October 2019

• Chair's message 
• Medical Board of Australia news
• Medical training survey
  • Building an evidence base for cultural change
• Doctors’ obligations
  • Your obligations to let us know … 
• Progress in managing notifications 
  • Working together: updating our stakeholders
• Registration renewal for 2019-20
  • Most doctors renewed on time
• Northern Territory Medical Board
  • Thank you to the outgoing Chair
• Board vacancies
  • Do you want to be on a state medical board?
• Consultations
  • Tell us what you think about four issues we are consulting on now
  • Consultation closing soon: Guidelines for medical practitioners in relation to blood-borne viruses
  • Consultation on Guidelines for mandatory notifications
  • Consultation on Guidelines for advertising regulated health services
  • Consultation on a Supervised practice framework
• Medical regulation at work
  • Latest tribunal decisions published
• Contacting the Board

Huge thanks to the 10,000 doctors in training who did the Medical Training Survey. The survey gave trainees a collective voice, and the results will give the rest of us an opportunity to listen and act on what they say. Survey results will be out in early 2020.

Working together with our stakeholders on the Medical Training Survey has been wonderful. With trust and goodwill, we have together built something more robust than any of us could have made alone. My sincere thanks to all the members of our steering committee and advisory group, who shared their expertise and experience so openly. And special thanks to our small advisory group of doctors in training – with your vision, enthusiasm and commitment, the future of medicine is bright.

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

Building an evidence base for cultural change

Close to 10,000 doctors in training took part in the first Medical Training Survey, which has now closed.

Thanks to every doctor in training who participated – 27 per cent of all doctors in training took the time to share their feedback, which will build the first national, comprehensive picture of medical training in Australia.

We’ll be analysing the data in the months ahead and publishing the survey results in early 2020. As promised, we will prioritise confidentiality and will only publish results with 10 or more responses.

Based on participation rates, we expect to be able to report by state and territory, specialist medical college and type of doctor in training – interns, prevocational and unaccredited trainees, specialist trainees and international medical graduates. Individual hospital level reporting will be possible where there were more than 10 responses for that hospital. We expect this level of detail to build year on year.

The results of the survey will help us to better understand the strengths and weaknesses in medical training across Australia. They will help build an evidence base that we can learn from to improve the culture of medicine. The survey has given trainees a collective voice that we should listen to and act on. Survey results will start to tell an important story about the culture and quality of training, and trigger ideas and discussion of what we can all do to improve it.

Working with our stakeholders to develop and implement the Medical Training Survey has been a highlight of the last two years. Through genuine collaboration and a strong shared commitment, together we developed a robust survey that has the support of a wide range of agencies. The incredible efforts of our partners to raise awareness and promote the survey significantly improved participation rates.

A huge thanks from the Board to every doctor in training who took the time to do the survey, to all our partners across the sector who supported it and to the members of our Medical Training Survey advisory group and steering committee who contributed so much. Stay tuned for survey results in 2020.

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Your obligations to let us know …

Did you know that you have to tell the Board when certain events happen? Some are administrative, so we can contact you, and some may indicate a change to your risk profile, when we need to consider if any changes to your registration are needed.

You are obliged to tell us within seven days if:

• you have been charged or convicted of certain offences
• you no longer have professional indemnity insurance
• your right to practise at a facility, your Medicare billing rights or your prescribing rights are withdrawn or restricted
• your medical registration in another country is restricted, suspended or cancelled, or
• a complaint is made about you to certain organisations such as Medicare, a health department or the Department of Home Affairs.

You must also tell us within 30 days about any changes to your:

• principal place of practice
• contact address, and
• name.

A full list of the ‘relevant events’ that you are obliged to tell us about is included in the Notice of certain events form published on the AHPRA website.

To inform us of a relevant event, complete the Notice of certain events form.

To update your address and contact details log into your AHPRA account or if the change of personal details includes a name change, use the Request for change of personal details form on the common forms page.

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Working together: updating our stakeholders

We had our regular annual meeting with the Australian Medical Association (AMA) on 20 August 2019. These meetings help keep us in touch with the current issues of the profession and give us the chance to update medical practitioners on what we are doing to improve our regulatory performance, especially in managing notifications. At our recent meeting, we also focused on what we are doing to make the notification process less difficult for the people in it, options to work together to make the new mandatory reporting laws clearer to doctors and our work on dealing with complaints about sexual boundaries.

The headline is that notifications (complaints) to regulators about doctors are increasing, but we are keeping pace and getting better at managing them in a more timely way. Read about this work in the Medical Board, AHPRA and AMA joint communiqué. There is of course always more we can do to improve, but we are pleased that some of the things we are doing differently appear to be delivering results. Here is an outline of some of our work:

• National Assessment Committee – our national committee meets up to six times each week with Medical Board members from all states and territories. The committee considers all notifications soon after they are received and quickly closes all matters that do not require further action. The medical practitioner about whom a notification has been made first learns about it when the matter has been closed.
• Medical clinical advisors – AHPRA has employed 14 part-time clinical advisors. These medical practitioners, from a range of specialties, screen every notification to identify and stratify clinical risk.
• Case conferencing – this brings the knowledge and expertise of senior staff across disciplines, including clinical advisors, to investigations.
• Sexual Boundaries Notifications Committee – this committee handles all notifications alleging a breach of sexual boundaries. Highly trained board members from across Australia meet ‘virtually’, once or twice each week, to manage an increasing volume of notifications of this kind. We received 48 per cent more notifications about boundary issues in 2018/19 than the year before.
• Risk assessment – AHPRA has developed a framework to assess the risk of notifications in a systematic way based on the characteristics of the notification, the practitioner, the practitioner’s setting and their practice.
• Mandatory reporting – the law about mandatory reporting has recently changed and we are working with partners across the profession on ways to communicate what doctors need to report and when.
• Vexatious notifications – after research, the evidence shows there are few truly vexatious notifications. Many notifications that are perceived to be vexatious are actually misconceived or without substance. We recognise that anyone who feels a notification is vexatious is likely to feel more stressed and have trained our staff to better identify and manage these types of complaints.

