An investigation into the business practices of a 29-year-old podiatrist, who describes himself as probably the highest-paid practitioner in Australia, has exposed some deep failings in the health system that open it up to rorting and privacy breaches.

Dr Sanjay Parasher is the founder of the Foot and Ankle Clinic of Australia, a podiatry business with a network of 30 locations across the country. 

The business stands accused of questionable practices that include fake GP referrals, bogus billing and charging fees for no service to schemes for injured workers and government-funded health schemes including the Department of Veteran Affairs (DVA). 

Dr Parasher declined an interview and denied any wrongdoing. 

Former workers of the clinic describe a sales culture where patients are seen as “leads” and some are sourced inappropriately in ways that may be in breach of Patient privacy.

Dr Parasher has a following of almost 120,000 people on his Instagram account The Parasher, where he refers to himself as “Dr Sanjay Parasher, public figure/professional property investor/podiatrist/founder of three health companies”.

Posts include “How I make 250k from Airbnb in only 3 steps,” “Make millions in only days,” and how he acquired 37 properties in three years.

Some of his posts espoused the virtues of being fit, pumping iron, exercising on the beach or posing with expensive cars.

In one video, he withdraws hundred dollar bills from an ATM then throws them in the air saying “Oh yeah baby I’m rich, it’s pay day – whoop whoop whoop” then runs off without the cash.    

Podiatry is booming. An ageing population and an explosion in the number of Australians diagnosed with diabetes has turned the profession into one that earns hundreds of millions of dollars a year from government-funded schemes including DVA, NDIS, workers comp, aged care and Medicare. 

Dr Margaret Faux, a health system lawyer specialising in payment systems, says these government-funded schemes are like open chequebooks.

“I have never come across a health payment system anywhere in the world that is easier to abuse than ours,” Dr Faux said.

She said in podiatry some health funding schemes such as DVA and workers comp entitled patients to more services and treatments than others.

For instance, while under Medicare five consultations a year are allowed, DVA provides for 12 consultations a year as well as treatments, tests and products including shoes and orthotics. 

Depending on the package, NDIS provides unlimited services and products, while under the NSW workers compensation scheme, icare, injured workers are entitled to unlimited products and services, if approved by the scheme.

Dr Faux said the various payment systems assume that practitioners will bill their services correctly.

“Basically you put in a number saying, I did this thing, now pay me and the answer comes back, here you go, here’s your money. There are no questions asked, there are no checks and balances in all of these systems,” Dr Faux said.

She said the various government health fund schemes all have their own codes, rates, rules and standards for similar services. 

7.30 spoke to some former workers at the Foot and Ankle Clinic of Australia who raised a series of questionable practices.

They included administrative staff saying they were instructed to breach patient privacy by accessing a patient booking system to compile lists of patients seeing other doctors; podiatrists and support staff being directed to cold call veterans; over-servicing; charging fees for no service; and some staff doing work they weren’t trained to do.

A group of veterans in Western Australia told 7.30 about their dealings with the Foot and Ankle Clinic of Australia, including receiving boxes of podiatry equipment they believed were free, but later discovered DVA had been billed. 

Perth-based veteran and Gold Card recipient, Philip Rowson, who served in the army for 15 years, says earlier last year he was cold called by a podiatrist at the Foot and Ankle Clinic of Australia who then sent him a box of podiatry equipment including balls, foot ointment and foam impressions for his feet.

Mr Rowson said he believed the box and the call were for research and sent impressions of his feet back and received an unsolicited pair of inserts for his shoes. He said he was shocked when he went to his regular podiatrist, Jason Rzepecki, who told him he couldn’t order a new pair of orthotics because he had used up his entitlement for the year.  

“They looked like something you would put in your shoes maybe to stop your feet from smelling, that sort of look to the device,” Mr Rowson said.

Mr Rzepecki remembered the orthotics and said in his opinion he didn’t believe they satisfied DVA’s rules and conditions for claiming orthotics. 

He said that DVA requires a GP referral and that all of the assessments for orthotics, including casting and fittings, are done in person.   

Mr Rowson told 7.30 he did not see anybody in person and did not get a GP referral.

Trying to find out what had happened, he rang the Foot and Ankle Clinic of Australia to inquire how they had billed him without a referral.

They sent him a copy of a referral but it was signed by a doctor he had never heard of. 

Dr Faux described the referral as fake.

“The patient does not know this doctor. He’s never heard of her. So this has been cooked up to enable the podiatrist to claim,” she said.

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Podiatry boxes billed to DVA

Mr Rowson was not the only veteran with a referral they did not know existed that was attached to their file. 

Decorated war veteran Colin Rewell, who spent two years serving in the Vietnam War, recently discovered he had three referrals from three different doctors all unknown to him and all dated this year. One was the same doctor used on Mr Rowson’s referral.

Mr Rewell, a DVA Gold Card holder who lives 120km out of Perth, came across the Foot and Ankle Clinic of Australia when some veteran mates told him podiatry boxes were being given out for free.

“I gave them a call and then a doctor [Dr Sanjay Parasher] started checking in with me, weekly for a few weeks,” he said.

