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Mandatory reporting – does it “create the problem it is trying to solve?”

Practitioner

It is well known from the beyondblue National Mental Health Survey of Doctors and Medical Students released in 2013 that doctors reported substantially higher rates of psychological distress and suicidal thoughts compared to both the Australian population and other Australian professionals. A retrospective study published in 2016 showed that suicide rates in female health professionals in Australia were higher than for women in other occupations. According to the BEACH Survey, around 12.4% of all patient encounters with general practitioners were mental health related in 2015-2016. It is also known that GPs are often the first port of call for people seeking help with a mental illness.

So how is it that the Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2018 can be passed in Queensland Parliament on 26th February and mean that there is still a requirement for treating doctors, in all states and territories except WA, to in some cases disclose the medical conditions of other practitioners to their regulatory board for review? Couldn’t this have the unintended consequence of deterring health professionals from seeking the treatment they require?

Dr Bruce Willet, Chair of the Royal Australian College of General Practitioners (RACGP) has said that the Bill “creates the problem it is trying to solve.”

“It is important that doctors and health practitioners can receive the healthcare they need, rather than feel the need to hide their health concerns due to fear of being reported by their treating practitioner.

“Removing this mandatory reporting requirement, which prevents registered health practitioners from seeking healthcare, will improve patient safety.

“The problem is that mandatory reporting legislation is very complex and clinicians feel they can’t afford to take the risk of not reporting everyone who presents with anything that could be possibly related to an impairment.

“And a lot of health professionals, not just doctors – we’re also talking about nurses and physios and others – are being reported where they don’t need to be because their treating clinicians feel under a great deal of pressure.

Federal President of the Australian Medical Association Dr Tony Bartone said that “being a doctor is a stressful vocation. We deal with life-and-death situations every day. We are only human, and our work takes its toll.

“When doctors and medical students find themselves needing professional help when they are unwell, often caused by the stressful work they are doing, they can be deterred by national laws that compel their treating doctor to report them to authorities as ‘impaired’.

“This can lead to them fearing that they will spend months, even years, fighting possible sanctions, including losing their registration, for simply seeking the help that their patients ask for, and receive, every day without judgment or repercussions.

“Any barriers to treatment for medical practitioners, real or perceived, must be removed and not hinder the same timely access to care that we as doctors fight for on behalf of our patients.

“Doctors and medical students must be accorded the same rights as any other patient – to be able to receive confidential, high-quality health care without fear of professional ramifications.

“While the fear of ramifications may be perceived, it still remains a palpable barrier to seeking help for many medical practitioners.

“We are still losing too many colleagues every year because they do not feel confident that they can seek help without risking their careers.

“We need consistent laws across the nation to ensure that all doctors and medical students can feel confident to seek medical help for all conditions.

How is it that a health professional such as a physiotherapist may treat patients who present with mental health conditions appropriately for whatever their physical condition is, but may be deterred from seeking mental health care themselves?

With the prevalence of mental health conditions rising, shouldn’t it be more important than ever that we know more about what health insurance providers are offering and whether mental health care is part of their plans? And shouldn’t health professionals be able to access whatever treatment they require without fear of repercussions?

The fact that the Bill was passed in parliament early in the year may come as a blow to those seeking change in 2019. Australian Psychological Society (APS) CEO Frances Mirabelli said that the “start of a new year can be a time of soul searching for many Australians, as they confront issues that come to the surface in their personal or work lives. This can feel painful, but it is not uncommon.”

President of the Australian Medical Association’s Queensland Branch Dr Dilip Dhupelia has said that the legislation does not go far enough to ensure that doctors and medical students can seek the treatment that they need, when they need it, without worrying that they will be reported to authorities and possibly lose their right to continue studying or to practise.

For support:

  • For 24/7 support in Australia you can contact beyondblue on 1300 22 4636
  • For urgent assistance call Lifeline on 13 11 14
  • The AMA Victoria Peer Support Service is an anonymous and confidential helpline provided for doctors by doctors and is available 8am to 11pm, 7 days a week on 1300 853 338