December 2022

Update Medical Board of Australia

Chair's message
Medical Board of Australia news
Consultations
News and alerts
- Ahpra warns clinics over unproven IV treatments
Medical regulation at work
- Latest tribunal decisions published
Contacting the Board

Chair's message

Recent months have given all of us good reason to pay attention to the use of data stored about us. Ahpra is now updating the rules around the responsible use of practitioners' data, for patient safety. I encourage you to help shape Ahpra's data strategy, which sets the framework for the regulatory use of data, including what is published about you on the public register. The consultation is open until 31 January 2023. Thank you for the care you have given to patients and your contribution to our health system in yet another challenging year. I wish you a safe and restful festive season.

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

Mandatory reporting

Treating medical students with health concerns

A third-year medical student consults you. She has been feeling anxious about her upcoming exams and is having difficulty concentrating and sleeping.

A first-year medical student has been feeling teary and has had some thoughts of self-harm. He is seeking your help.

In these fictional examples, the students have health conditions that need to be managed. Although these conditions may impact on their academic studies, they will not put the public at risk.

We are disturbed to hear from the Medical Deans Student Support Network that some doctors and other health practitioners are advising students that a possible consequence of consulting a health practitioner is a mandatory report under the National Law. We are told that this is deterring students from seeking medical care.

The advice is simply not true, and there can be serious consequences for the health of students who do not seek help out of fear of being reported.

For students, there is only one ground for a mandatory report. Practitioners and education providers only need to notify us when they have a 'reasonable belief' that a student has an impairment that, when they are doing clinical training, may place the public at substantial risk of harm.

This is a very high threshold. It will not be reached by a student with anxiety, depression, diabetes, an eating disorder and most other health conditions.

It is very important to remember that:

health practitioner students must be given accurate information and be cared for to the same standard that we care for all our patients
the threshold for reporting students is different to reporting practitioners. Students do clinical placements under supervision and don't have primary responsibility for patients
the threshold for reporting is very, very high
a health condition is not the same as an impairment.

Before you report a student, we encourage you to call us on 1300 419 495 to discuss this (anonymously if you want) or speak with your indemnity insurer.

Mandatory reporting is designed to protect the public. There is little risk of harm to the public from students, which is why the reporting threshold is so high. Unnecessary reporting can cause harm to individuals. It is much better for individual students – and for the future and culture of our profession – to get care, so their health condition is managed well and does not lead to actual impairment.

More information is in the Guidelines: Mandatory notifications about registered students on the Medical Board website.

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Annual report published

Latest data shows regulation at work

During the last year of the pandemic, there was an upward trend in complaints about doctors in Australia according to the latest annual report of Ahpra and the national health practitioner boards, now published.

The annual report is a comprehensive record of the National Registration and Accreditation Scheme for the 12 months to 30 June 2022.

The number of complaints about doctors went up. The increase in the number of notifications mainly related to notifications about COVID-19 and to a lesser extent, cosmetic surgery.

2022 was another year of intense pressure for health practitioners and systems in Australia. The National Scheme responded to the changing phases of the pandemic, workforce needs and emerging models of healthcare delivery, while supporting health practitioners in their professional practice through ongoing policy and standards work.

A medicine-specific snapshot and data tables are also published.

Highlights include:

More health practitioners: There are 852,272 registered health practitioners across 16 regulated professions.
More registered doctors: There are more registered medical practitioners, who make up 15.5% of all health practitioners registered nationally (131,953 individual registered medical practitioners in 2021/22; up from 129,066 in 2020/21).
More complaints about medical practitioners: There were 6,176 notifications to Ahpra about 4,652 medical practitioners (12% increase). There were 8,146 registered medical practitioners Australia-wide who had notifications made about them (including to Ahpra, the Health Professional Councils Authority (NSW) and the Office of the Health Ombudsman (Queensland)).
Of 5,874 medical matters closed in 2021/22, 41.8% led to further regulatory action. In 5.5% of closed matters, the Medical Board accepted an undertaking from the practitioner or imposed conditions on the practitioner's registration; 3.6% received a caution or reprimand; in 0.8% registration was surrendered, suspended or cancelled. The other 31.9% were referred to another body or retained by a health complaints entity.
In 58.2% of matters, the Board took no further regulatory action: The Board takes no further action when, based on the available information, there is no risk to the public that needs to be managed.
Referrals to an adjudication body: The Board refers the most serious allegations to tribunals. In 2021/22, 92 matters were decided by a tribunal and 1 matter was decided by a panel.
339 mandatory notifications were made about doctors: 127 were about professional standards.
Criminal offences by medical practitioners: 130 new complaints were made relating to possible criminal offences by medical practitioners. Almost 68% of these related to title and practice protection and 29% to advertising breaches.
Immediate action was taken 344 times about doctors: 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 2021/22 Annual report, along with supplementary tables that provide data about registrations, notifications, criminal offence complaints, tribunals and appeals, and monitoring and compliance, is available on the Annual report page of the Ahpra website.

