November 2018

• Chair's message
• Medical Board of Australia news 
• Board appointments 
  • Ministers appoint new Medical Board 
• Guidelines 
  • Revised sexual boundaries guidelines: Trust — the cornerstone of good medical practice 
• Annual report published 
  • 2017/18 annual report now available 
• Quarterly registration data published 
  • Latest profession-specific statistics published 
• Accreditation 
  • Providing high quality education and training 
• Medical regulation at work 
  • Latest tribunal decisions have been published online 
• Contacting the Board

We now have a substantially different Medical Board, having farewelled five long-standing members and welcomed five new members who will bring new perspectives to our work. It will be regulatory evolution, not revolution, in the years ahead. We have very strong foundations and a clear regulatory direction set by the Professional Performance Framework. We can now fine-tune our approach to better support the vast majority of doctors who provide excellent care to their patients and respond effectively to the small number of practitioners whose behaviour puts patients at risk. We will work with the profession and the community to strengthen the mutual trust and respect that are the cornerstones of medical practice and medical regulation. Under the leadership of Dr Joanna Flynn AM, the previous Board created strong foundations on which we will build. We salute the retiring members for their wisdom and hard work. As Chair, I look forward to engaging with the profession, the community and other stakeholders on our important task of regulating the medical profession, in the public interest.

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

Ministers appoint new Medical Board

Australia’s Health Ministers have appointed members to the Medical Board of Australia. Seven members were reappointed and five new members were appointed.

Dr Anne Tonkin, former Chair of the South Australian Board and existing National Board member, has been appointed Chair of the Medical Board of Australia.

The following new members have been appointed to the Medical Board of Australia:

• Dr Kerrie Bradbury, practitioner member and Chair of the Australian Capital Territory Board of the Medical Board of Australia
• Professor Richard Doherty, practitioner member, Victoria
• Ms Eileen Jerga AM, community member, Australian Capital Territory
• Dr Hannah McGlade, community member, Western Australia
• Dr Andrew Mulcahy, practitioner member and Chair of the Tasmanian Board of the Medical Board of Australia.

The following members have been reappointed to the Medical Board of Australia:

• Associate Professor Stephen Adelstein, practitioner member and Chair of the New South Wales Board of the Medical Board of Australia
• Mr Mark Bodycoat, community member, South Australia
• Dr Samuel Goodwin, practitioner member, Northern Territory
• Professor Con Michael AO, practitioner member and Chair of the Western Australian Board of the Medical Board of Australia
• Dr Susan O’Dwyer, practitioner member and Chair of the Queensland Board of the Medical Board of Australia
• Ms Michelle Wright, community member, Victoria.

Terms are for three years and existing members can apply for reappointment. Read more about the members of the Medical Board of Australia on the website.

A full list of appointments for all the National Boards is available in the COAG Health Council Communiqué.

The Board thanks recently retired members Dr Joanna Flynn AM (former Chair), Professor Belinda Bennett, Associate Professor Stephen Bradshaw AM, Ms Prudence Ford and Dr Fiona Joske for their enormous contribution.

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Revised sexual boundaries guidelines: Trust — the cornerstone of good medical practice

Sexual misconduct is an abuse of the doctor-patient relationship and can cause significant and lasting harm to patients.

Revised guidelines on Sexual boundaries in the doctor-patient relationship will take effect on 12 December 2018 and remind doctors that trust in the relationship between doctors and patients is a cornerstone of good medical practice.

The updated guidelines apply to all registered medical practitioners in Australia and define the standards of ethical and professional conduct expected of doctors by the Board, their peers and the community. They complement Good medical practice: a code of conduct for doctors in Australia and do not change the ethical and professional conduct expected of doctors.

Patients have a right to feel safe when they are consulting a doctor. They trust doctors to act in their best interests, treat them professionally, protect their privacy and never take advantage of them.

Breaches of sexual boundaries in the doctor-patient relationship are one reason the Board refers doctors to tribunals for disciplinary action. In 2017/18, 10 cases involving allegations of serious sexual misconduct were decided by tribunals – all received an adverse finding.

