March 2018

• Patient consent  
  • When can an employer attend an employee’s medical appointment? 
• Health services for doctors 
  • Health services are available for doctors and medical students 
• Chaperone review  
  • Chaperone recommendations implemented  
• Research on notifications data 
  • Research finds that older doctors have higher notification rates 
• Quarterly registration data released 
  • Latest profession-specific statistics released  
• Accreditation 
  • Providing high quality education and training 
• Alerts 
  • Media statements 
• Medical regulation at work  
  • Latest tribunal decisions have been published online 
• Contacting the Board 

When can an employer attend an employee’s medical appointment?

A recent case of an employer who insisted on attending an employee’s medical appointment highlighted that it is the patient who has the right to decide if a third party (including their employer) can attend their consultation with a doctor. 

It is common for medical students and trainee doctors to observe medical consultations. This is an important part of medical education. The Board has provided guidance on this in Good medical practice: a code of conduct for doctors in Australia and Guidance on clinical observerships. Good medical practice involves informing your patients about the involvement of medical students and obtaining their consent for student participation, while respecting their right to choose not to consent.

Occasionally, employers also seek to attend an employee’s medical appointment. When this occurs, doctors need to ask the patient before the consultation starts, in private and out of hearing of the employer, whether they consent to this. Patients have a right to privacy and to decide when a third party sits in on their medical consultation, whether the employee is seeing their regular doctor or a company doctor.

The Commonwealth Fair Work Ombudsman has given the same advice. It does not condone or support an employer attending an employee’s medical appointment and sees no reason why an employer should seek to attend a private and confidential appointment with an employee, unless the employee specifically asks them to do so.

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Health services are available for doctors and medical students

Doctors and medical students across Australia can access help and support through an expanded network of doctors’ health advisory and referral services. Confidential health advice and support is available in all states and territories by calling:

• New South Wales and the Australian Capital Territory (02) 9437 6552
• Victoria and Tasmania (03) (03) 9280 8712
• South Australia and the Northern Territory (08) 8366 0250
• Queensland (07) 3833 4352
• Western Australia (08) 9321 3098

Visit the drs4drs website to find out more.

The national network of services is coordinated by Doctors’ Health Services Pty Ltd, a wholly-owned subsidiary of the Australian Medical Association (AMA). The confidential health services are funded by the Board but administered at arm’s length from the Board and AHPRA.

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Chaperone recommendations implemented

AHPRA and the Medical Board of Australia have now implemented all the recommendations of the 2017 Independent review of the use of chaperones to protect patients  in Australia.

In March 2017, we committed to making wide-ranging reforms to our management of sexual misconduct cases, as recommended by Professor Ron Paterson in the chaperone review report. Reforms included:

• introducing a national committee backed by specialist investigators to handle all sexual misconduct allegations
• changing the Board’s policy on the use of chaperones, and
• auditing all cases where chaperone conditions have been previously applied.

AHPRA has now implemented the final recommendation and added to the information published on the national online Register of practitioners. The register now includes links from individual practitioner listings to published disciplinary (tribunal and court) decisions when these exist, in line with the report’s recommendations.

Good medical practice is based on a partnership between doctors and their patients, based on trust. This change to the register will give patients access to published information about doctors who have been involved in disciplinary action, so they can make informed decisions about their care.

Read more about changes to the Register of practitioners and progress since the last update in the media release.

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Research finds that older doctors have higher notification rates

Research published in the Journal of Patient Safety and Risk Management on 21 March 2018 looked at whether ‘older doctors’ (defined as aged over 65) are at higher risk of notifications to the medical regulator than doctors aged 36-60 regarding their health, performance and/or conduct.

The researchers used de-identified data on all doctors about whom there had been a complaint to the Medical Board of Australia over a four year period between 1 January 2011 and 31 December 2014. They analysed nearly 13,000 notifications about doctors and found that overall, older doctors had a 37 per cent higher rate of notification than ‘younger’ doctors. The older doctors had a higher risk of notifications relating to physical illness or cognitive decline (incidence rate ratio = 15.54), inadequate record keeping (incidence rate ratio = 1.98), unlawful use or supply of medications (incidence rate ratio = 2.26), substandard certificates/reports (incidence rate ratio = 2.02), inappropriate prescribing (incidence rate ratio = 1.99), disruptive behaviours (incidence rate ratio = 1.37) and substandard treatment (incidence rate ratio = 1.24).

The researchers also found that older doctors were at lower risk for notifications about mental illness or substance misuse (incidence rate ratio = 0.58) and for performance issues with procedures (incidence rate ratio = 0.61).

They conclude that incorporating knowledge of these patterns into regulatory practices, workplace adjustments and continuing education/assessment could enhance patient care.

This research aligns with the findings of the Board’s Expert Advisory Group on Revalidation. The Board’s response, which was to develop a Professional Performance Framework, can be found on the Board’s website at Professional Performance Framework.

The article can be accessed at the Journal of Patient Safety and Risk Management.

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Latest profession-specific statistics released

The Board publishes statistics each quarter profiling the profession. Data are broken down by state and territory, by registration type and for specialists, by specialty and field of specialty.

The latest data have been released and are available on the Board’s website under Statistics on the News page.  

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Providing high quality education and training

The Board has approved the following medical school programs of study.

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Media statements

Register changes improve consumer access to public information – The Board has implemented all the recommendations of the 2017 Independent review of the use of chaperones.

Scheduled review of accreditation assignments ‒ National Boards and AHPRA have started a process to consider accreditation arrangements from mid-2019, when the current term of assignment of accreditation functions ends.   

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Latest tribunal decisions have been published online

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

• a psychiatrist has had his registration suspended after he received a criminal conviction for fraudulently obtaining payments (Medical Board of Australia v Mazumdar).

Publication of panel, court and tribunal decisions

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 Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law¹, 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 National Law.

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

In New South Wales and Queensland, different arrangements are in place. More information is available on AHPRA’s website on the Make a complaint page.

¹The Health Practitioner Regulation National Law, as in force in each state and territory

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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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