The post-pandemic rise of telehealth has created a health ecosystem which sits outside the reach of traditional regulation, says the AHPRA CEO.
AHPRA CEO Justin Untersteiner warned delegates at the Medical Board of Australia conference last week that when health ministers expected change, the regulator was left with little option but to comply.
During his address, Mr Untersteiner brought up last year’s review into the complexity of AHPRA as a scheme, and the finding that the regulator had struggled to rise to its full potential and that it was “too inward looking, too fragmented, and too slow to respond to emerging risks”.
As a result, he said, there were “strong expectations” from federal health ministers that the national scheme continues to reform, look outward, address fragmentation and do better at identifying issues on the horizon.
“In my experience when working with Ministers, there are two choices: illustrate you are listening by moving in the direction Ministers signal they want to go, or, expect them to do it to you. And not always in the way you would prefer,” Mr Untersteiner said, directly referencing the medical board.
“I think you should be looking at your structures and challenging yourselves with the question – what can we do to simplify structures and drive national consistency?
“In other words, be the master of your own destiny.”
The Medical Board of Australia is currently considering several changes to the way that specialist and non-specialist doctors who trained overseas can enter practice in Australia.
Some of these, such as the proposal to streamline the specialist pathway, are a direct response to recommendations from Robyn Kruk’s review of the regulatory settings related to overseas health practitioners.
But perhaps the most contentious issue currently before a national board is that of how a prescribing endorsement for pharmacists should work, which is currently before the Pharmacy Board of Australia.
While the proposal has been lambasted by the AMA and the medical community at large, it’s also worth noting that the pharmacy board was asked by health ministers to “commence a program of work exploring formal recognition of endorsed pharmacist prescribers”.
Mr Untersteiner’s speech also touched on AHPRA’s plans to address the “alternative models of care” which have sprung up post-pandemic.
“We know that… economic pressures are changing consumer behaviour, driving people towards alternative models of care, including those that sit outside traditional regulatory settings,” he said.
“And we’re seeing the sometimes disastrous outcomes of that care.
“Public expectations are shaping the context in which we work … I don’t think it’s overstating our operating context to say that in this post-pandemic environment, the professional and political order we once understood, and possibly valued more than we realised, is a thing of the past.”
Related
The mechanisms for healthcare provider regulation in Australia can be divided into two broad categories: complaints and Medicare money.
AHPRA tends to act on notifications made by the public, often to address breaches of professional standards.
The PSR, meanwhile, acts in cases where MBS or PBS funds are potentially being misused.
When it comes to something like an online-only telehealth clinic operating entirely outside the auspices of Medicare, the regulatory bodies can hit something of a brick wall.
But it appears that the AHPRA CEO, at least, has a plan. He spoke to the importance of “proactive regulation” when it came to cracking down on potential cannabis overprescribing.
“Driven by exceptional leadership from the Medical Board, our work went beyond publishing new guidance,” he said.
“This developing risk needed a targeted strategy, one that clearly demonstrated how AHPRA and the Boards are working together.
“Our approach highlighted the concerning patterns we were seeing – single prescribing models accelerated by telehealth, with confirmation provided by new data sources. And we sought not just to educate and raise awareness of the impact of this, but to signal our willingness to act to deter further unsafe practice.”
