November 2023

In this month's issue:

• Chair’s message
• Medical Board of Australia news
  • Have you got a CPD home?
  • Telehealth guidelines: asynchronous prescribing is not good practice
  • Annual report published
  • Accreditation: providing high-quality education and training
  • Latest registration data published
• Consultations
  • Do you have a view on non-surgical cosmetic procedures?
  • Should rural generalist medicine become a new field of specialty practice?
• News and alerts
  • Launch of new checklist for managing patient complaints
  • Reminder: clinical governance survey for hospital doctors
• Medical regulation at work
  • Latest tribunal decisions published
• Contacting the Board

Chair’s message

Engagement with life-long learning is embedded in the culture of medicine. It’s how we reassure ourselves that we’re keeping our knowledge and skills up to date. It’s how we can be confident we’re giving our patients the best care. And it’s how we can stay intellectually engaged with our peers and our profession. We’ve made some changes to continuing professional development (CPD). You can check if there’s anything you need to do to comply with our updated CPD registration standard.

Dr Anne Tonkin AO
Chair, Medical Board of Australia

Medical Board of Australia news

Have you got a CPD home?

Continuing professional development (CPD) is changing and all doctors will need an Australian Medical Council (AMC) accredited CPD home for their 2024 CPD (unless they are exempt from doing CPD).

All specialist medical colleges are already AMC-accredited CPD homes and there are four other AMC-accredited CPD homes:

• Doctorportal Learning, the Australian Medical Association’s (AMA) CPD home – open to all medical practitioners
• Health Education and Training Institute (HETI) – open to NSW-based Junior Medical Officer (JMO) doctors in their early years of practice who are not on an accredited training pathway
• Osler – open to all medical practitioners
• Skin Cancer College Australasia – open to general practitioners who have an interest in skin cancer medicine.

If you’re already doing your CPD through a college or another AMC-accredited CPD home, you already comply with updated CPD requirements and don’t need to do anything else.

If you don’t have a CPD home, before you start next year’s CPD, you will need to find a CPD home and write a plan for the CPD you will do in 2024. You’ll need to tell the Board the name of your CPD home when you renew your registration in 2024.

More information about CPD requirements is on the Medical Board’s CPD page.

A list of accredited CPD homes is available on the Medical Board’s CPD homes page. New homes will be added to this list as they are accredited.

Telehealth guidelines: asynchronous prescribing is not good practice

In case anyone missed the message – new telehealth guidelines say no to asynchronous prescribing.

The updated Guidelines: Telehealth consultations with patients took effect on 1 September 2023.

Doctors who continue to promote prescribing without consultations may be putting themselves at risk of regulatory action.

Providing healthcare (including prescribing, issuing certificates and referring) via questionnaire-based asynchronous web-based tools in the absence of a real-time patient–doctor consultation is not good practice.

The telehealth guidelines clearly state that prescribing without a real-time doctor–patient consultation for each request (whether in person, by video or telephone) is not good practice and is not supported by the Board.

Any doctor who does not meet the standard set out in the Board’s code of conduct and the telehealth guidelines must be ready to explain how their management of the patient was appropriate and necessary in the circumstances.

All the detail is in the Guidelines: Telehealth consultations with patients.

Annual report published

The number of practitioners went up and the number of complaints about doctors went down in 2022/23, according to the latest annual report of Ahpra and the national health practitioner boards, now published.

The annual report is a comprehensive record of the National Registration and Accreditation Scheme for the 12 months to 30 June 2023.

The Medical Board had a particularly busy year. Much of our work was high profile and contentious, but we held our focus on public safety. Key achievements include reform of the cosmetic surgery industry and strengthening telehealth guidelines. Workforce issues have emerged as a significant, ongoing challenge.

A medicine-specific snapshot and data tables are also published.

Highlights include:

• More health practitioners: There are 877,119 registered health practitioners across 16 regulated professions.
• More registered doctors: There are more registered medical practitioners, who make up 15.6% of all health practitioners registered nationally (136,742 individual registered medical practitioners in 2022/23; up from 131,953 in 2021/22).
• More international registrants: 4,211 first-time international medical graduates.
• Fewer complaints about medical practitioners: There were 5,615 notifications to Ahpra about 4,494 medical practitioners. There were 9,938 notifications about 7,761 registered medical practitioners Australia-wide (including to Ahpra, the Health Professional Councils Authority (NSW) and the Office of the Health Ombudsman (Queensland)).
• Of 6,087 medical matters closed in 2022/23, in 6.6% the Medical Board accepted an undertaking from the practitioner or imposed conditions on the practitioner's registration; 3.9% received a caution or reprimand; in 0.7% registration was suspended or cancelled or they were disqualified from applying. The other 27.9% were referred to another body or retained by a health complaints entity.
• In 60.8% of matters, the Board took no further regulatory action: The Board takes no further regulatory action when, based on the available information, there is no risk to the public that needs to be managed.
• Referrals to an adjudication body: The Board refers the most serious allegations to tribunals. In 2022/23, 78 matters were decided by a tribunal and three matters were decided by a panel.
• 305 mandatory notifications were made about doctors: 100 of these were about professional standards.
• Criminal offences by medical practitioners: 127 new complaints were made about possible criminal offences by medical practitioners. Over 60% of these related to title and practice protection and 35% to advertising breaches.
• Immediate action was taken 148 times about doctors: The Board can take immediate action to restrict or suspend the registration of a medical practitioner as an interim measure to protect the public while notifications are being investigated.

