Impostors and Impersonators: Fake Health Practitioners and the Law.

The phenomenon of unqualified persons dishonestly holding themselves out as registered health practitioners has a lengthy and colourful history. Many notorious examples of such conduct have been exposed only after significant periods of successful deception by the perpetrators. However, there is a very limited scholarly literature on the phenomenon. A number of explanations have been proffered for such examples of deceptive conduct, including the commercial, the pathological and even the socially and sexually opportunist. Pseudologia fantastica is a term coined by Delbrück in 1891 for compulsive lying and has been mooted as an explanation for at least some impersonators of health practitioners. It may be that in many scenarios the explanation lies more closely in personality disorders, especially those featuring grandiosity, including Antisocial Personality Disorder and Narcissistic Personality Disorder. This article instances a variety of current and historical examples of impostor health practitioners. It provides 12 recent Australian and New Zealand case studies across the broad spectrum of general medical practice, gynaecology and obstetrics, psychiatry, psychology, paramedics, orthodontics, and general dentistry. It identifies that it is persons coming from overseas who disproportionately have utilised the opportunity to engage in premeditatedly fabricating and misrepresenting their qualifications. Such conduct endangers the wellbeing of patients, undermines the health regulatory system and can have both criminal and disciplinary consequences. In spite of a general tightening of checking of asserted qualifications, persons determined to fake their credentials and to create fictional professional lives continue to make their way through the regulatory net. This article seeks to understand better the phenomenon of impostor health practitioners, to consider how the criminal and disciplinary law should respond to their conduct, and to emphasise the importance of regulatory processes that will reduce the prospects of success for persons minded to engage in such dangerous misrepresentations.