page 58 of the PSR Annual Report 2003-04.

Meanwhile, on 4 July 2003, the committee informed the Director, pursuant to section 106XA of the Act, that during the hearing it had concluded that Dr Piesse's conduct during 2000 caused a significant threat to the life or health of his patients. It was concerned that Dr Piesse failed to make appropriate investigations of patient symptoms of possibly serious conditions (such as cancer, meningitis, depression, anaemia) and that he used multiple 'Bforte' doses from one vial. On 4 July 2003 the Director referred this information to the Medical Practitioners Board of Victoria.

The final determination on 6 August 2004 directed that Dr Piesse be reprimanded, counselled, repay Medicare benefits totalling $18,179, and be disqualified for 18 months from all group A1 services (items 1–51).

On 22 September 2004, one day before the determination took effect, Dr Piesse initiated further (second) proceedings in the Court seeking (again) the transcript and review of the committee and Determining Authority findings. Dr Piesse raised the new issues of procedural fairness and constitutional validity of the legislation. After various directions hearings, amendments by Dr Piesse of his application, changes of his lawyers, and periods of selfrepresentation, both applications were heard together by Gray J.

At that hearing, on 6 February 2006, Dr Piesse sought a further adjournment saying he had only received some documents very recently and, having spent about $100,000 on legal assistance during the committee hearings, wanted to get free legal advice from friends as he could no longer afford a solicitor. His Honour observed that the documents were simply responses to Dr Piesse's submissions and had been served in accordance with his timetable, there had already been many delays, and it was Dr Piesse's responsibility to be ready to run his case.

Dr Piesse expressed concern about a lack of nutritional and environmental medical expertise on the committee. When Dr Piesse said he wanted to obtain affi davits to demonstrate that the committee had made errors, his Honour pointed out that he could not retry the facts—only errors of law. He had to consider whether the committee performed its statutory function according to law. Professional medical judgements were for the committee. Further, the fact that the bulk of the medical profession, including the committee, apparently did not agree with the smaller group practicing complimentary medicine was not of itself evidence of bias.

Dr Piesse ultimately decided that he could not proceed without an adjournment to further prepare his case. His Honour was not prepared to adjourn again and offered Dr Piesse the option of having the matter determined on the existing papers. Dr Piesse decided to withdraw his applications. Both were then dismissed with costs awarded to the respondents.

The final determination took effect on 13 March 2006.

This aerticle was posted on August 28, 2017

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