The 2022/23 annual report is available on Ahpra’s website and a medicine-specific snapshot and data tables are available on the Medical Board website.

Accreditation: providing high-quality education and training

The Board has approved the following:

Medical school program of study

Intern training accreditation authority

Latest registration data published

The Board publishes data each quarter on the medical profession. Data are broken down by state and territory and registration type, and for specialists by specialty and field of specialty practice. Visit our Statistics page to view the latest report.

Consultations

Do you have a view on non-surgical cosmetic procedures?

Advertising and social media are tightly linked with patient demand for non-surgical cosmetic procedures. We’re keen to hear what you think about possible new rules to increase patient safety, promote informed consent and reduce risk.

Ahpra and the National Boards are consulting on three documents for health practitioners who perform and advertise non-surgical cosmetic procedures:

1. Guidelines for registered health practitioners who advertise non-surgical cosmetic procedures (applies to all registered health practitioners including medical practitioners)
2. Guidelines for nurses who perform non-surgical cosmetic procedures (applies to nurses only)
3. Guidelines for registered health practitioners who perform non-surgical cosmetic procedures (does not apply to medical practitioners because there are existing guidelines for doctors; applies to other health practitioners).

The draft shared advertising guidelines will apply to anyone advertising non-surgical cosmetic procedures, including medical practitioners, nurses and dentists. Much like the Medical Board’s new cosmetic surgery advertising guidelines – now in place – these advertising guidelines include guidance around issues such as before and after images, claims about expertise and qualifications, and the ban on the use of testimonials. The use of social media influencers is also a focus.

The draft practice guidelines are for health practitioners (other than doctors) performing non-surgical cosmetic procedures – this includes nurses and dentists. These practice guidelines will not apply to doctors, who are already working to new Medical Board cosmetic practice guidelines that came into effect on 1 July 2023. But if you’re interested, we’re keen for feedback from doctors on the guidelines for other registered health practitioners, particularly if you work in cosmetics with other health practitioners.

The consultation is open for 10 weeks and closes on 2 February 2024.

Learn more about the consultation and how you can have your say on the Medical Board consultation page.

Should rural generalist medicine become a new field of specialty practice?

Please share your feedback about whether rural generalist medicine should be recognised as a new field of specialty practice within general practice.

Submissions are welcome until 12 December 2023 on a joint application from the Australian College of Rural and Remote Medicine and the Royal Australian College of General Practitioners to expand the list of recognised specialties to include rural generalist medicine.

The currently approved List of specialties, fields of specialty practice and related specialist titles in medicine is published on our website.

Your feedback and advice from the Australian Medical Council, the Board’s accreditation authority, will inform the Board’s recommendation to health ministers.

The consultation paper is available on the Board’s Current consultations page.

News and alerts

Launch of new checklist for managing patient complaints

It’s a big challenge to reframe a complaint made about you into constructive feedback. But when managed well, complaints can lead to improvements that increase patient and community confidence in you as a doctor. Effective and timely local management can also help prevent a concern escalating to an external complaint body or regulator.

We’ve developed a new Checklist for practitioners handling feedback and complaints. It’s designed to help you when a patient raises their concern with you directly or with the health service where you work.

Because it can be confronting and stressful to receive negative feedback or a complaint, we’ve also published a list of general support services and practitioner support services available to medical practitioners.

We hope the checklist is helpful if a patient raises their concern with you or your practice staff directly. It might also be relevant if you have a role in establishing and maintaining complaints systems and processes at a health service.

Ahpra and the National Boards partnered with the Australian Commission on Safety and Quality in Health Care, in a joint project, to develop the checklist and other resources to support consumers to navigate the various complaints options available.

The checklist and other resources are available on Ahpra’s Resources page.

Reminder: clinical governance survey for hospital doctors

The Royal Australasian College of Medical Administrators (RACMA) has extended its clinical governance survey. Those who responded provided a range of disturbing insights into clinical governance, however the response rate has been too low to extrapolate the findings. Medical practitioners working in hospitals are invited to provide their views to help determine the current maturity of clinical governance across Australasian health services.

Doctors from all types and sizes of hospitals can participate (acute through to community, public and private). The survey is anonymous with an option to identify your hospital. Results will help inform opportunities to enhance medical practitioner involvement in quality and safety.

The survey will take about eight minutes and can be accessed via the Clinical governance maturity survey link. It has been extended to 5 December 2023. For enquiries contact clinicalgovernance@racma.edu.au.

Medical regulation at work

Latest tribunal decisions published

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

• ACT doctor reprimanded and disqualified from applying for registration for 12 months for discriminatory and offensive racist behaviour toward an Aboriginal practitioner (Medical Board of Australia v CDA)
• Victorian general practitioner’s registration cancelled after pleading guilty to patient assault (Medical Board of Australia v Thompson)
• Victorian general practitioner reprimanded and conditions imposed about poor record keeping and medical certificates (Medical Board of Australia v Fitzpatrick).

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 not to publish summaries, for example about cases involving practitioners with impairment.

In New South Wales and Queensland, different arrangements are in place. More information is available on Ahpra’s website on the Concerned about a health practitioner? page.

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 AO, 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.

Comments on the Board newsletter are welcome, send your feedback and suggestions 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).