‘Deeply confronting’ findings show acute distress of AHPRA notifications

Jolyon Attwooll

27/03/2023 4:00:18 PM

The regulator has released study findings showing there were 16 suicides over four years among practitioners facing regulatory scrutiny.

MEdical practitioner
The study tracked those subject to notifications from January 2018 to December 2021.

Warning: This article contains reference to suicide and self-harm.
AHPRA has promised ‘major regulatory reforms’ in the management of notifications, following the ‘confronting’ results of a study into instances of suicide and self-harm by practitioners under investigation.
The regulator has disclosed top-level findings of research carried out by independent experts, members of health practitioner National Boards as well as AHPRA, which looked at instances of suicide and self-harm by practitioners facing regulatory scrutiny.
It found 16 practitioners took their own lives during the study period, which tracked those subject to notifications from January 2018 through to December 2021, while there were four attempted suicides or instances of self-harm.
The study findings were first reported in News Corp publications at the weekend. While AHPRA said it could not release the full report due to an ongoing peer review process for the study’s publication in a medical journal, it did send a detailed press release on the results.
It said the research followed similar studies in the UK, citing one carried out by that jurisdiction’s General Medical Council (GMC).
The latest GMC figures confirmed five suicides among doctors over a three-year period from 2018–20 in the UK, from 5370 investigations. During the study period of the AHPRA research, there was a total of 36,997 notifications.
The RACGP has consistently flagged the impact of notifications on GPs and advocated for systemic reform.
An AHPRA spokesperson said the research has already prompted changes, including the introduction of a ‘Health Management Team’ last year ‘to better support unwell practitioners’.
They also highlighted that the research period included the COVID pandemic, with ‘practitioners and the wider public … under increased stresses that exacerbated mental health issues for many people’.
AHPRA said in-depth reviews identified that practitioners who took their own lives often faced ‘significant life and health challenges’, including pre-existing mental health conditions or a history of substance misuse, or a combination of both.
‘The findings of this research are deeply confronting – but we commissioned it to learn and do better,’ AHPRA CEO Martin Fletcher said.
‘We want to clearly understand the pressure points in our processes that cause the greatest distress and change them.
‘We want to ensure that mental health safety is a thread that runs through all our essential regulatory work.
‘We are trying to increase the sensitivity of our approach, to strike a better balance between effective regulation that protects the public, and due care and respect for the practitioners involved in our regulatory processes who are often facing complex health and life challenges.’
The Medical Board of Australia Chair Dr Anne Tonkin said that patient safety remains a priority.
‘At the same time, we must do all we can to ensure our processes don’t make it harder for practitioners than the fact of regulatory scrutiny already makes it,’ she said.
The research was conducted by an expert advisory group brought together in September 2021, AHPRA said.
Associate Professor Manaan Kar Ray, a psychiatrist at Princess Alexandra Hospital, is part of that group.
‘The statistics show that health professionals are at a higher risk of taking their lives through suicide, and then you add a notification process to it, so you are in dangerous territory,’ Associate Professor Kar Ray said.
‘Most notifications actually don’t result in regulatory action, but the practitioners feel under threat, they feel their identity is under threat.
‘They worry that they can’t work, that they can’t provide, that they won’t be able to do the roles they have been doing for the rest of their lives.’
Another member of the group, the Chair of the Psychology Board of Australia Rachel Phillips, said the findings have led to changes.
‘The research has helped us see things from the point of view of the hardworking, often perfectionist and committed health practitioners,’ she said.
‘Their experience has been key to reforming our regulatory approach and the changes we are making aim to better align our processes with their needs, while keeping the public safe.’
AHPRA said that the average time to finalise a notification in instances where a health assessment is required has reduced from 265 days to 125 days since the establishment of the Health Management Team.
The college in the meantime has also highlighted the burden of trivial complaints, with the RACGP Vice President Dr Bruce Willett recently revealing how it took 10 months for a trivial complaint against him to be resolved.
Dr Tonkin has said that a triage process for such complaints has been set up to reduce the impact on clinicians.
AHPRA also stated the number of health assessments ordered has gone down by two-thirds, with more emphasis now placed on reports by the doctor’s treating practitioner when appropriate.
Further ‘wide-ranging reforms’ will be put in place in response to the research findings, the regulator has said.
As well as focusing on the management of health concerns, openness and transparency, and increasing support for at-risk practitioners, the regulator said it is committed to continue research into the impact of investigations.
These would include reviews of all serious incidents, with details on lessons learned and improvements to be published each year.
Mental health support for GPs
For immediate support, you can call Lifeline 13 11 14, or Beyond Blue 1300 22 46 36.
The RACGP also has self-care and mental health resources for GPs published on its website.
There are free, confidential doctor-to-doctor telephone services available across Australia.
ACT 1300 374 377
NSW 02 9437 6552
NT 08 8366 0250
Qld 07 3833 4352
SA 08 8366 0250
Tas 1800 991 997
Vic 03 9280 8712
WA 08 9321 3098

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Dr Christine Colson   27/03/2023 5:14:49 PM

It seems that AHPRA is trying to distance itself from any significant connection to theses suicides by invoking covid and the practitioners' health status. It seems that research is required to ascertain that a process should be timely, transparent, effective in weeding out trivial complaints and designed to uphold the principles of natural justice if it is to have minimal negative impacts. To say that '...patient safety remains a priority...' implies that AHPRA can't walk and chew gum at the same time. For a psychologist to say '...The research has helped us see things from the point of view of the hardworking, often perfectionist and committed health practitioners' does not instill confidence. Similarly, from the CEO, '...‘We want to clearly understand the pressure points in our processes that cause the greatest distress and change them...' How many more lives will it take before these understandings develop?

