Melbourne emergency medicine specialist Thomas Kossman has become a national figure because he has been subjected to what looks disturbingly like a witch hunt on the part of the powerful medical establishment. Over the past 12 months, the German-trained Dr Kossman has been the subject of investigation over allegations that he botched surgical procedures and that his billing practices are questionable.

But because of the way the matter has been dealt with by his peers, Dr Kossman has been subjected to a media and professional campaign of vilification.

Yesterday Melbourne’s Alfred Hospital, where Dr Kossman ran emergency medicine, revealed the results of its own “external” inquiry into Dr Kossman and surprise, surprise, the conservative doctors who made up the inquiry have found that Dr Kossman “put lives at risk” in the way he carried out surgery.

Dr Kossman is an outsider in the predominantly Anglo/Australian medical world of Melbourne. Dr Kossman comes from a school of medical practice that threatens the turf of specialist surgeons. Even The Age newspaper, whose coverage of the Kossman saga has generally taken the medical establishment’s side in the Kossman matter (today it headlines a piece on the findings of the inquiry, No winners here-except fairness), admits that the “medical culture Professor Kossmann dived into in Melbourne was different to that in much of Europe, where the concept of a generalist surgeon who specialises in managing trauma is more established. In many Australian hospitals, the preference remains in specialisation, such as orthopaedics or neurosurgery.” In other words, Dr Kossman was different.

That the Alfred Hospital allowed a three man inquiry made up of fellow doctors to investigate a man who obviously trod on the toes of the medical establishment in Melbourne is disgraceful. The Alfred says it has accorded procedural fairness and natural justice to Dr Kossman throughout the seven month inquiry by the doctors. The head of the inquiry, a surgeon Bob Dickens, told The Age today that his panel had interviewed Dr Kossman on at least six occasions, including a five and a half hour session. So what? Suspects in criminal investigations get interviewed for long periods as well, but unless strict procedural fairness is followed, the courts will judge the interview process unfair.

What we are dealing with here is a man’s reputation, livelihood and sense of esteem. Anyone accused of fraud and professional incompetence as Dr Kossman has been is entitled to expect that at the very least his case is investigated by someone of legal training. Doctors, no matter how clever they are, have no professional skill in legal inquiry and they are far too close to the action. The Alfred should have appointed a retired Supreme Court judge or a senior lawyer, of which there are many, to head its investigation. In other words, someone who has no direct or even indirect interest in the matter, and who has ingrained into them the concept of true procedural fairness.

What is also disturbing about the way The Alfred has conducted its probe into Dr Kossman has been its preparedness to use the media to be a vehicle to besmirch Dr Kossman and prejudice his reputation before any inquiries are completed. It is obvious that Dr Kossman’s enemies have used The Age to grind their axes, and the Alfred has been prepared to fuel that fire.

Dr Kossman may or may not be a brilliant surgeon, but that is not the point. The conduct of the Alfred Hospital and its so called external inquiry of three doctors have ensured his name is mud before anything anywhere has been proved against him.

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Peter Fray
Peter Fray
Editor-in-chief of Crikey
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