4 options for mandatory reporting overhaul


By Tessa Hoffman

3 Oct 2017

Options to toss out, keep or tweak rules which force treating doctors to report an impaired peer have been handed to the medical community for comment.

The options paper comes after health ministers in August agreed that doctors should be able to seek treatment for health issues with confidentiality, but stressed the public must still be protected.

Lobbying by the medical profession for a universal ‘WA-style’ exemption has intensified in the wake of a spate of doctors’ suicides, with proponents arguing those needing help are not getting it for fear of being hauled in front of the health regulator.

The AMA highlights the 153 suicide deaths of health professionals between 2011 and 2014 recorded by the Australian National Coronial Information System.

A discussion paper outlining the four options for reform was released by Australian Health Ministers Advisory Council in early September.

Option 1 maintains the status quo, with treating doctors obligated to report all impairments and notifiable conduct – such as sexual misconduct – that place the public at ‘substantial risk’ of harm – including incidents that occurred in the past.

Option 2 adopts the Western Australian model, giving doctors full exemption from the requirement to report any impairment or notifiable conduct they became aware of through treating their patient. However the paper notes  confidentiality is not absolute and “there are a range of circumstances, particularly in relation to protecting the public from serious threats of harm, where confidentiality is not, and should not be, guaranteed”.

Under option 3, doctors are exempt from reporting impairments if they form the belief it will not put the public at risk of substantial harm now or in the future. They are still required to report other notifiable conduct, such as sexual misconduct or practising while intoxicated, including historical incidents.

Option 4 is a softer version of option 3, where doctors are exempt from reporting impairments and must only report other notifiable conduct that is currently occurring, not that which is historical.

The options paper was open for consultation during September.

The AMA is backing option 2.

President Dr Michael Gannon said Australia needs a model that will enable doctors to seek help for mental health and stress related concerns without fear of impact on their registration.

A study of more than 12,000 doctors by Beyondblue in 2013 revealed that 34.3 per cent cited concerns about their medical registration as a barrier to seeking treatment for a mental health condition.

“The AMA believes the current model in WA is the right one. It is a proven model. It has given doctors the confidence to seek the help they need and there is no evidence that it has diminished patient safety in any way.

“It is also a model that was recommended in the Independent Review of the National Registration and Accreditation Scheme, a Senate report, and a number of academic studies.

“It in no way stops the medical profession’s ethical and professional responsibilities to report a practitioner who may be placing the public at risk.”

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