Cognitive tests flagged for doctors over 70


By Tessa Hoffman

30 Nov 2017

Doctors will need to meet stricter CPD requirements and undergo health checks after their 70th birthday in order to meet registration requirements, under the Medical Board’s proposed new revalidation scheme.

Unveiled this week, the “professional performance framework” that will apply to some 111,000 registered doctors aims to protect the public from unsafe care while being supportive not punitive, the board has said.

It has also tossed out the name “revalidation” – a term used in the UK – on advice from its expert committee which warns this name may confuse and does not describe the system developed for Australia.

A system for competency checks has been on the cards for some time, after the board estimated that approximately six per cent of medical practitioners are poorly performing at any one time.

“No Australian research has yet reliably identified how many medical practitioners in Australia fall into this category and future Australia-specific research should ratify this number,” the model’s architect, the expert committee on revalidation, said in its final report released this week (read full report here).

The toughest element requires doctors aged 70 or above to undertake a confidential health check – including cognitive screening and formal managed performance review process with feedback – every three years.

With around 6500 doctors in this age bracket there is “increasing evidence” the checks are needed to protect the public from identifying doctors at risk of undetected poor performance.

However, it concedes there may be “insurmountable legal obstacles” preventing the reform.

An overhaul of CPD will see doctors required to do a mandatory minimum of 50 hours CPD activities of which 25% must be performance-based (eg multi-source feedback) and 25% must measure patient outcomes.

Doctors will need to nominate a CPD program as their ‘CPD Home’, prepare a CPD plan and complete CPD for every specialty they are registered in.

There will be new requirements for other at-risk groups – doctors working in isolation and those who have multiple substantiated complaints against them.

Medical Board chair Dr Joanna Flynn said the changes will not come in overnight.

“We will be consulting widely and seeking expert advice on many elements of the framework.”

AMA president Dr Michael Gannon told the limbic the board has “got it about right”.

“Certainly we had great concerns when they started talking about a UK-style model of revalidation,” he said.

“We would have strongly resisted anything like a conversation on mandatory retirement but we think that instituting health checks and more frequent certification for doctors over 70 is a recognition of the fact that some abilities do diminish with time.”

Dr Gannon said the model is broadly consistent with current requirements for college fellows while strengthening requirements for doctors not pursuing specialisation.

However the AMA is concerned over suggestions the Medical Board may be given powers to directly access information about doctors’ health or complaints history from their medical defence organisation.

A timeline for rollout has not been released, but Dr Gannon said he expects it to be in place when doctors are required to register with AHPRA next year.

However, the RACGP says it is concerned that mandatory health checks could lead to “discriminatory profiling” of older doctors.

“This proposal requires further explanation,” college president Dr Bastian Seidel said.

“Our members dedicate their lives to general practice and the Australian community and do not deserve to be subjected to any form of discriminatory screening.”

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