‘They treated me like a criminal’: GP calls for AHPRA system reform

Anastasia Tsirtsakis

22/06/2021 4:31:53 PM

It took two years for a complaint brought against GP Dr Raed Masoud to be resolved, a period of prolonged stress that he says impacted on his physical and mental health.

A distressed GP reading a letter of complaint.
A number of RACGP members have reported personally experiencing, or knowing other practitioners who have experienced, issues relating to AHPRA’s processes.

It was in March 2019 that Dr Raed Masoud received the notification every GP dreads. He was under investigation by AHPRA, following a complaint from a former patient he had in his care five years prior.
The patient had presented in 2013 with a cough. Dr Masoud ordered an X-ray, which came back normal, and the GP noted in the patient’s records that a CT scan should be ordered if symptoms persisted.
In the meantime, the patient was being treated for chronic obstructive pulmonary disease with antibiotics and inhalers, and a follow up consultation confirmed a good response.  
Five months later however, the patient returned with persistent symptoms, at which point Dr Masoud had ceased working at the practice. A CT scan ordered by a former colleague confirmed the patient had lung cancer.
‘It wasn’t until March 2019 when this particular patient reported me to AHPRA. The entire case was closed in March 2021 – so it dragged on for two years,’ Dr Masoud told newsGP.
‘It was a triggered complaint; the patient wrote that the doctor informed the patient that I should have sent the patient for a CT scan.’
Almost 15 months after the GP was informed of the complaint, AHPRA issued him with a caution on 6 June 2020. His solicitor was only informed one month later, yet it had already been published on the public domain.
‘I tried to find out when it was up in the public domain. Nobody wanted to give me the information,’ Dr Masoud said. ‘When I pressed on it, they said to me it was up and running on the 30th of June. That’s seven days before I was informed – that’s inappropriate.
‘I am the one who is concerned, I am the one who is being investigated, I am the one who should be fully informed.’
Dr Masoud followed up his complaint to the Ombudsman and received a letter of apology. But he says it was too little, too late.
‘I’m not really looking for a letter of apology,’ he said.
‘Everything was put on COVID-19, everything. For God’s sake, a case like this shouldn’t be entertained for more than six months, at most.
‘They said one of their staffers resigned and they were short of staff. This is not my issue. Why do I have to put up with the stress and anxiety and unpleasant time because one of your staff has resigned?’
Over the course of the two-year investigation, Dr Masoud says he was made to feel like a ‘criminal’, and that when he tried to contact AHPRA he struggled to get a response to his queries.
‘Throughout the investigations they were ruthless; they didn’t care, they treated me with disrespect,’ he said.
In the meantime, Dr Masoud’s son had been diagnosed with cancer, and he was also facing health issues of his own. He says the uncertainty and lack of a clear timeline from AHPRA was distressing and impacted his confidence as a GP.
‘AHPRA doesn’t know anything about my private circumstances, they just follow a certain way of dealing with practitioners; they don’t really care about their psychological wellbeing,’ Dr Masoud said. ‘I was completely disenchanted with my profession.
‘I was practising more like medical legal medicine. I was overcautious; I was ordering investigations left, right and centre. Sometimes I had to go back to my notes the following day to write more notes.’

Dr-Raed-Masoud-Article.jpgDr Raed Masoud says during the course of the two-year investigation, he suffered from severe stress and anxiety, and his confidence as a GP was shattered. (Image: Supplied)
Dr Masoud is not alone in his experience.
During a 2017 Senate inquiry, the RACGP identified a series of issues regarding AHPRA’s notifications process and stated it had received ‘an overwhelming response’ from members who had experienced, or knew of practitioners who had experienced, issues relating to AHPRA’s processes.