The vast majority of doctors in Australia provide the community with excellent medical care. However, a small number of doctors cause serious harm to patients when they do not maintain sexual boundaries.

The revised guidelines replace the current guidelines, Sexual boundaries: guidelines for doctors. They follow a scheduled review, supported by wide-ranging stakeholder consultation.

The guidelines remind doctors that:

• it is never appropriate for a doctor to engage in a sexual relationship with a current patient
• a doctor must only conduct a physical examination of a patient when it is clinically indicated and with the patient’s informed consent
• good, clear communication is the most effective way to avoid misunderstandings in the doctor-patient relationship, and
• doctors are responsible for maintaining professional boundaries in the doctor-patient relationship.

The key changes to the guidelines include:

• a change in the title to make the scope of the guidelines clearer
• editorial updates that reorder the content, make it easier to read and clarify terms and definitions
• a new section on social media that complements the Board’s Social media policy
• a requirement for patient consent if medical students or anyone else is to be present during an examination or consultation
• advice that an unwarranted physical examination may constitute sexual assault. This includes conducting or allowing others, such as students, to conduct examinations on anaesthetised patients, when the patient has not given explicit consent
• replacing the term ‘chaperone’ with the term ‘observer’. The revised section on the use of observers reflects the advice and principles in Professor Ron Paterson’s report of the Independent review of the use of chaperones to protect patients in Australia, February 2017.

Read the revised guidelines and watch the Board’s video: It’s all about trust.

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2017/18 annual report now available

The 2017/18 annual report of AHPRA and the national health practitioner boards has been published.

The annual report is a comprehensive record of the National Registration and Accreditation Scheme for the 12 months ending 30 June 2018.

During the year, the Medical Board re-examined how it triages and responds to complaints so regulatory effort is targeted and proportionate. It also explored ways to make sure that all doctors in Australia keep their knowledge and skills up to date and announced its Professional Performance Framework.

These changes are being progressively applied to improve our work.

Other highlights include:

• More registered doctors: Medical practitioners made up 16.4% of all health practitioners registered nationally (115,113 individual registered medical practitioners in 2017/18; up from 111,166 in 2016/17).

• Medical students on the register: On 30 June 2018, there were 20,272 medical students, an increase of 1.1% from 2016/17.

• Complaints received about medical practitioners: There were 3,749 notifications (complaints or concerns) lodged with AHPRA about medical practitioners in 2017/18.

• Of 3,703 matters closed in 2017/18, less than 20% led to further regulatory action. 7.8% of matters closed resulted in the Board accepting an undertaking or conditions being imposed on the practitioners’ registration; 6.7% resulted in a caution or reprimand; 1.0% resulted in cancellation or suspension of registration.

• In 80.2% of matters, no further regulatory action was taken: The Board takes no further action when, based on the available information, there is no risk to the public that needs to be managed.

• 255 mandatory notifications were made, the majority (188) were about standards, 43 were about impairment.

• Statutory offences by medical practitioners: 176 new complaints were made this year relating to possible statutory offences by medical practitioners. Almost two-thirds of these related to title and practice protection. AHPRA and the Board closed 191 statutory offence matters in 2017/18.

• Immediate action was taken 148 times: The Board takes immediate action to restrict or suspend the registration of a medical practitioner as an interim measure to protect the public while notifications are being investigated.

The 2017/18 annual report, along with supplementary tables that provide data about registrations, notifications, statutory offences, tribunals and appeals, and monitoring and compliance, is available on the annual report page of the AHPRA website.

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Latest profession-specific statistics published

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

The latest data 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:

Specialist college programs of study

Medical school programs of study

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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. These cases were published recently:

• The Tasmanian Health Practitioners Tribunal has reprimanded a medical practitioner for purchasing pharmaceutical products in breach of conditions on his registration (Medical Board of Australia v Tucker).
• The Victorian Civil and Administrative Tribunal has reprimanded a junior doctor and imposed conditions for prescribing testosterone and growth hormone without clinical justification (Medical Board of Australia v Abi Hailer).

Publication of panel, court and tribunal decisions

AHPRA, on behalf of the 15 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.

¹ The 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 Anne Tonkin, 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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