DVA requires a face-to-face consultation for fitting customised shoes. Mr Rewell said at one stage Dr Parasher tried to sell him shoes.

“I said to him, ‘What’s going to happen if DVA rings me up and says, ‘Well when did you see this chap?’” Mr Rewell said.

“And he said ‘I’ll just say to DVA Colin was over here in Sydney and I caught up with him then.’

A number of veterans including Mr Rowson and Mr Rewell contacted DVA as part of this investigation to access their billing history in an attempt to find out what had gone on.

Their inquiries exposed a serious flaw in the system whereby patients are unable to easily access their own billing records. 

Instead of being readily available, in a similar fashion to the government services portal myGov where Medicare billing records can instantly be downloaded, the veterans were told by DVA that it would take weeks or months to process. They also had to navigate a complex form, that many struggled to complete. 

Dr Faux said it is not like Medicare where patients can jump onto myGov and immediately access their Medicare records.

“So at least you’ve got something that you can go and look at your records, but with DVA, you cannot do that,” she said.

Dr Faux said DVA had created a fortress.

“It is almost impossible to access these records… there’s no way that these veterans would have known that this was happening, had it not been for this investigation,” she said.

When the billing history finally came in, it was difficult to understand. 

In Mr Rewell’s case, the DVA records show DVA had been billed for 70 services this year, valued at almost $5500, with most of them listed under Dr Parasher, and most of them in person, which didn’t happen but is a requirement under DVA for these types of claims.

They included claims for manipulation of foot joints in person, muscle testing in person, gait analysis in person, joint manipulation appointments and range of motion study in person.

Mr Rewell was stunned.

“You’re saying 70? I would have been battling to have seen him seven or nine times on the phone to speak to,” he said.

“None of those people put a hand on me and I haven’t been to NSW since before COVID.

Veterans including Doug Stevenson, Ray Peele and Robert Donaldson also received podiatry boxes, which they believed were complimentary.

Their billing history showed the boxes were billed to DVA, along with the postage, and DVA had been charged for in-person consults, which did not happen.

Ex-workers speak up

A number of former workers have spoken to 7.30 about the clinic.

A podiatrist who previously worked at the Foot and Ankle Clinic of Australia described the sales practices as aggressive.

“It’s almost like an Americanised type of thing where you just target the insurance pathways,” he said.

Another ex-podiatrist said he was paid $100 every time a patient ordered a pair of orthotics.

He said it was a common practice across the podiatry industry.

“It’s a conversation that should be had around if it’s okay or not because it can push people into… being motivated to flog stuff,” he said.

Another former employee who worked in administration, Angus Mahon, said he was sometimes directed to process patient orthotics, a specialised role he wasn’t medically trained to do.

“So everyone for a period of a couple of months got the exact same orthotics sent out to them,” he said.

He said workers compensation patients in NSW were often overserviced, something some other former workers have told 7.30 that they also witnessed.

The former worker also told 7.30 that Dr Parasher had a practice of charging NSW workers compensation for appointments that the patient had missed, which meant that he received a payment from workers comp for a service that hadn’t been provided.

He said Dr Parasher stopped doing this when he pointed out to him that this was not permitted under workers comp rules in NSW.

NSW workers compensation scheme icare said in a statement it had taken actions against the clinic which had resulted in repayments. It declined to comment any further.

Mr Mahon and another administrative assistant Dannielle Whitehand said they were instructed by Dr Parasher to access a patient booking system at the Seaview Clinic based inside Wollongong Private Hospital, where the Foot and Ankle Clinic of Australia rented a room. This gave them access to patient information relating to other doctors’ patients.

“We were told just go through the books, find anyone who’s a new workers compensation patient that’s going to any of the other specialists and put them on the list, give the list to the podiatrist, they will call them and convince them to come in and see us,” Mr Mahon said.

He said it felt wrong and refused to do it.

Ms Whitehand, who worked at the clinic for more than 18 months and left last October, said she was also instructed by Dr Parasher to access this confidential patient information from the files of specialists who did not work at the Foot and Ankle Clinic of Australia.

This involved accessing the data to find out who the patient’s GP was, calling the GP and arranging a phone meeting between the GP and Dr Parasher, who they said would seek to persuade the GP to send their patient to Dr Parasher for podiatry services.

Ms Whitehand said she made a complaint to Dr Parasher and stopped doing it, believing it was breaching patient confidentiality.

Seaview Clinic said in a statement that it was investigating based on the allegations made by the former administrative staff at the Foot and Ankle Clinic of Australia (FACA).

It said its system was managed by a professional IT provider to maintain a high level of security for patient information that is held.

Dr Parasher said in a statement he and all FACA staff are committed to ethical medical practices and approach patient care and confidentiality with the utmost seriousness.

DVA declined to comment on the Foot and Ankle Clinic of Australia, citing privacy and commercial considerations.

It said it was in the process of revising billing requests to make it simpler.

The national regulator the Australian Health Practitioner Regulation Agency said it could not comment on specific matters until they are on the public record.

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