The Senate Committee agreed with the college’s recommendations, resulting in the release of a new framework by AHPRA to help identify and deal with vexatious complaints.
However, in the college’s most recent submission to the Senate Community Affairs References Committee, the RACGP has called for more to be done to improve the notifications process, particularly with regards to ‘communication, transparency, timeliness and recognition of the impacts of the assessment and investigation process on a practitioner’s mental health’.
‘The Senate Committee should recommend an overhaul of the notifications process with the intention of easing pressure on AHPRA and the National Boards,’ the RACGP has recommended.
‘This will ensure more resources can be dedicated to managing remaining notifications and supporting practitioners and notifiers through the notification process.’
Dr Masoud says a timely response, and clearer communication, would have made a world of difference to his mental health.
‘I know that they are out there to protect and safeguard the public,’ he said. ‘But again, they cannot treat us with disrespect.
‘You cannot ask us to comply with a condition within 10 days, whereas I wait for months just for them to make a decision. For instance, my educational plan that I needed to do to comply with the conditions, I had to wait three months for that – why?
‘Why do they put me under pressure to comply with a condition, whereas once I need answers from them, I had to wait for months and months?’
Dr Masoud also believes there should be more accountability for the impact of AHPRA’s processes on healthcare professionals through the establishment of an independent body.
‘I don’t think they put into consideration practitioners’ wellbeing,’ he said.
‘I feel a lot of their decisions, the way they practice, needs to be supervised and overseen by a more powerful organisation that oversees and monitors their actions and decisions.
‘Unfortunately, there isn’t, so they have the upper hand, and no one can actually stand up to them.’
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Dr Michael Lucas Bailey   23/06/2021 6:45:15 AM

I’ve had to deal with AHPRA complaints myself. The AHPRA process is guilty until you confess. Irrespective of truth/circumstances/situation. The “new” APHRA process is they call you straight away and give you the option to say you were in the wrong immediately. Even if your weren’t - that does not matter. OHO and AHPRA need to be scrapped!

The aircraft and oil and gas industries use a process called Root Cause Analysis. The focus is on system failures not on individuals - because individuals are human and make mistakes. Why is medicine still stuck with a centuries old inquisitorial process?

As a mechanical engineer who became a doctor it is appalling to see how messed up the system is.

Adopting a Root Cause Analysis would be better for doctors and it would go a long way to fixing the systemic administrative nonsense in the public system.

It will probably never happen - proven responsibility requirements on bureaucrats and politicians instead of scapegoating doctors?

Dr Farid Zaer   23/06/2021 7:08:05 AM

The GP gave him lung cancer, he is a god, so he can do such magic!

Dr Mylapanahalli Krishnappa Shivashankaraiah   23/06/2021 7:14:11 AM

AHPRA is basically run by lawyers and the doctors who sit on the Board just sign the document the lawyers produce without reading or understanding the contents. It is little more than 3 years since my wife and I received notification because we treated our son. We were told that despite treating our son successfully many years back, we were told that we don't have insight. We were asked to complete a study plan. This was completed more than 6 months back and still haven't heard from them. The restrictions were posted in the public domain are still there. In South Australia it is legal to treat oneself and family members. AVANT lawyers do not want to be proactive. They wake up when we send them an email to say that they have been in touch with AHPRA. Frankly, we are disgusted at the way we are treated. We agree entirely with Dr Masoud. Hope RACGP takes an active role in this sorry affairs.

Dr Jeanine Suzanne McMullan   23/06/2021 7:48:34 AM

Good article

Dr Vishal Kohli   23/06/2021 7:52:39 AM

Very painful and powerful account. Thank you for sharing

Dr Naveed Shaukat   23/06/2021 9:17:09 AM

Good you had the guts to pursue your complaint. You suffered. Please imagine thousands like u who go through this hell for 5 years or more as they despite resolving the issue, they hunt for faults, to do the notes to liking of auditors who judge you on your notes alone. Amounts to endless hours and stress over the years. Massve loss of income affects tremendously. Not many doctors who have done anything to challenge for the suffering that go through. I wish there were private Barristers to help those as the Imdeminity legal teams help but without doing much. Everybody watches fate of the sufferers in silence. Once you have a complaint best say goodbye to practice not worth it anymore. Everything changes in your life. Good to know you survived. What's the next day going to be no one knows in Gp life. Uncetain timeline to settle the matters, finding unrelated faults in notes, stigma , ongoing audits adds to stress no one should go through. Nothing will change sadly...

Dr Ashwin Menon   23/06/2021 9:37:32 AM

AHPRA is ruthless and their methods draconian and indifferent at the same time. Funnily enough coming from a medical based body, there is not a hint of empathy shown by them. There needs to be more advocacy for doctors regarding this issue.

Dr Sin Yong Liaw   23/06/2021 9:41:42 AM

Vexatious complains are unfair and malicious. AHPRA should investigate such people and the complaints ,before they contact the doctor for response.

AHPRA has been wrong to Dr Masoud.
Due process must be in place, to prevent such thing happen again.

