Ritalin-pioneering psychiatrist suspended for undermining patients' trust in treatment

June 28, 2004

A consultant child psychiatrist who sent letters to GPs questioning other psychiatrists’ competence, and forwarded copies to their patients, has been suspended for 12 months by the General Medical Council for serious professional misconduct.

Dr Patrick Cosgrove was one of the pioneers of the use of controversial methylphenidate (Ritalin) to treat attention deficit hyperactivity disorder (ADHD). The Citizens’ Commission on Human Rights and Overload Network, the Scottish based advocacy group for patients with the condition, have both complained to the GMC about Dr Cosgrove, saying he was too ready to prescribe off label drugs.

But Professor Norman Mackay, chairman of the Professional Conduct Committee, said: "Throughout the course of this inquiry there has been no criticism of Dr Cosgrove’s prescribing practice ... Instead this case has been centred around Dr Cosgrove’s monitoring of those patients whom he diagnosed as suffering from ADHD and the letters he subsequently sent to other practitioners."

Bmj.com reported that in four letters Dr Cosgrove criticised five other psychiatrists who had seen his patients, some of whom disagreed with his opinions on the subject of the condition.The website reported that copies were sent to the psychiatrists themselves, to the patients’ general practitioners, and to adult patients or the patients’ parents. In one letter he suggested that two psychiatrists at the Cardiff and Vale NHS Trust were arguably guilty of medical negligence in knowing less about attention deficit hyperactivity disorder in adults than the patient himself did.

In another letter, written last summer, he wrote that a psychiatrist who had treated the patient might not believe in the existence of attention deficit hyperactivity disorder and might therefore have trouble being revalidated by the GMC’s Fitness to Practice Committee, bmj.com reported.

Finding Dr Cosgrove guilty of serious professional misconduct, Professor Mackay said he had contravened the GMC’s code of practice, which states that: "You must not undermine patients’ trust in the care or treatment they receive, or in the judgement of those treating them, by making malicious or unfounded criticisms of colleagues."

Professor Mackay added: "The nature of this correspondence goes far beyond what amounts to robust criticism ... Further similar incidents occurred after 2002 despite Dr Cosgrove being notified of these matters by the GMC." Dr Cosgrove "considered he had the best interests of his patients at the forefront of his mind," but had "not demonstrated any remorse or insight into his behaviour."

The case, which began in January but was adjourned, ended in a 12 month suspension for Dr Cosgrove, who has been retired since closing his private practice, the Bath Priority Clinic, in February. In a statement he denied to bmj.com that the closure was linked to the GMC case, but said that registering with the National Care Standards Commission "would not be meeting the needs" of his patients.

See bmj.com article in full

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