Mandatory notification of impaired doctors

Abstract

Mandatory reporting of impaired doctors is compulsory in Australasia. Australian Health Practitioner Regulation Agency guidelines for notification claim high benchmark though the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians suggest they still obstruct doctors seeking help. Western Australia excludes mandatory reporting of practitioner-patients. This study examines reporting, consequences and international experiences with notification. Depressed doctors avoid diagnosis and treatment, fearing consequences, yet are more prone to marital problems, substance dependence and needing psychotherapy. South African research confirms isolation of impaired doctors and delayed seeking help with definable characteristics of those at risk. New Zealand data acknowledge: errors occur; questionable contribution from mandatory reporting; issues concerning competence assessment; favouring reporting to senior colleagues or self-intervention to compliance with mandatory reporting. UK found an anaesthetist guilty of professional misconduct for not reporting and sanctioned doctors regarding Harold Shipman. Australians are reluctant to report, fearing legalistic intrusion into care. Australian research confirmed definable characteristics for doctors with psychiatric illness or alcohol abuse. Exposure to legal medicine evokes personal disenchantment for doctors involved. Medicine poses barriers for impaired doctors. Spanish and UK doctors do not use general practitioners and may have suboptimal care. US and European doctors self-medicate using samples. US drug-dependent doctors also prescribe for spouses. Junior doctors are losing empathy with the profession. UK doctors favour private care, avoiding public scrutiny. NZ and Brazil created specific services for doctors, which appear effective. Mandatory reporting may be counterproductive requiring reappraisal.

Mandatory reporting of impaired doctors: protecting the community or increasing the risk?

“…The articles by Beran and Bismark and colleagues in this issue of the Journal examine the issues raised by mandatory reporting of impaired doctors. On the basis of an analysis of the international literature, Beran concludes that the requirement to report may actually be counterproductive, by discouraging practitioners at risk from seeking assistance and increasing inappropriate and potentially harmful practices, such as self‐prescribing.…”

‘Blowing the whistle’: the ethical, professional and legal implications of raising concerns and self‐regulation within dentistry

“…There is a worry that regulatory action will be punitive and this misconception is aided by the language used by the guidance. The language choice of ‘complaints’, with words such as ‘against’ being utilized when discussing taking action involving a colleague, could cause professionals to be discouraged from whistle‐blowing . The inclusion of sexual misconduct alongside health impairment may give the impression that both are viewed as being equal impairments to being a fit and proper professional.…”

Mandatory reporting of impaired practitioners

“…The articles in the December 2014 issue of the Journal on mandatory reporting of impaired practitioners [1][2][3] indicate the complexity of this provision. In particular, Komesaroff has drawn attention to the negation of professional and ethical responsibility by the compulsion, 3 which arguably is the most important long-term effect.…”

“…[1][2][3] Rehabilitation therapy focussed initially on strengthening abdominal and neck musculature and balance, increasing cardiovascular endurance, improving shoulder and hip range of motion, functional transfers and bed mobility. Thereafter, weight shifting on ischial tuberosities progressed to walking, first without and then with prostheses.…”