April 2017

Dr Joanna Flynn AM
Chair, Medical Board of Australia

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Recent decisions have been published online

There are important lessons for registered medical practitioners from tribunal decisions. The Board refers the most serious concerns about medical practitioners to tribunals in each state and territory. Cases published recently have included:

• Professional boundaries and inappropriate prescribing (Medical Board of Australia v Duck) 

Publication of panel, court and tribunal decisions

The Australian Health Practitioner Regulation Agency (AHPRA), on behalf of the 14 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.

When investigating a notification, the Medical Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law, panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Practitioners’ names are not published, consistent with the requirements of the National Law.

Summaries of tribunal or court cases are published at Tribunal decisions on the AHPRA website. The Board and AHPRA sometimes choose to not publish summaries, for example about cases involving practitioners with impairment.

In NSW and Queensland, different arrangements are in place. More information is available on AHPRA’s website under Notification outcomes and hearing decisions.

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Report finds chaperones do not always keep patients safe

The Medical Board and AHPRA have accepted all the recommendations of the Independent review of the use of chaperones to protect patients in Australia.

The review found the use of chaperones does not meet community expectations and does not always keep patients safe.

In August 2016, the MBA and AHPRA commissioned the review to consider whether, and if so in what circumstances, it is appropriate to impose a chaperone condition on the registration of a health practitioner to protect patients while allegations of sexual misconduct are investigated.

It is common practice for regulators around the world to use chaperone conditions in this way. Chaperone conditions have also been imposed as a protective measure at the end of a disciplinary process.

The review was triggered by the concerns of patients whose doctors abused their trust.

The review was undertaken by Professor Ron Paterson, Professor of Law at the University of Auckland and Distinguished Visiting Fellow at Melbourne Law School and an internationally recognised advocate for patient safety. The review involved extensive consultation with the community and the profession.

Professor Paterson said he was left in no doubt that there are better ways to protect and inform patients when allegations of sexual misconduct are made about a health practitioner, despite chaperones being widely used in many countries.

The report recommends three areas for regulatory reform:

• no longer using chaperones as an interim restriction while allegations of sexual misconduct are investigated
• establishing a specialist team within AHPRA working with the MBA to improve our handling of sexual misconduct complaints, and  
• strengthening monitoring and providing more information to patients in the exceptional cases when chaperone conditions are in place.

The Board and AHPRA have adopted all the recommendations made in the report which will mean:

• using more effective ways to protect patients when allegations of sexual misconduct are made, including gender-based restrictions, restricting patient contact or suspending the doctor’s practice
• establishing a specialist, national, medical board committee to make decisions about all these cases, supported by a specialist team within AHPRA to manage all sexual misconduct notifications, auditing all open notifications about allegations of sexual misconduct by doctors and reviewing all doctors currently subject to chaperone conditions, and
• writing to all police departments in Australian states and territories to establish clear inter-agency protocols.

Medical Board of Australia Chair, Dr Joanna Flynn AM, told the media the report clearly set out the problems with chaperone conditions and makes a compelling case for change.

We’ve been told very clearly that chaperone conditions don’t do the job we need them to do and don’t match current community expectations,’ Dr Flynn said.

The Board and AHPRA are changing the way we deal with concerns about sexual boundary violations.

We are confident that the vast majority of registered medical practitioners understand the importance of trust in the doctor patient relationship and want us to deal fairly and firmly with anyone who exploits this trust.

AHPRA CEO, Mr Martin Fletcher, said the report makes a clear statement about the need to strengthen public protection and keep the system fair to practitioners.

AHPRA is developing new approaches so it can deal with sexual misconduct matters as quickly as possible and make clear arrangements with other bodies like the police to ensure good communication and appropriate information sharing.

The final report has been published on the AHPRA and Medical Board of Australia websites, and on the National Health Practitioner Ombudsman and Privacy Commissioner website, where submissions are also published.

The media release is published on the Board’s website.

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Meeting your legal and professional advertising obligations

Registered medical practitioners who advertise health services need to check, correct and comply with their professional and legal advertising obligations.

Under the National Law, a regulated health service or a business providing a regulated health service must not advertise in a way that:

• is false, misleading or deceptive
• uses gifts, discounts or inducements without explaining the terms and conditions of the offer
• uses a testimonial or a purported testimonial
• creates an unreasonable expectation of beneficial treatment, and/or
• directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services.

There are also restrictions on advertising in a way that identifies a health practitioner as a specialist when they do not hold registration as a specialist or as an endorsed practitioner in a health profession.

The National Boards and the Australian Health Practitioner Regulation Agency (AHPRA) have published a strategy for the National Scheme¹ aimed at keeping health service consumers safe from misleading advertising.

