As many members are aware (for all the wrong reasons!), the Australian Health Practitioner Regulation Agency (AHPRA) receives and manages complaints about health practitioners on behalf of the Medical Board of Australia.
Complaints can be made by a range of people or entities; but, in our experience, they are most often made by patients.
Members who have received a letter from AHPRA informing them about a notification will have seen the document called “Regulatory Principles for the National Scheme” which is invariably annexed to the notification. A copy of the document is also available on the Medical Board of Australia website.
A key principle is to protect the health and safety of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered. AHPRA’s primary consideration is to protect the public.
In performing its role many complaints become the subject of investigation and are sent to the practitioner requesting a response.
MIGA assists and supports hundreds of members each year with this process. The sanctions available are vast. Fortunately, many complaints are resolved with no further action after AHPRA/the Medical Board have considered the practitioner’s response. However, others are also resolved by issuing a Caution and, on occasion, the imposition of Conditions on a medical practitioner’s registration with respect to that practitioner’s practice.
A Caution is a written warning and is intended to act as a deterrent so that the practitioner does not repeat the conduct or behaviour. A Caution is not usually recorded on the public register of practitioners. If a Caution is proposed, the practitioner is provided with an opportunity to make a submission on why the Caution should not be imposed.
In circumstances where it is proposed that Conditions be imposed, practitioners are also provided with an opportunity to make a submission. Conditions that restrict a practitioner’s practice of the profession are published on the public register of practitioners.
In both instances, it can be difficult to dissuade AHPRA/the Medical Board from implementing proposed sanctions.
With this in mind, we share a recent experience where, with the assistance of MIGA’s in-house legal team, a submission disputing the need for Conditions on practice was successful.
Dr Smith (GP) was investigated by AHPRA/the Medical Board when her patient, Jenny, developed lithium toxicity. Dr Smith had only been consulting Jenny for 6 months when Jenny developed lithium toxicity, a medication which had been prescribed for a number of years by Jenny’s treating psychiatrist.
Dr Smith was advised by Jenny’s family that her lithium levels were being monitored by her treating psychiatrist. Dr Smith assumed that Jenny’s treating psychiatrist would report back to her regarding Jenny’s lithium levels given Jenny’s regular review with her psychiatrist. This did not happen.
At first instance the Medical Board proposed to impose Conditions on Dr Smith’s registration that she undergo education regarding communication with other treating practitioners and in relation to prescribing medication for mood disorder.
With the assistance of MIGA’s team, Dr Smith made a further submission to the Board that the proposed education was unnecessary to protect the public. Dr Smith accepted and acknowledged that as Jenny’s GP she was responsible for co-ordinating her care with other health practitioners and that in this instance her failure to follow up with Jenny’s treating psychiatrist fell below a standard reasonably expected of a general practitioner and did not accord with A Good Medical Practice: A Code of Conduct for Doctors in Australia.
Dr Smith satisfied the Medical Board that she had the requisite knowledge surrounding safe prescribing of lithium by providing evidence of courses that Dr Smith had previously completed and further resources she had revisited and reviewed in light of this incident. Dr Smith also advised the Board of changes she had made to her practice to prevent a communication breakdown (such as the one which occurred with Jenny’s psychiatrist) from occurring again.
The Board accepted Dr Smith’s submission and ultimately decided to impose a Caution only, determining that imposing Conditions to undergo education was unnecessary.
In the event you become the subject of an AHPRA investigation, give our team a call on 1800 839 280. We are here to help you.