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AHPRA eyes mandatory health checks for older GPs
The watchdog says complaints against older GPs have ‘jumped disturbingly’, but the RACGP warns it is a fine line between assessing competency and ageism.
Public consultation is now open about whether GPs aged 70 and over should be regularly assessed.
Regular health assessments could become the norm for GPs aged over 70 years old to check if they are still fit to practice.
That is according to a new plan from the Australian Health Practitioner Regulation Agency (AHPRA) as it responds to a spike in patient complaints for older practitioners.
It is proposing doctors aged over 70 undergo general health checks with their GP or another doctor every three years, and then every year from 80 upwards, with consultation on the idea now open.
It comes as the rate of notifications made for those over 70 related to health impairments, AHPRA says, is now more than three times higher than for younger colleagues.
‘There is an increased incidence of health impairment as individuals age, and this affects medical practitioners in the same way as the rest of the community,’ the plan states.
But RACGP President Dr Nicole Higgins said the medical board is walking a delicate line between ensuring competency and enacting ageist policies.
‘It has to ensure it finds a balance between patient safety and ensuring that we’re addressing competency versus ageism,’ she told newsGP.
‘There’s always concern about using a blunt instrument, such as age.
‘We have to follow the evidence to inform the decision about the best way to assess competency and not make decisions based purely on age.’
AHPRA’s data also shows older GPs are 80% more likely to be the subject of any notification.
‘Overall, the rate of notifications about late-career doctors has almost doubled over the past eight years, rising from 36.2 notifications per 1000 practitioners aged 70 and older in 2015, to 69.5 complaints per 1000 in 2023,’ AHPRA says.
It says notifications for those aged between 70 and 74 have ‘jumped disturbingly’ by 130% since 2015.
For those aged 80 and over, notifications climbed by more than 180% in that same period, while notifications for doctors under 70 also increased by 63%.
AHPRA says its Board saw three options ‘to keep late-career doctors in safe practice’:
- Retain the ‘status quo’ without enacting any changes
- Introduce extensive and detailed ‘fitness to practice’ assessments to be conducted by specialists
- Introduce general ‘health checks’ with a GP for those aged 70 and older to ‘support early detection of concerns’
Board Chair Dr Anne Tonkin said AHPRA favoured option three as a measure to identify issues earlier and potentially prevent patient harm.
‘Doctors are often reluctant patients, and we are concerned they don’t always seek the care they need,’ she said.
‘General health checks for late-career doctors will give individual doctors and their treating practitioners information to help them manage any health concerns early and re-equip doctors to practise past their 70th birthday.’
The health checks put forward would operate similarly to the existing Medicare general health checks for patients aged over 75.
AHPRA says the results of the checks would be confidential and stay ‘between the late-career doctor and their treating practitioner and would not be provided to the Board routinely’.
‘The Board would only be informed if a treating practitioner made a mandatory report about a late-career doctor who refused to manage the risk to patients caused by ill health,’ it says.
Dr Higgins says, while the data raises concerns, she would like to know how many of the complaints within the data had been substantiated.
‘I’d like to see if they’ve been validated and proven, and if this reflects competency or other issues,’ she said.
Concerns were raised late last year over the AHPRA notification process, with complaints about notifications rising by more than a third labelled ‘troubling’ by the National Health Practitioner Ombudsman.
Dr Higgins says the move could also affect an already worsening workforce shortage of GPs.
‘If doctors are forced to leave earlier or choose to retire earlier it may have significant impacts on workforce as older GPs work longer hours, even than their younger counterparts,’ she said.
‘Our older workforce holds up many of our rural and regional communities.
‘Older GPs bring a wealth of knowledge, mentorship and they’re also often performing many other roles, in leadership, in voluntary roles within the profession so it would be a shame to see doctors leave that.’
AHPRA says its response is proportionate and data-driven following a comprehensive review of Australian complaints records.
‘There is strong evidence that there is a decline in performance and patient outcomes with increasing practitioner age, even when the practitioner is highly experienced,’ it states.
‘These concerns are also reflected in the type of complaints reported to AHPRA, with the rising rates of notifications for issues relating to clinical care [52% higher], communication [141% higher], and pharmacological or medication [162% higher] for doctors over 70.’
Consultation on the AHPRA proposal is open now, with
submissions to be made online.
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