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Clearing the air on mandatory reporting
It’s an area often filled with angst and confusion, impacting GPs who are patients and their treating doctors – so, how does it work?
‘In reality, the threshold for mandatory reporting is high, and most treated or well-managed conditions do not trigger reporting obligations.’
GPs seeking care for their own health concerns will rarely find it ends in a notification to regulators. Despite this, mandatory reporting is an area often filled with angst and confusion, impacting not only GPs who are patients but also their treating doctors.
To help members feel more comfortable with the process, and clearer on what’s required of them, the RACGP has been working to make this complicated area easier to understand.
Mandatory reporting rules set out the circumstances for when a notification to the Australian Health Practitioner Regulation Agency (AHPRA) is required.
While both treating and non-treating doctors have mandatory reporting obligations under the law, the situation can become particularly stressful for treating doctors who are caring for other GPs.
In Western Australia, treating practitioners are completely exempt from mandatory reporting, a move that the RACGP would like to see applied nationally, but they can make a voluntary notification.
In all other states and territories, a treating doctor is required to notify a regulator about a practitioner-patient if there is a substantial risk of harm to the public or sexual misconduct.
However, a concern is that some GPs may pull back from seeking the care they need due to a perceived risk that it will impact their careers, their health or have a domino effect on other areas of life.
Reassuringly, Tracy Pickett, legal and policy adviser at Avant, says the threshold for a treating doctor to make a mandatory report about a doctor-patient is intentionally high across Australia.
‘The concept of mandatory reporting still creates a lot of anxiety for doctors, particularly in the context of mental health conditions which may require lifelong management,’ she told newsGP.
‘Doctors can be reluctant to seek treatment because of their fears of being reported to the regulator and the understandable concerns about the professional implications.
‘In reality, the threshold for mandatory reporting is high, and most treated or well-managed conditions do not trigger reporting obligations.
‘A major risk of misunderstanding these rules is that doctors’ untreated conditions may deteriorate, posing risks to both their own wellbeing and patient safety.’
And research suggests that when doctors are unwell, ‘the entire health ecosystem suffers’.
‘Physician burnout correlates directly with reduced quality of care, increased medical errors, diminished patient satisfaction and higher healthcare costs,’ according to a recent editorial in the Australian Journal of General Practice (AJGP).
When to notify
Ms Pickett says that in deciding whether a doctor’s impairment puts the public at substantial risk of harm, as outlined in the legislation, the treating doctor should consider:
- the nature, extent and severity of the impairment
- what steps the doctor is taking, or is willing to take, to manage the impairment
- how well the impairment can be managed with treatment.
‘In most cases, doctors can seek treatment safely, as mandatory reporting is required when there is a substantial risk of harm to the public or serious unprofessional conduct,’ Ms Pickett says.
‘Treating practitioners consider the nature of the impairment, the steps the doctor is taking to manage it, and how well treatment can control it.
‘Often, support, time off, or adjustments to practice are enough to protect both the doctor and their patients without triggering a report.’
When notifications aren’t required
AHPRA explains that when treating a doctor-patient, ‘it’s very unlikely that you will need to make a mandatory notification about them’.
‘You don’t need to notify us about a practitioner-patient unless there is a substantial risk of harm to the public or sexual misconduct,’ it says in its
information to health practitioners.
‘In most cases, balancing the health needs of your practitioner-patient with public safety doesn’t mean making a mandatory notification.
‘Like with any other patient, your practitioner-patient’s health is the priority. A practitioner who is managing a physical or mental health issue by seeking help, or who takes time off to get well, is highly unlikely to pose a substantial risk of harm.
‘You need to understand your obligations and only make a mandatory notification to us if it is necessary to do so. If you think there is a substantial risk of harm to the public or sexual misconduct, then you may need to make a mandatory notification.’
Prioritising GP health
A recent series of articles published in
AJGP explores some of the pressures GPs face within Australia’s demanding healthcare system, including unrelenting perfectionism, excessive self-sacrifice and a risk of burnout.
On top of that, are the life pressures and health issues that no one is immune from.
RACGP President Dr Michael Wright reminded GPs that they are patients too, and there is a need to reduce the barriers GPs face when seeking the healthcare they need.
One of those barriers is the very existence of mandatory reporting requirements.
‘Although every GP is ultimately responsible for our own self-care and wellbeing, the systems around us must actively support our efforts,’ Dr Wright said.
‘That is why we’ve repeatedly
called on state and territory governments to follow Western Australia’s lead and scrap mandatory notification laws [for treating practitioners].
‘The thresholds for mandatory reporting are high; however, these laws can deter GPs from reaching out for the help they need, including for mental health concerns.’
Future goals
While advocacy work continues in this space to bring about national alignment in mandatory reporting rules, there have been developments in recent years to better support doctors.
In 2020,
changes to mandatory reporting requirements were introduced and aimed to support doctors to seek help about their health without fearing repercussions.
More recently,
AHPRA progressed changes to make its complaints process less stressful for doctors, following long-held concerns over the impact of notifications on practitioner wellbeing.
As a result of the ongoing changes, a recently released
AHPRA report showed a 94% drop, between 2021–22 and 2023–24, in the number of immediate actions taken where the single concern was health.
For more information on mandatory reporting requirements, visit the
AHPRA website or the following Avant guides for doctors:
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