The medicine-specific snapshot and data tables are on the Medical Board website.

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Cosmetic surgery

Who sets the standard for cosmetic surgery endorsement?

There are a lot of questions about which qualifications will meet the standard for cosmetic surgery endorsement and who gets to decide.

The answers will flow from a process now underway. The process is rigorous, standards based and consultative. The outcomes (and the answers to these important questions) will emerge as cosmetic surgery training programs are assessed. Some programs will meet the standard and its graduates will be eligible for endorsement. Some may not.

Establishing an endorsement for cosmetic surgery will help consumers know who is trained and qualified to perform cosmetic surgery safely. It will also make it clear on the public register if a doctor has met cosmetic surgery standards set by the Australian Medical Council (AMC) and the Medical Board of Australia.

Creating an endorsement is part of a program of reform in cosmetic surgery, which includes higher professional standards, tougher advertising requirements and new registration requirements.

There are two planks in the platform for endorsement for cosmetic surgery:

Medical Board of Australia (MBA) registration standard
Australian Medical Council (AMC) accreditation standards, including graduate outcome/capability statements.

The MBA registration standard defines what a doctor applying for endorsement needs to do to gain and keep their endorsement. The registration standard is the regulatory tool that makes it possible to identify who is trained and qualified to do cosmetic surgery safely.

AMC accreditation standards set the standards for programs of study and will determine which qualifications are approved for endorsement. AMC graduate outcome/capability statements are part of the standards. They define the knowledge, skills and professional behaviours and attributes that graduates of an accredited cosmetic surgery program will be able to demonstrate.

When AMC accreditation standards and graduate outcome/capability statements are in place, education providers will be able to apply to the AMC to have their cosmetic surgery program assessed and accredited.

Graduates of accredited programs of study (from a specified date), will be eligible to apply to the Medical Board for endorsement in cosmetic surgery. Endorsement in cosmetic surgery will clearly show on the public register if a doctor has met cosmetic surgery standards.

About the registration standard

Who: Developed by the Medical Board of Australia, approved by Australia's Health Ministers.
What: Legal requirement, that sets the requirements for eligibility for endorsement – for application and ongoing. (See section 98 of the National Law, where the requirements for area of practice endorsements are specified.)
When: Medical Board consultation closed on 11 December 2022. The proposed new registration standard, informed by the consultation, will go to Australia's Health Ministers in February 2023 for approval.
Where: Find out more on the Medical Board consultations page.
Why: To make cosmetic surgery safer, by making it clear to patients who is trained and qualified.

About the AMC cosmetic surgery accreditation standards for cosmetic surgery programs

Who: Developed by the AMC, on advice from an AMC Cosmetic Surgery Accreditation Standards and Procedures Project Advisory Group to include: accreditation and regulation experts, the Royal Australasian College of Surgeons (RACS), plastic surgeons, cosmetic practitioners, related disciplines, educators, and consumers. The accreditation standard will be approved by the Medical Board of Australia.
What: Legal requirement. Sets the standards for accreditation of cosmetic surgery programs for endorsement.
When: Work is underway.
Where: Find out more about AMC accreditation on the AMC website.
Why: To make cosmetic surgery safer, by setting standards in cosmetic surgery education and training.

About the AMC cosmetic surgery graduate outcome/capability statements for cosmetic surgery programs

Who: Set by the AMC, on advice from a Technical Advisory Group (expert advisors on the development of the statements) to include medical educationalists, surgical educators and clinicians, and members with education and training expertise from related disciplines. The graduate outcomes will be approved by the Medical Board of Australia.
What: Form part of the legal requirement for accreditation standards. Set the knowledge, skills and professional behaviour requirements for graduates of accredited cosmetic surgery programs.
When: Work is underway.
Where: Find out more about AMC graduate outcomes on the AMC website.
Why: To make cosmetic surgery safer, by setting specific requirements for graduates of accredited cosmetic surgery programs.

When the cosmetic surgery registration standard, accreditation standard and graduate outcomes are in place

Cosmetic surgery education providers will be able to apply to the AMC to have their cosmetic surgery program assessed and accredited for endorsement.
The Medical Board will approve and publish a list of approved qualifications for endorsement, based on advice from the AMC.
Graduates of accredited cosmetic surgery programs will have recognised qualifications.
Doctors with an approved qualification and who meet the other requirements in the registration standard, will be eligible to apply for a cosmetic surgery endorsement. If granted, endorsement will be published on the public register.
There will be a simple and quick administrative process for eligible doctors to apply for an endorsement on their registration. There will be an application form available when the accreditation standards are in place and there are approved qualification(s).

