December 2018

Update Medical Board of Australia

Chair's message

A few months into this challenging and interesting role, I’ve been thinking about the part medical regulators can play in some of the important issues facing the medical profession. Working with others to try to improve doctors’ health, including by helping shift the culture of medicine and removing the barriers so doctors feel able to seek the healthcare they need, are right at the top of the list of challenges we all need to face. I encourage all doctors, especially at this time of year, to look after themselves. Please seek care and support if you need it. Doctors and medical students in all states and territories can access help and support through a national network of doctors’ health advisory and referral services.

This newsletter includes a call for applications to join the state and territory boards – we need practitioner members in the Australian Capital Territory, Northern Territory, Queensland, South Australia and Victoria. It is interesting and worthwhile work, so please consider bringing your clinical perspective to the Board.

I wish you all a safe and happy holiday season, and a healthy and enjoyable 2019.

Dr Anne Tonkin
Chair, Medical Board of Australia

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Medical Board of Australia news

Call for applications

Are you interested in joining your local medical board?

Doctors and other members of the community are invited to apply to fill multiple vacancies on the following state and territory medical boards:

  • Australian Capital Territory – two medical practitioner members and one community member
  • Northern Territory – two medical practitioner members and two community members 
  • Queensland – one medical practitioner member and one community member 
  • South Australia – four medical practitioner members, the Chair position and three community members
  • Tasmania – one community member
  • Victoria – one medical practitioner member and the Chair position.

Applications close Friday 11 January 2019.

More information is on AHPRA’s Board member recruitment page.

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Consultation

Good medical practice public consultation submissions published

You can now read the submissions we received about proposed changes to Good medical practice: a code of conduct for doctors in Australia. We received approximately 800 submissions.

It was great to hear from so many people and organisations – and interesting to see how social media and other forms of digital communication have increased the number of people motivated to get involved in regulatory discussion and made it easier to share their opinions.

Some of your feedback showed us that we need to express what we mean much more clearly, to prevent misunderstanding. Other comments highlighted the strength and variety of opinions held about some of the guidance in the code. There was particular interest in:

  • professionalism and doctors making public comment (section 2.1)
  • doctors’ consideration of ‘medically relevant’ factors (section 3.4.3), and
  • culturally safe and respectful practice (section 4.8).

The Board is now considering all the ideas and suggestions from the consultation and will make changes to the code that support good medical practice in Australia. This will take time. In the meantime, the current (2014) version of Good medical practice applies and is available on the Board's website. Previous versions have been in place since 2009.

We publish all submissions, except when confidentiality is requested or when they contain defamatory comments or which are outside the scope of the subject of the consultation.

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Public register

Do you practise under the name published on the online Register of Medical Practitioners?

Governments recently consulted on possible changes to the National Law, which would allow us to publish on the online Register of Medical Practitioners, the names that doctors use in practice and not just their legal name.

The national online Register of Medical Practitioners is a vital part of Australia’s system of regulating medical practitioners to support patient safety. Each registered health profession has an online register. The public and employers can look up the names of all health practitioners who are registered to practise. The registers also provide important information about limits or restrictions placed on the way a registered practitioner is allowed to practise.

The national online registers must remain an authoritative and trusted source of information about health practitioners. Consumers rely on them for accurate and up to date information to inform their healthcare decision-making and employers rely on them to validate their employees’ registration status.

We know that some health practitioners practise their profession using a name that is different from their legally recognised name published on the register (an alias).

AHPRA has asked governments to consider changes to the law that would enable a practitioner to nominate one or more aliases to be recorded on the public register. Governments recently consulted on this, among a range of other possible amendments to the National Law.

AHPRA believes that recording additional names (or aliases) on the register will help to inform and protect the public, by making it easier to identify a practitioner who may be registered and able to practise but who is not using their legal name.

There are some operational and practical issues that will need to be considered if governments make this change. A clear definition of an ‘alias’ is required, so practitioners’ reporting obligations to AHPRA and National Boards are clear. We will need to consider what information practitioners will need to provide about their use of aliases in practice and whether any verification of this will be necessary to protect the validity of the register. Finally, there may be risks of unintended consequences - including whether publishing aliases could be used for commercial gain or benefits that are not related to public information and protection, which is the focus of the National Law.

We will keep you informed of any changes to the law and reporting requirements.

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Guidelines

Revised sexual boundaries guidelines now in effect

The Board’s revised guidelines Sexual boundaries in the doctor-patient relationship came into effect on 12 December 2018.

The guidelines remind doctors that trust in the relationship between doctors and patients is the cornerstone of good medical practice.

The updated guidelines apply to all registered medical practitioners in Australia and define the standards of ethical and professional conduct expected of doctors by the Board, their peers and the community. They complement Good medical practice: a code of conduct for doctors in Australia and do not change the ethical and professional conduct expected of doctors.