Dr Mileham Geoffrey Hayes   28/03/2023 7:26:03 AM

It has been all of my colleagues considerable experience that AHPRA attracts the "Doctor Haters", does not dismiss obvious vexatious or trivial claims and actively, aggressively encourages the pursuit and prosecution of Medical Practitioners. Sadly there seem to attract the disturbed 'Peter the Policeman' elements of the profession as well and employ lethargic, incompetent public servants wherein the longer they can drag it out, the less decisions they have to make, the better. It really should be disbanded. But we have seen the future. Don't advise you children to do Medicine.

Anonymous due to fear of AHPRA   28/03/2023 9:54:15 AM

AHPRA is hostile against doctors -system of no verification of verifier (any troll under fake name) can make 1 min complaint, which is allowed to be any lie (AHPRA waves responsibility for slender for notifier) and then forces under fear of licence loss to respond in details and runs no time limits investigations.
They acknowledge in their email to practitioner "we know how much stress and anxiety it causes you", yet gaslighting public to report as much as they can.
At the same time they allow no training and the unsafest in the world standards in cosmetic medicine - they failed public safety.
Open sadism with negligence to public safety may be explained by hald of AHPRA staff calling themselves "Dr" while they have no medical doctors staff members. Guess who created the rule that "Dr" title is no longer protected and everyone can call themselves "Dr"? - AHPRA...
Whatever psychological issues AHPRA management has - it's up to the Government to stop these unreasonable people

Dr Craig Gordon   28/03/2023 12:05:06 PM

Is wide ranging reforms truly taking responsibility for the tragic fact that AHPRA had a role to play in the death of 16 people in the past 4 years?
Even worse is that is took a study to expose this issue - how were AHPRA not aware of these tragic deaths? The death of our colleagues together with the mental health issues faced by others strongly suggest the need for a Royal Commission.

Dr Peter JD Spafford   28/03/2023 12:31:42 PM

"The latest GMC figures confirmed five suicides among doctors over a three-year period from 2018–20 in the UK, from 5370 investigations. During the study period of the AHPRA research, there was a total of 36,997 notifications."
Unbelievable that there is such a difference. There are many more doctors in the UK than in Australia but far more investigations here. Is this because AHPRA is a little over zealous?? Reading this article, AHPRA shows no real concern, only blames it on doctors having ‘significant life and health challenges’. And then the psychology advisor for AHPRA suggests we are flawed because we are "perfectionist and committed" so no wonder we commit suicide more often. Not helpful in the least.

Dr Graham James Lovell   28/03/2023 2:40:52 PM

I have survived a vexatious complaint recently, that being palliative care related goes first to a Coroners office for “X” months , which can simply = >many.
& AHPRA won’t even start a review until the Coroner commends your correct management,so we suffer “double-dipping “ .
The stress of this experience over a protracted period is much worse than any other life experience one is likely to face.
So I just want any other person for whatever reason facing the now acknowledged stress of defending a complaint to do what I did, and get EXPERT Psychological support.
Don’t ignore that you both need it , and deserve it, especially if you have made a mistake you’re probably even more at risk.
Meaningful changes ,with processing of, and consequences for vexatious complaints are the biggest issue going forward for all Doctors. As per the unprecedented 99% of us who voted NO to AHPRA being able to manage Vexatious complaints …

Dr Abdul Ahad Khan   28/03/2023 8:06:29 PM

GPs take pride in their Profession & they strive to build a Good Name & a Good Reputation in the Community that they serve .
A vexatious / Frivolous Attack on his / her Dignity & Self-respect can be too much for the GP to bear & Suicidal Ideations are understandable.
GPs are dBig Firms like Coles / Woolworth / Harvey Norman, / David Jones / Myers, etc. thrive on the Reputation & the Image that they have Painstakingly made.

There are 2 things which need to be considered :
1. When any Frivolous / Vexatious Attack by an unhappy Customer results in the Courts dismissing that Attack , the Complainant faces paying out Damages to the Firm.
Why should not GPs be similarly protected against Frivolous / Vexatious Attacks on his / her Reputation ???
2. The Name of the GP should not be displayed to the Public prior to the Courts convicting the GP of Wrong-doing - the GP, like the rest of Society, deserves to remain Innocent in the Public eyes, until proven Guilty by the Courts.

Dr Peter James Strickland   30/03/2023 1:00:34 PM

Any vexatious complaint that is not proven should be included in the AHPRA legislation that ensures that the complainant in those cases needs to to pay compensation to the aggrieved doctor in unproven and vexatious complaints, AND complainants thus need to know they are on 'strong' ground in making a complaint. The only complaint I had against me was a woman with a blistering rash on her forearms who stated I frightened her by referring her promptly to a dermatologist for biopsy and confirmation that the rash was not early pemphigus--as It was, it turned out to be dermatitis herpetiformis. AHPRA thus needs to be dissolved, and local Medical Boards with appropriate professionals on them re-instated to prevent delays and bureaucratic nonsense causing unnecessary trauma and costs in monies and reputations (plus suicides).

Dr peace seeker   19/05/2023 1:05:56 PM

16 victims (doctors ), lost their life , the reasons could be anything except AHPRA that what AHPRA insist to claim!! What about the hundreds of victims who are still breathing !!!
AHPRA , its regulation, bureaucracy and the mentality that is leading its decision makers should be put under the authority and society microscopes.
AHPRA should be registered medically as one of the major risk factors for committing suicide among the health professionals .