There is more information on the Cosmetic surgery hub on the Ahpra website.

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Medical Board vacancy

Are you interested in joining the Northern Territory Medical Board?

Applications are open to fill one practitioner member vacancy on the Northern Territory Board of the Medical Board of Australia.

Applications close Sunday 22 January 2023. More information is on Ahpra's Statutory appointments vacancies page.

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Quarterly registration data

Latest registration data published

The Board publishes data 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 practice. The latest report is available on our website under Statistics on the News page.

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Consultations

Consultation on Guidelines for telehealth consultations with patients

Telehealth changed dramatically during the pandemic. It became widely used and well accepted by patients and doctors across Australia. We're proposing changes to the Board's telehealth guidelines to better support doctors to provide these consultations safely.

The draft guidelines merge and update the existing Guidelines for technology-based consultations and an Information sheet – Inter-jurisdictional technology-based patient consultations. We hope they make clearer our expectations of doctors in telehealth consultations with patients.

Let us know what you think. We want to hear from practitioners, businesses and patients to make sure the guidelines are practical, sensible, helpful and clear.

The consultation closes on 17 February 2023 and the consultation paper is available on the Board's Current consultations page.

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Changes to intern requirements in 2024

Tell us what you think about proposed updates to the registration standard that defines what interns need to do to be eligible for general registration. The updates reflect the Australian Medical Council's National Framework for Prevocational (PGY1 and PGY2) Medical Training (the AMC Framework), which will take effect from 2024.

The changes remove mandatory terms in medicine, surgery and emergency medical care and replace them with terms that include experience in:

undifferentiated illness patient care
chronic illness patient care
acute and critical illness patient care, and
peri-procedural patient care.

They apply only to PGY1.

Email your submission, marked 'Public consultation on a revised standard – Granting general registration to Australian and New Zealand medical gradutes on completion of intern training', to medboardconsultation@ahpra.gov.au.

We generally publish submissions received, with some exceptions. Please see the consultation paper for details.

The consultation closes on 25 January 2023. The consultation paper and more information is available on the Board's Current consultations page.

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How should Ahpra use the data it holds about you?

Should Ahpra collect and publish more information about you and your practice on the public register?

How much of a practitioner's disciplinary history should appear on the public register?

Ahpra is updating its data-strategy, and your feedback on these questions will inform our approach.

Ahpra's data strategy sets the rules for the data it collects, stores and uses. The data strategy affects all registered health practitioners in Australia and guides what data we share and publish, including on the public register of health practitioners.

To help protect the public, improve access to health services and contribute to patient safety for Aboriginal and Torres Strait Islander Peoples, Ahpra is exploring sharing some of the data held, always maintaining privacy and confidentiality and within the law.

To help make our regulatory work more efficient and effective and streamline practitioners' interactions with us, we're looking at using new data technologies ethically and safely.

We want to hear from you about how we can share, or receive data, to benefit health practitioners and the public.

The consultation is open until 31 January 2023. To learn more or to make a submission, read the consultation paper and information for practitioners on the Ahpra website.

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News and alerts

Ahpra warns clinics over unproven IV treatments

Ahpra has put sections of the wellness industry on notice over concerns that unproven intravenous infusion treatments may be being marketed inappropriately. The warning covers popular IV treatment claims that are not supported by a medical justification or scientific evidence.

Ahpra has written to several businesses warning their advertising of IV infusion treatments may be in breach of the National Law, which prohibits material that makes misleading or unfounded claims.

Clinics charging hundreds of dollars for cocktails promising everything from boosting immunity, clearer thinking, beauty, right through to anti-aging, need to be honest with their clients about the lack of scientific evidence supporting their infusion services.

Patients also need to be aware of infection and other risks which come with all medical treatments. Clinical interventions should only be provided when necessary.

IV infusions are an invasive procedure with inherent health and safety risks for patients.

Under Australia's National Law, anyone advertising a regulated health service must ensure their advertising does not include false, misleading or deceptive information, does not use testimonials, and does not create an unreasonable expectation of beneficial treatment.

Advertising that encourages the indiscriminate or unnecessary use of regulated health services is banned.

Anyone with concerns can contact Ahpra on 1300 419 495 or at the Ahpra website. More information is available in the news item on the Ahpra website.

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Medical regulation at work

Latest tribunal decisions published

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

a Western Australian general practitioner received a 25 year practice ban and had his registration cancelled for sexual misconduct and poor performance (Medical Board of Australia and Lagrange)
a tribunal has upheld the Board's decision to again refuse registration to a former Tasmanian doctor who was convicted for possessing child exploitation material in 2011 (Buddle v Medical Board of Australia).

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 Concerned about a practitioner? 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.

Comments on the Board newsletter are welcome, send your feedback and suggestions 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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