Dr Rodney Francis Stobart   23/06/2021 10:09:14 AM

I have spent sometime trying to get Aus Doc to print details of the way AHPRA dealt with a vexatious complaint about me
A girl who was looking for the result of an MRI on her knee having been to the clinic and seen other doctors to be told it was not available
The result was now back and I informed her she had a torn meniscus which required surgery
I gave her referrals to several surgeons and hospitals at her request( demand)
She complained to AHPRA that I did not give her the result or the referrals ?!!!
I sent a reply to AHPRA saying see the records which suggest she is an unmitigated liar or a fool or both
AHPRA told me I had to undergo 6 hours retraining ( after49 years of unblemished practise ) at a cost of $2400:00
The letter was for AHRA’s eyes only
If they had responded to the girl in an appropriate manner she would never have asked for a copy of my response
We are operating under the supervision of a cruel tyrannical body.
Why would any clever young person want to becom

Dr Catherine Susan Falconer   23/06/2021 11:13:08 AM

Why hasn’t the system for notification by AHPRA overhaul been addressed ? ‘The Senate Committee should recommend an overhaul of the notifications process with the intention of easing pressure on AHPRA and the National Boards,’ the RACGP has recommended

Dr Manikandaswamy Rajendran   23/06/2021 12:29:00 PM

The basic rule all doctors should follow is not to be afraid of AHPRA. I wonder if Doctors can not approach the high/supreme courts to seek redressal. If this is not possible practice as long as you can. All Doctors should also develop/invest in other business opportunities on the side and say Goodbye when the right moment arrives. Being a Doctor is a privilege and precious, lets us not compromise our self-respect

Dr Antje Vogelsang - Sharman   23/06/2021 12:54:26 PM

I think what often goes unrecognised is that we are normally very diligent. So when a complaint comes in the first thing is the incredible stress of ' what did I do wrong, have I really missed something, have I harmed a patient " This distress does not get recognised in any of these processes. But even more damaging is when there is no GROUND for the complaint and after note searching soul searching it becomes obvious - but the complaint drags on and on and once you are cleared - there is NEVER a clearance - a dry sentence that the case was dismissed . NO acknowledgement of the distress the time the sleepless nights NO acknowledgement that in fact the work was done perfectly fine and to standard.AHPRA and ombudsman have taken on the public opinion 110 % - most doctors are killers who only want money and dont care a bit and one day we will get them and there will be no mercy. So desillusioned wtih the whole set up.

Dr Julian Hadden Fidge   23/06/2021 1:23:28 PM

I just received ANOTHER anonymous complaint and have been notified by AHPRA.

I took the Medical Board of Australia to VCAT a couple of months ago (and won, easily), and as part of the discovery process, the Board provided my complaints profile.

I stood for local council, and got elected, in 2012. I have stood for some state and federal elections unsuccessfully since then, but managed to get regional drug and alcohol rehabilitation facilities provided in Victoria through good policy and campaigning. But what stood out was since 2012 I have had one or two complaints every year, most of which had nothing to do with patient safety, some of which are anonymous and some were clearly vexatious.
I have learnt through experience that I don't need to be distraught when I receive a notification, and so it mystifies me why I still find them, after about ten, now, so distressing. It takes me hours to calm myself.
It is true that the medical indemnity providers generally do a poor job.

Dr Radhakrisha N. Naidu   24/06/2021 4:56:43 PM

Dr Mahousd has been abused / neglected / failure to listen to the GP
It looks like the Aphra needs to be reviewed

Dr Graham William S Cato   25/06/2021 6:19:24 PM

I had vexatious complaints from ANON[of course]though our Clinic knew exactly who it was on the basis of a recent forced redundancy of our Practice Manager for multiple reasons.The whole Clinic was accused of Medicare fraud, and I was accused of "inappropriate sexual activity "at the Clinic.I won't go into all the details, but every member of the staff supported me.Despite this, after the "complaint"was sent in Dec 2020,and a "reminder"from ANON in Jan,I was not even informed about the complaint until April--guess what??!!Given a couple of weeks to reply!!Which I did, in one paragraph, but then it was another 2 months before I received notification that "I had no case to answer"!!
Please,RACGP,solve this problem.

Dr Bijay Pandey   27/06/2021 8:49:40 PM

This is an unfair system. Doctors work diligently for the welfare of all his/her patients. Yet the welfare of physicians does not count. The physician is handled like a criminal even though every physician has patient's best interest at hand.
I agree. RACGP needs to demand this unfair system to address at Cabinet level.

A.Prof Christopher David Hogan   29/06/2021 9:53:38 PM

On 26 June 2013 as a Represntative of RACGP I presented to the Legal and Social Issues Legislation Committee of Victoria which tabled its report on the Inquiry into the Performance of the Australian Health Practitioner Regulation Agency on 12 March 2014 .