Changes to the guidelines include:

  • a change in the title to make the scope of the guidelines clearer
  • editorial updates that reorder the content, make it easier to read and clarify terms and definitions
  • a new section on social media that complements the Board’s Social media policy
  • a requirement for patient consent if medical students or anyone else is to be present during an examination or consultation
  • advice that an unwarranted physical examination may constitute sexual assault. This includes conducting or allowing others, such as students, to conduct examinations on anaesthetised patients, when the patient has not given explicit consent, and
  • replacing the term ‘chaperone’ with the term ‘observer’. The revised section on the use of observers reflects the advice and principles in Professor Ron Paterson’s report of the Independent review of the use of chaperones to protect patients in Australia, February 2017.

Read the revised guidelines and watch the Board’s video: It’s all about trust.

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National training survey

Progress on the 2019 National Training Survey

Working with our stakeholders, we are making progress on a National Training Survey (NTS), to better understand the quality of medical training in Australia. The first survey will be run with the registration renewal process in 2019 and we will be inviting all doctors in training to participate. We estimate there to be in excess of 35,000 doctors in training.

We are carrying out a tender process and we will appoint a provider early in 2019 who will administer the survey, house and analyse the data and create reports. The survey will be tailored to different groups of doctors in training and results will be published, while protecting the confidentiality of all doctors in training.

We are now focused on refining the survey questions, encouraging stakeholders to think about how they can apply the results to improve medical training, working on ways to maximise participation and fine tuning how results will be reported so we protect participant confidentiality and provide useful information that employers, specialist colleges and governments can act on.

Read our progress update on the NTS on the Board’s website.

Send us an email to NTS@ahpra.gov.au if you would like more information or are interested in helping us develop the NTS.

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Alerts

Assessing patients’ fitness to drive 

Doctors have a key role in assessing patients’ fitness to drive. This includes assessing if a person’s health, disability or medical condition is likely to affect a person’s ability to drive safely, advising patients about the results and implications of the assessment and if required, notifying the relevant road safety authority.

This responsibility applies to all doctors in Australia. Common conditions that may affect a person’s ability to drive safely include:

  • vision and eye disorders
  • blackouts
  • cardiovascular conditions
  • diabetes
  • dementia and cognitive impairment
  • seizures and epilepsy
  • neurological conditions
  • musculoskeletal conditions
  • psychiatric conditions
  • sleep disorders, and
  • alcohol and other substance misuse. 

Currently in most states, drivers are required to self-report to the relevant road safety authority when they have a medical condition that may affect their ability to drive safely. The road authority may request the license holder to have a Medical fitness to drive assessment with a medical practitioner or other registered health professional (e.g. optometrist). Drivers are assessed according to the national Assessing fitness to drive standards.

In South Australia and the Northern Territory, it is mandatory for health practitioners to notify the road authority about a patient’s fitness to drive in certain circumstances.

A number of jurisdictions have online resources for doctors to promote conversations with patients and some have online medical assessment forms to streamline the assessment process.

More information is available for doctors in each state and territory:

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Media statement

AHPRA made this media statement last month:

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Medical regulation at work

Latest tribunal decisions published online

There are important lessons for registered medical practitioners from tribunal decisions. The Medical Board of Australia refers the most serious concerns about medical practitioners to tribunals in each state and territory. This case was published recently:

  • The State Administrative Tribunal of Western Australia has reprimanded a surgeon and placed conditions on his registration in relation to his clinical care and decision making (Medical Board of Australia v Jaboury).

Publication of panel, court and tribunal decisions

AHPRA, on behalf of the 15 National Boards, publishes a record of panel, court and tribunal decisions about registered health practitioners.

When investigating a notification, the Board may refer a medical practitioner to a health panel hearing, or a performance and professional standards panel hearing. Under the National Law , panel hearings are not open to the public. AHPRA publishes a record of panel hearing decisions made since July 2010. Practitioners’ names are not published, consistent with the National Law.

Summaries of tribunal and court cases are published on the Court and tribunal decisions page of the AHPRA website. The Board and AHPRA sometimes choose to not publish summaries, for example about cases involving practitioners with impairment. 


1 The Health Practitioner Regulation National Law, as in force in each state and territory.

In New South Wales and Queensland, different arrangements are in place. More information is available on AHPRA’s website on the Make a complaint page.

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Contacting the Board

  • The Medical Board of Australia and AHPRA can be contacted by phone on 1300 419 495.
  • For more information, see the Medical Board of Australia website and the AHPRA website.
  • Lodge an enquiry form through the website under Contact us at the bottom of every web page.
  • Mail correspondence can be addressed to: Dr Anne Tonkin, Chair, Medical Board of Australia, GPO Box 9958, Melbourne, VIC 3001.

More information

Please note: Practitioners are responsible for keeping up to date with the Board’s expectations about their professional obligations. The Board publishes standards, codes and guidelines as well as alerts in its newsletter. If you unsubscribe from this newsletter you are still required to keep up to date with information published on the Board’s website.

Comment on the Board newsletter is welcome and should be sent to newsletters@ahpra.gov.au.

For registration enquiries or contact detail changes, call the AHPRA customer service team on 1300 419 495 (from within Australia).

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Page reviewed 20/12/2018