Compared to their fellowed peers, non-specialist doctors face a higher risk of being referred to AHPRA for health impairments.
Non-specialist doctors are the most likely section of the profession to be the subject of an AHPRA notification involving substance misuse – and it’s not quite clear how to reach them.
An analysis published in the Medical Journal of Australia earlier this month looked at the past 10 years’ worth of AHPRA medical register health impairment notifications.
The headline finding was that some groups – GPs among them – were more likely to be the subject of a health impairment notification than others.
The Medical Republic covered those findings last week.
But GPs weren’t the only groups identified as high risk.
Study lead author Professor Marie Bismark, a psychiatrist and health systems researcher, told TMR that she had been surprised to see non-specialist doctors emerge as a group that were at particularly high risk of health impairment.
“It doesn’t come out so much in the raw data, because most non-specialists are young and younger doctors generally have lower rates of health impairment reports, but once you control for age – for example, if you look at a doctor who’s 40 who’s finished their specialist training, and another doctor who’s 40 who has not done specialist training – the non-specialist is going to be at higher risk of a health impairment report,” she said.
Unfellowed doctors made up 40% of the 659 substance use-related health notifications to AHPRA over the decade to 2022, as well as 44% of the notifications about a potential mental illness.
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Doctors who worked rurally were also more likely to be the subject of a health-related notification, particularly in the area of substance misuse.
Professor Bismark said more research would be required to work out exactly why non-specialists appeared to be at higher risk.
“They’re often working in these unsupported, less secure roles, perhaps with less peer support or collegiality,” she said.
“I worry about who’s advocating for that group of doctors.
“If you’re a specialist, you’ve got your college who’s able to advocate for you – but there’s not really anyone who’s doing that advocacy for doctors who might be in their 40s or 50s and have not completed specialty training.”
The data also told an interesting story about the practitioners who were not being referred to AHPRA with health concerns.
Overseas-trained doctors from countries other than the UK, Ireland or New Zealand received a significantly lower rate of health impairment reports, Professor Bismark said.
While it may indicate that overseas-trained doctors are physically and mentally healthier than Australian graduates, Professor Bismark said there was cause for concern.
“We know that, overall, those doctors are at substantially increased risk of reports to AHPRA,” she said.
“So why have they overall been getting lots more reports to AHPRA, but they’re not showing up in the health impairment data?
“I worry that maybe there’s some institutional bias, some systemic racism that means that when a doctor from a country like India is struggling at work, maybe assumptions are being made that it relates to misconduct or incompetence.
“[Maybe] people are not asking the question about whether they might be struggling with a health concern.”
