Mandatory reporting requirements problematic for overseas-trained doctors

Different cultural beliefs may make overseas-trained doctors reticent to report colleagues for impairment or professional misconduct under the new mandatory reporting laws, according to Medical Board of Australia chair, Dr Joanna Flynn.

Mandatory reporting by all registered medical practitioners came into effect on July 1 under new national legislation governing 10 health professions and their national boards, which now fall under the Australian Health Practitioner Regulation Agency (AHPRA).

Under the legislation, registered health practitioners, their employers and education providers must report “notifiable conduct”, such as working while intoxicated, sexual misconduct, or impairment placing the public at risk of substantial harm.

Dr Flynn’s concerns follow a study of almost 1900 US physicians that found 17% knew a colleague who was incompetent to practise but only two-thirds reported them.

Underrepresented minorities, graduates of non-US medical schools and doctors practising alone or with one partner were the least likely to report.

Dr Flynn said doctors from other cultural backgrounds needed the opportunity to understand the culture of reporting, but president of the Australian Doctors Trained Overseas Association Dr Viney Joshi said it was fear of repercussions that made OTDs reluctant to report.

“If overseas trained doctors feel so marginalised here, do you think they are going to report colleagues who are impaired? They feel very vulnerable as it is.”

Dr Joshi said many OTDs had been bullied, harassed and tormented and did not speak up.

“If an overseas trained doctor is working with an Australian doctor who is their supervisor they are not going to want to [report] for fear of being absolutely castigated,” he said.

Dr Flynn said if doctors in Australia fail to report when it was clear they should, action could be taken against them. She is encouraging doctors who are unsure of their new obligations to seek advice from colleagues, administrators or indemnity insurers.

"I know there is a lot of concern, understandably, that somebody could make a malicious report or be put in a position where they would have to make a report about their spouse,” she said.

“In general, the record of regulatory systems is that people don't make malicious reports and in fact there are penalties if reports are not made in good faith."

Reporting guidelines are available on the AHPRA website .

JAMA 2010; 304: 187-193.
Posted 2 August, 2010