The sudden deaths of four junior doctors in Victoria have focused national attention on the issue of doctors’ workloads and wellbeing. Yet mandatory reporting laws may be forcing doctors who treat other doctors for mental health issues to report them to regulators, writes Ann Arnold.
Doctors are travelling to Western Australia to seek treatment for their own mental health issues to avoid a mandatory reporting law which applies in other states.
Doctors in distress – Background Briefing – ABC Radio National (Australian Broadcasting Corporation)
WA’s health minister and deputy premier, Kim Hames, told Background Briefing that his state has unintentionally become a safe haven for unwell doctors after it decided four years ago to have different reporting laws to the rest of the country.
In other states, mandatory reporting requires doctors, including those who treat other doctors, to report colleagues for inappropriate conduct.
Doctors can also be reported under the category of ‘impairment’. If a doctor is perceived to be impaired, he or she may need to be referred to the regulators—the Medical Board of Australian and AHPRA, the Australian Health Practitioners Regulatory Authority.
A notification could lead to suspension or having conditions placed on their practice; as well as having this information placed on the public AHPRA website in general terms.
After the sudden deaths of four young doctors in Victoria, the spotlight is back on doctors’ wellbeing, with some claiming that mandatory reporting fears are deterring doctors from seeking help for their mental ill-health or forcing them to travel to Western Australia.
‘They clearly do so because they’re scared of being reported,’ said Mr Hames. ‘They come here for that anonymity and for getting treatment early when they think they might have a condition.’
In WA, treating doctors are exempt from reporting.
‘Sometimes you don’t even know how bad you are and what the problem is. It takes others to recognize it. It’s really important for people who have mental illness particularly to seek early treatment and management,’ Mr Hames, who is himself a doctor, said.
The national mandatory reporting law, which was brought in as part of a package of new national regulations in 2010, was in part a response to high profile medical scandals such as the Dr Jayant Patel case in Queensland and the Dr Graham Reeves case in New South Wales.
The ‘impairment’ category was not meant to apply to doctors simply seeking treatment. Notification is only supposed to occur when a doctor’s health problem presents a clear risk to the public. Critics say the law is too unclear, and that’s why there’s a prevailing fear of it.
The number of doctors who have gone to WA for treatment is unknown.
‘It’s all anecdotal… but we do have doctors saying to bodies like the [WA branch of the] AMA that they have had doctors coming across for treatment, without being more specific than that,’ said Mr Hames.
Background Briefing sought confirmation from the WA branch of the AMA, which said in a statement: ‘We are aware of reports from a range of sources that doctors have come from interstate. We are not able to provide any specific data however.
‘At the time that this legislation was being discussed, the AMA (WA) urged Minister Hames to not follow other states. We have congratulated the minister for his decision.’
This article represents part of a larger Background Briefing program. Listen to the full report on Sunday at 8.05 am, repeated on Tuesday at 9.05pm.
An independent review of mandatory reporting and the other national laws has just been completed, but has not yet been made public. It will be tabled at the COAG Health Council meeting in April.
Many in the medical profession hope that the rest of the country will revert to the West Australian model.
Two submissions to the review—from medical insurers Avant and MDA National—argued as much. Both companies report that unwell doctors tell them they’re afraid of getting treatment.
In the meantime, the medical community has been rocked by the Victorian deaths, and there is an increased focus on ways to help young doctors in particular seek support when they need it.
Three of the doctors who died were psychiatry registrars, or trainees. The other was an intern, just out of medical school. All four were at public hospitals.
It’s not publicly known how or why the doctors died. The deaths will be investigated in the Victorian Coroners Court.
Advocates like Helen Schultz, a Melbourne psychiatrist and mentor for registrars, say changes must also be made in working environments.
‘I would imagine what’s happening at the moment is that the psychiatry registrars and the consultants that are grieving, who worked alongside those who have tragically passed away, will be expected to fill the backflow of work and to fill the vacancies that have been left, unfortunately, by the passing of these doctors,’ she said.
‘Now, these same doctors that are going to be asked to take up second, extra duties will also be the doctors that are grieving at the moment.
‘There’s a calling to be a doctor. There’s a calling to help people, but who really helps us?’
Ann Arnold’s investigation is the first in a two part Background Briefing series about mental health in the workplace.
In part two, Di Martin will look at the enormous economic and personal impact of mental illness across the Australian workforce.
Background Briefing is investigative journalism at its finest, exploring the issues of the day and examining society in a lively on-the-road documentary style.
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