Study reveals factors influencing impairment notifications

There are calls to ensure GPs are better supported to seek ‘safe and early care’ for their own health challenges, as a study reveals the profession is over-represented in health impairment notifications to the regulator.
 
But despite fears among some doctors that getting support will trigger a mandatory notification from their treating doctor, researchers say ‘the data doesn’t back that up’.
 
Published in the Medical Journal of Australia, the 10-year study analysed data from the Australian Health Practitioner Regulation Agency (AHPRA) between 2012 and 2022, examining the records of 112,677 doctors registered to practice in Australia.
 
It found 1% of registered doctors in the study received at least one health impairment notification during this period – a total of 1732.
 
Substance abuse was the most common reason for health impairment notifications, accounting for 38% of all cases, while mental health concerns were the second most frequent at 33%.
 
General practice was one of the five specialty groups that had the highest number of overall notifications recorded, with 417 notifications.
 
Lead researcher Professor Marie Bismark said GPs are ‘really overrepresented’ in the data.
 
‘[Some] 17.7% of all the doctors were GPs but 33.6% of the doctors with health impairment notifications were GPs,’ she told newsGP.
 
‘Also, for GPs, they were 1.9 times more likely than physicians to get a health impairment notification.
 
‘When compared with physicians, GPs had twice the risk of a health impairment notification, and for substance use for the GPs, they were two and a half times more likely than the physicians to have a substance use notification.’
 
A total of 536 health impairment notifications analysed in the study were mandatory notifications, and 21.5% of notifications resulted in practice restrictions.
 
And despite being a cause for concern among some doctors, mandatory reporting notifications were made by treating doctors in just 6% of records.

Professor Bismark said she was motivated to undertake the research to help dispel myths and ease doctors’ anxiety over seeking care.
 
‘I’m aware some doctors are scared that if they see their GP about their depression or anxiety, they might end up being reported to AHPRA and maybe losing their license, which is just not the case at all,’ she said.
 
‘In the interviews that we’ve done with doctors who’ve gone through the AHPRA health processes, they’ll often say, “the reason I became so sick is I was so scared of the medical board that I didn’t see my GP”.
 
‘[They say] “I was self-prescribing, surviving, avoiding care, and trying to hide my illness from my colleagues, and that’s how I ended up so sick, subject to conditions or [being] suspended”.’
 
The study found doctors aged 70 or older are nearly three times more likely to receive notifications than those aged 30–39.
 
It also revealed that doctors in rural areas are more likely to have health impairment notifications than those in metropolitan areas, and male doctors are 1.45 times more likely to receive health impairment notifications than female doctors.
 
RACGP President Dr Michael Wright said it is important to understand how often these notifications are made, and it is reassuring to see that they are rare.
 
‘It’s an important call out to make sure that GPs take care of their health and wellbeing, and continue to see their regular GP,’ he told newsGP.
 
‘If any doctor has concerns with their physical health, mental health or issues with drugs of addiction, it’s really important that they seek care.’
 
Dr Wright also urged AHPRA to continue its work to ensure processes are effective and clear as well as supportive for doctors.
 
‘We’ve got to make sure that AHPRA does its job so that people who do have these notifications are dealt with fairly and in a timely manner,’ he said.
 
As well as expertise, Professor Bismark speaks from personal experience.
 
‘As someone who’s been an unwell doctor myself, I want to say that it’s totally possible to receive care and to come back to work and to not need to go through a regulatory process,’ she said.
 
‘I received such amazing care from my GP, and I’ve made a really good recovery.
 
‘I was unwell enough that I needed hospital admission, and my GP was just amazing throughout that whole process.’
 
The study emphasises that ‘illness does not necessarily indicate impairment, and only some unwell doctors are impaired in their ability to practise safely’.
 
The researchers added that while 1.1% of doctors received notifications, this figure likely underestimates the true prevalence of health impairment in the medical workforce.
 
AHPRA Acting Executive Director of Health Regulation, Monica Lambley, said too often, practitioners ‘struggle in silence’ when living through health challenges.
 
‘Seeking help when they need it, and actively engaging with recommended treatments, is the best thing that a practitioner can do to get the support they need to continue to practice safely, and ensure their patients receive safe care,’ she said.
 
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