By Jill O’Meara, Principal Communications, Medical Council of NSW - NSW Heath Professional Councils Authority
DON’T LET FEAR OF MANDATORY NOTIFICATION RUIN YOUR HEALTH
Mandatory reporting is rare and it’s rarely career-ending
After laying a strong groundwork in last year’s budget and reaching an important agreement at the December 2023 National Cabinet meeting, this budget is a lost opportunity to make further progress in addressing key health system challenges, including greater funding and support for patients to access care in general practice.
SHAME, A CULTURE OF INVINCIBILITY
and the difficulty a doctor can have in separating their professional identity from their whole self, can stop them getting help and treatment early on. This can negatively impact a doctor’s care for their patients but also mean, their own health can be put at risk.
But perhaps the most worrying barrier in the way of a medical practitioner or student getting support when they become unwell is fear of a mandatory notification to the Australian Health Practitioner Regulatory Authority (Ahpra).
This is of deep concern to the Medical Council of NSW, because it means a doctor or medical student
may suffer in silence and potentially become more unwell because of a delay in accessing the support and care they need and are entitled to.
In this article we explain the high bar required for a mandatory notification, what happens if you receive one if you practise in NSW, and why it’s rarely career ending.
FEAR FACTOR IN MANDATORY NOTIFICATION
According to the Medical Council’s medical director, Dr Penelope Elix, there is still a prevalent and unfortunate myth attached to mandatory notifications. She suggests that some in the profession continue to think that a treating
doctor will automatically report their practitioner-patient to Ahpra.
“There is still a view amongst doctors, if you experience symptoms of poor mental health, don’t tell your colleagues or seek help from a health professional because they’ll lodge a mandatory notification”.
“This is simply not the case, because the bar for mandatory notification is a high one”, says Dr Elix.
If you suffer from a mental health condition, such as depression and you are getting treatment and support, then it is not something that should be subject to a mandatory notification.
HIGH THRESHOLD FOR TREATING PRACTITIONERS
The threshold for when a treating practitioner is required to make a mandatory notification relating to impairment, intoxication or practice that departs from accepted professional standards was raised in 2020.
A treating practitioner is required to make a mandatory notification about their practitioner-patient
A treating practitioner is required to make a mandatory notification about their practitioner-patient only when there is substantial risk of harm to the public.
only when there is substantial risk of harm to the public.
This high threshold means the circumstances for justifying this reporting by a treating practitioner is likely to be infrequent.
HOW
ARE MANDATORY
NOTIFICATIONS
MANAGED IN NSW?
While a mandatory notification must be initially lodged with Ahpra, if it relates to a NSW doctor or student, it will be referred to the Medical Council of NSW for assessment.
The Council has a well-regarded health program. It involves working with doctors to identify if there is an impairment putting patients at risk and, if so, putting in place guard rails and support, so a doctor continues to practise where possible. This might include
arranging an independent health assessment initially to understand the health condition and its impacts more fully. The Council may then, subject to this and other information, including from the doctor, place conditions on a doctor’s registration. The Council, might for example, require a doctor with an addiction disorder, to participate in regular drug screening and engage with an addiction specialist while still enabling the doctor to continue to practise.
The national regulatory framework guiding the Medical Council is not a punitive one. The paramount goal, always, is to ensure the public is protected, not to punish doctors.
It is also important to remember too that illness does equal
impairment when it comes to mandatory notifications.
In order for the Medical Council to be satisfied a doctor’s health is impaired, it must also be satisfied that their illness detrimentally affects (or is likely to) the doctors’ ability to practice. This will generally only be the case when there is a substantial risk to patient safety.
In 2022/23, less than 4% of all complaints received by the Council related to a mandatory notification (either sexual misconduct, intoxication, health impairment, or departure from professional standards). dr.
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