A former WA doctor has been reprimanded and disqualified from applying for registration for four years, as well as ordered to pay $4000 in costs, after having an inappropriate relationship with a patient.
In January 2023, the Medical Board of Australia referred Dr Raymond Marchesi to the Western Australia State Administrative Tribunal, alleging that while employed as a medical officer at Joondalup Health Campus in 2008, he started an intimate personal relationship, including sexual activity, with a former inpatient of JHC identified as ‘Patient A’.
Patient A had a history of anxiety, depression, and panic disorder. She had also been diagnosed with chronic dysthymia, with social anxiety, personality disorder and agoraphobia, and just prior to the start of the long-term relationship being investigated, Patient A had asked Dr Marchesi to be her support person – and he had agreed.
During the investigation, Dr Marchesi confirmed that he had:
engaged in an inappropriate sexual relationship with Patient A for around four months in 2008/2009 and once during a weekend in March 2013
The respondent paid for: Patient A to fly to Sydney to meet up with him; and
A hotel room, where he and Patient A stayed for a duration of two nights and engaged in sexual activity
engaged in an inappropriate personal relationship with Patient A over the course of 13 years
breached another person’s confidentiality by disclosing to Patient A that her brother was a patient of the JHC Hospital in the Home Service, and
made an inappropriate comment to Patient A in October 2021 when he said words to the effect, “I feel bad for you as it means your whole family [are] loo-loo.”
Dr Marchesi agreed that he had breached relevant codes and guidelines by abusing his professional position to establish an improper personal relationship with Patient A; using his professional position to establish a sexual relationship with Patient A; and failing to maintain professional boundaries.
The tribunal was satisfied that proper cause existed for disciplinary action, and ordered that he:
be disqualified from applying for registration as a registered health practitioner for a period of four years from 4 August 2023, and
pay $4000 towards the board’s costs.
The tribunal’s decision noted that from 2008 to August 2009, the respondent was employed as a Medical Officer at JHC, while from September 2009 to August 2019, he practised in Victoria and the ACT as a psychiatric registrar, apart from a period of about three months in 2016 when Dr Marchesi undertook casual work as a medical practitioner at Midland Hospital.
From August 2019 to October 2021, the respondent was employed by the North Metropolitan Health Service as a Medical Officer and worked in various roles, including Graylands Hospital, JHC and the Adult Hospital in the Home Service (HitH Service).
In his defence, the tribunal acknowledged that Dr Marchesi had no disciplinary history with the applicant and his conduct could be characterised as an “isolated but ongoing breach of patient boundaries with a single patient.”
“The Respondent was an inexperienced and naïve junior doctor when the sexual relationship commenced, and this contributed to his decision making with respect to this matter,” the tribunal said.
“The Respondent received psychological treatment for mental health issues relating to personal stress and general anxiety in the 6 months prior to the commencement of the sexual relationship.
“He also experienced the breakdown of a long-term relationship around 1 month prior to meeting Patient A and these mental health issues contributed to his decision making with respect to this matter.”
As Dr Marchesi surrendered his registration in October 2021 — at the time the notification was made — there was no need for the tribunal to cancel his registration, and after he admitted to the conduct, the matter was settled by mediation.
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