We are pleased to be improving our processes but recognise that there is still work to do. We need to reduce timeframes, reduce practitioners’ stress and help notifiers make their complaints to the right agency. Receiving a complaint about your practice is likely to become more common with the increase in notifications being made. While we improve our processes, we are also keen to work with our partners across the health sector to help reduce practitioners’ anxiety about complaints and increase knowledge of the likelihood of being the subject of a complaint.

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Most doctors renewed on time

We are pleased to report that 94 per cent of medical practitioners submitted their renewal of registration on time, and of these, 99.1 per cent renewed online.

Medical practitioners with general, specialist and non-practising registration were due to renew their registration by 30 September 2019. If you meant to renew and still haven’t, you can renew in October, but a late fee applies.

Under the National Law, practitioners who do not renew their registration within one month of their registration expiry date must be removed from the national register of practitioners. Their registration will lapse and they will not be able to practise medicine in Australia until a new application for registration is approved. This could take time.

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Thank you to the outgoing Chair

Dr Charles Kilburn has finished his term as Chair of the Northern Territory Board of the Medical Board of Australia. Dr Kilburn, a paediatrician, has been involved in medical regulation for more than 20 years and has been the Chair of the NT medical board since 2002, leading the board through the transition to the National Scheme. He was also a member of the National Board from 2010 to 2015. The Medical Board of Australia thanks him for his dedication, commitment and significant contribution to medical regulation in Australia over his long career.

Dr Hemanshu ‘Hemi’ Patel, an otolaryngologist, has been appointed as Chair of the NT Board. He is an experienced board member with experience in both the clinical setting and medical regulation. The Medical Board welcomes him to his new role.

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Do you want to be on a state or territory medical board?

Applications are invited from medical practitioners and members of the community to fill vacancies on three state medical boards.

New South Wales medical board:

• Chair
• 2 practitioner members
• 1 community member

South Australia medical board:

• 4 practitioner members
• 1 community member

Tasmania medical board:

• Chair
• 7 practitioner members
• 2 community members

Applications close Friday 29 November 2019. Further information is available on the Statutory appointments page.

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Tell us what you think about four issues we are consulting on now

Consultation closing soon: Guidelines for medical practitioners in relation to blood-borne viruses

This consultation closes soon.

All registered health practitioners who perform exposure-prone procedures, or who are living with a blood- borne virus need to comply with the Communicable Diseases Network Australia (CDNA) guidelines. These draft guidelines for medical practitioners in relation to blood-borne viruses support compliance with the CDNA guidelines.

We welcome your feedback. The consultation closes on 1 November 2019 and is available on the current consultations page.

Consultation on Guidelines for mandatory notifications

Governments have recently changed mandatory reporting laws. Our guidelines aim to give you clear and straightforward advice about what you have to report to us, and when.

We are keen to hear what you think. The consultation closes on 6 November 2019 and is available on the current consultations page.

Consultation on Guidelines for advertising regulated health services

These guidelines aim to help advertisers understand their obligations, so they can advertise responsibly. They apply to anyone who advertises a regulated health service or business, including registered health practitioners and businesses.

We welcome your feedback. The consultation closes on 26 November 2019 and is available on the current consultations page.

Consultation on a Supervised practice framework

Our proposed Supervised practice framework would apply to supervised practice for practitioners returning to practice and as part of the notification process, but not to international medical graduates or interns. It includes draft fact sheets on supervision levels, and information for supervisors and those being supervised.

The consultation closes on 17 December 2019 and is available on the current consultations page. We welcome your feedback.

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Latest tribunal decisions

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 State Administrative Tribunal of Western Australia has reprimanded a general practitioner and imposed conditions on his registration for practising without appropriate professional indemnity insurance (Medical Board of Australia and Bhamjee)
• the State Administrative Tribunal of Western Australia has reprimanded and fined a urologist for his failings in the treatment of a patient with bladder cancer and for failing to inform the Board that his accreditation to practise at a health service was suspended (Medical Board of Australia and Stephens)
• the Queensland Civil and Administrative Tribunal has cautioned a psychiatrist in relation to his diagnosis and treatment of patients with attention deficit hyperactivity disorder (ADHD) (Medical Board of Australia v Bird)
• the ACT Civil and Administrative Tribunal imposed conditions on a general practitioner’s registration in relation to informed consent for a circumcision and the follow-up care of the patient (Al-Naser v Medical Board of Australia)
• the ACT Civil and Administrative Tribunal has made adverse findings about a general practitioner following his inadequate care of a patient at a beauty clinic (Medical Board of Australia v Al-Naser).

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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 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 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 not to 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 Raise a concern page.

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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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