The former AHPRA CEO was among the co-authors on a new paper looking at how the regulator responds to concerns about health impairments.
The prospect of receiving an AHPRA notification about practising with a health impairment is an oft-cited reason for unwell doctors to avoid seeking care – but in reality, just 1% of doctors have been reported for health-related reasons.
Psychiatrist and University of Melbourne health researcher Professor Marie Bismark, the lead author on a new Medical Journal of Australia paper covering AHPRA’s handling of health impairment notifications, said this should be “reassuring” for doctors.
“I think doctors should take confidence from the study that they can seek confidential healthcare and that the medical board really only wants to get involved if there are risks to patient safety,” she told The Medical Republic.
“If a doctor is unwell and they’re accessing care, taking sick leave when they need to, engaging with treatment, taking steps to make sure that their patients are safe – that’s a matter between them and their doctor, and that is not an issue for the medical board.”
Long-term former AHPRA CEO Martin Fletcher is also listed as a co-author on the paper.
The physician’s treating doctor was the source of the health impairment notification less than 10% of the time, with the largest proportions of notifications coming from other health practitioners.
Of the 1.1% of doctors who received a health impairment-related notification between 2012 and 2022, one in five had their registration restricted or removed.
This is a comparatively higher rate of action than that arising from other types of notifications, Professor Bismark said.
“Performance notifications and conduct notifications are less likely to result in conditions on your practice, so when [health-related notifications] do occur, they can definitely be serious,” she said.
“And then a theme with all of our research over the years is that notifications to the medical board are not evenly distributed across the workforce. As with every other type of medical legal action we’ve ever looked at, there are certain groups of doctors who are at higher risk than others.”
GPs are one of these groups, making up 45% of notifications related to a possible cognitive impairment, as well as around 30% of notifications about substance abuse, mental illness and physical illness.
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“We know that … GPs practice in environments with huge amounts of psychosocial stress, high levels of occupational violence, huge demands and maldistribution … which means that there are areas with really significant workforce shortages,” Professor Bismark said.
She also noted that while the majority of doctors who received a health-related notification did not go on to have conditions placed on their registration, the numbers did not always tell the whole story.
“We could see in the research that older doctors are at significantly higher risk of health impairment reports,” Professor Bismark said.
“If a doctor is 80 and they get a health impairment report and they decide that it’s time to retire, the medical board will most likely take no further action, because … there’s no ongoing risk to the public, so that will show up in the data as a no further action.
“But that doesn’t mean that the initial concern, perhaps raised by a colleague, was not well founded.
“I think it’s a common misperception that no further action means that there was nothing to see, whereas very often it means that the doctor has taken appropriate steps to make sure that the patients are safe, and therefore there’s no need for the Medical Board to take formal action.”
Ultimately, Dr Bismark’s paper recommended further research into how to identify the psychosocial hazards in environments like primary care and mental health care.