The Advertising compliance and enforcement strategy explains how National Boards and AHPRA will manage advertising complaints and compliance, including the regulatory powers available to deal with breaches of the National Law².

The strategy is designed to keep improving how regulated health services are advertised so healthcare consumers can be better informed.

When preparing advertising, registered medical practitioners should always put the consumer first and ensure that their advertising is not false, misleading or deceptive in any way.

This strategy builds on the previous education and enforcement work from National Boards and AHPRA.

More information is available on the Advertising resources section of the AHPRA website and more information will be published in coming months.

¹National Registration and Accreditation Scheme
²The Health Practitioner Regulation National Law, as in force in each state and territory

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Doctors’ obligations when using social media

Doctors who use social media need to remember that their professional obligations continue when they are active online.

The Board’s Social media policy and Good medical practice: A code of conduct for doctors in Australia both apply to all digital activity, including public forums and in closed groups.

The Social media policy provides guidance on doctors’ responsibilities and obligations when using and communicating on social media. Good medical practice sets out the required standards of professional behaviour, which apply to interactions in person and online.

Some of the principles that are useful to remember when active online include: 

• maintain professional standards and be aware of the implications of your actions, as in all professional circumstances
• be aware of your ethical and regulatory responsibilities when you are interacting online – they are the same as when you interact in person
• ensure that you protect the privacy and confidentiality of patient information, and
• comply with the advertising provisions in the National Law and with the Board’s advertising guidelines.

The Social media policy and Good medical practice are available on the Board’s website.

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Providing high quality education and training

One of the objectives of the National Law is to facilitate the provision of high quality education and training of health practitioners. The accreditation function is the primary way of achieving this. More information about the Medical Board’s accreditation function is available on our Accreditation page.

The Royal College of Pathologists of Australasia

After receiving accreditation advice from the Australian Medical Council, the Board approved the accredited specialist medical programs and training and continuing professional development programs of The Royal College of Pathologists of Australasia (RCPA) that lead to fellowship of the RCPA in the recognised specialty of pathology and in the following fields of specialty practice:

• General pathology
• Anatomical pathology (including cytopathology)
• Chemical pathology
• Haematology
• Immunology
• Microbiology
• Forensic pathology.

The Board has approved these as providing qualifications for specialist registration to 31 March 2023.

Health Leaders Australia trading as Queensland Prevocational Medical Accreditation

After receiving advice from the Australian Medical Council, the Board approved Health Leaders Australia trading as Queensland Prevocational Medical Accreditation (HLA QPMA) as an intern training accreditation authority for Queensland, until 31 March 2019.

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EICS primary source verification service for IMGs ends soon

All international medical graduates (IMGs) must have their primary medical qualifications verified.

From 1 July 2017, the Australian Medical Council (AMC) will no longer accept primary source verification (PSV) of medical qualifications through the ECFMG International Credentials Services (EICS) service.

All existing qualifications going through the EICS service must be verified by 30 June 2017. Any requests for verification via EICS that are not completed by 1 July 2017 must be resubmitted via ECFMG’s web-based Electronic Portfolio of International Credentials (EPIC).

Any IMG who has an application for PSV that is waiting for EICS verification should contact the institution(s) that issued their qualifications directly, and ask them to respond to the ECFMG’s request for verification as soon as possible before 30 June 2017. The AMC will not accept verifications through EICS after this date.

All new applications for PSV must be made through ECFMG’s EPIC service and the IMG must also establish an AMC portfolio (a fee is payable).

More information on EPIC, including additional benefits not accessible through EICS, is available on ECFMG’s website, and more information on how to establish an AMC portfolio is available on the AMC’s website.

Media statements

AHPRA has made media statements about the following matters during the last month:

• Medical Board and AHPRA adopt all recommendations of chaperone report
• AHPRA successfully prosecutes NSW fake doctor and welcomes proposed new powers - AHPRA has successfully prosecuted Mr Shyam Acharya, for knowingly and recklessly holding out as a medical practitioner in NSW and Health Ministers announced that penalties for claiming to be a registered health practitioner will be toughened.

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Contacting the Board

• The Medical Board of Australia and AHPRA can be contacted by phone on 1300 419 495.
• For more information, see the Medical Board of Australia website and the AHPRA website.
• Lodge an enquiry form through the website under Contact us at the bottom of every web page.
• Mail correspondence can be addressed to: Dr Joanna Flynn AM, Chair, Medical Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

More information

Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.

Comment on the Board newsletter is welcome and should be sent to newsletters@ahpra.gov.au.

For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).

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