For Patient A, visiting a doctor about a pain in her foot led to a 12-year affair, an addiction to painkillers and admission to hospital for mental illness.
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But the doctor responsible made out that he was a victim, "preyed upon by his patient" as she threatened to expose the relationship.
Zeitoun Athour, 58, had practised medicine in Fairfield in Sydney's west since 1999. But on Thursday, the Health Care Complaints Commission struck him off the medical roll after it found him guilty of "reprehensible" conduct of the most serious kind.
The woman, known as Patient A for legal reasons, first came to see Mr Athour in 2001 for treatment of a foot she had injured in a car accident.
She confided in him early on about problems in her marriage, her traumatic past and the nature of her chronic pain.
The pair slept together at Patient A's house that year, beginning an affair that was to last until 2013.
During that time, Mr Athour gave her money towards TAFE fees, a car and abdominal surgery.
More gravely, he secretly prescribed her opiates and sedatives even when he was no longer her treating doctor.
Mr Athour acknowledged to the commission that "each of these medications contributed to the drug dependency of Patient A".
He visited Patient A in 2010 when she was taken to hospital against her will with an acute mental illness created by her drug dependency and the sexual relationship.
Mr Athour said he did not know it was improper to conduct social relationships with patients until he undertook a Monash University ethics course last year. He did not complete the course.
At the same time, he told the commission he stayed in the sexual relationship to appease Patient A and to stop her from telling medical authorities.
"He presented himself as a victim, preyed upon by his patient," the commission said.
"We view his conduct as reprehensible and perfidious."
Psychologist Bestegul Tungandame reported that Mr Athour had "learnt from his wrongdoing...[and] it is very unlikely for him to commit a similar offence".
But the commission said the doctor showed "a profound lack of insight" into his behaviour and had been evasive in parts of his evidence.
The commission had already restricted Mr Athour's practice in April 2014 after he was found guilty of inappropriately treating 14 heroin addicts. He had treated them using a risky procedure, rapid opioid detoxification, sometimes in their homes or in hotel rooms.
He will be eligible to reapply for registration in three years' time.
