This is an edited version of a conversation with Dr Anne Tonkin, Chair of the Medical Board of Australia, conducted on Tuesday 19 February 2019. You can listen to the full interview as a podcast, here.

InSight+: Congratulations on your appointment. You’ve been in the job 6 months. How’s it been? Are you settling in?

Dr Anne Tonkin: I’m having a very interesting and challenging time, but it is very fascinating. When I was first offered this appointment, my big thing was [that] I would really like us to be a little bit more outward facing. I’d like us to be understood a bit better, which is part of that. And so those are some of the things I’ve been talking about – making contact with the profession and the public, in a better way.

Part of that is also about reducing the fear factor, reducing the distress that notifications cause. I’ve had a notification myself … which didn’t come to anything, but just having it was very distressing. I’m not looking through rose-coloured glasses.

I’d like [notified doctors] to care but not be absolutely laid flat by it, not be devastated. Knowledge is power and if we can get more knowledge out [about] what we are trying to do and what we’re not trying to do, that will be extremely useful. That’s my overarching vision for the time that I’m in this position – trying to get us better understood.

I don’t expect us to be loved, but if we could get understood, that would make me very happy.

InSight+: What’s become clear to us is that there are a lot of doctors out there who have a [negative] view of the Medical Board and the Australian Health Practitioner Regulation Agency (AHPRA) generally, and of mandatory reporting, in particular. We’ve had a poll running for a couple of months now that’s got almost 3000 respondents and it’s sitting at about 60% of doctors who believe that they cannot seek treatment from a doctor for their mental health issues without putting their career in danger.

Dr Tonkin: I’m very concerned about that. We have our own information that says the same.

InSight+: Do you think people are not understanding the law? Is the law not written clearly enough or is there some kind of miscommunication going on?

Dr Tonkin: I think most people probably haven’t got around to reading it because it’s not exactly gripping reading. And the recent consideration in Queensland led to quite a bit of discussion about it and I think there’s a lot of fear and confusion.

I’m very concerned about people saying that they don’t think they can get help, because the Medical Board is not the slightest bit interested in hearing about anybody who has any kind of health issue that they are dealing with appropriately, and that doesn’t affect their practice. We don’t even want to know.

One of the things that [health] ministers are asking the Board to do is to be part of an education campaign. We’re already starting to negotiate with people like the Australian Medical Association and the medical defence organisations to get the information out there and have people less fearful. We don’t want anyone to be fearful of seeking any help they might need.

InSight+: What does this education program entail from your point of view?

Dr Tonkin: We are at the very early stages of that. It will be a matter of waiting until the national [mandatory reporting] law is amended, which is going through the process at the moment. We’ve started to talk to people in principle about whether they would be willing to be involved. [So far], everybody’s saying yes, because I think everybody’s seeing the same fear and misunderstanding.

It is very concerning if people need help and they’re not going to get help because of a fear of mandatory reporting, which is unfounded in terms of what it means. So, we need to get a message out about what it really means – who is liable to be reported and who isn’t.

The majority of doctors seeking any kind of medical attention do not need to be reported. They do not reach the threshold, which is a high threshold.

InSight+: Are you also aware of a perception among health professionals of both AHPRA and the Board as being the “bad guys”?

Dr Tonkin: We’ve done some research ourselves. The numbers of practitioners who actually said they didn’t trust the Board were pretty low.

For most people, the only interaction they have with us is at renewal of registration time. Unless they have a notification about them.  And that’s when some people have experiences that they find very distressing, and we understand that as well.

We’re working very hard to try and improve that experience as much as possible. We’re doing some research on that. We’re getting interviews from those who’ve had notifications made about them. About 80% of them don’t have any regulatory action taken at all. Again, it’s a case of people fearing for their career in a situation where the chances of their career being in any danger is extremely low, unless it’s a particular kind of notification, like a sexual boundary transgression or something like that.

It is most likely they’ll have no further action taken because it will turn out that their practice was perfectly fine and there was an unfortunate complication, and that happens in medical practice.

But occasionally there may be someone who has a pattern of poor outcomes that we might deal with by asking them to do some extra training or some education courses. Then, they can return to practise. They might have conditions on their practice, but they go on practising while they’re up-skilled.

Our entire goal here is to protect the public while taking the least onerous possible action against the practitioner’s registration. We are constantly doing that balancing act.

There are occasions when we can do things that do make the public safer. Public perception of the Board, I hope, is that’s what our job is.

And I’d like the medical profession to understand that that’s our job, but also to feel that we’re at the same time protecting their profession from reputational damage caused by the very few who end up behaving in a way that’s not consistent with being a medical professional.

One of the things I’m very passionate about is trying to improve the experience that medical practitioners have when they are notified about, and to improve the experience that the notifier has.

One of the things that we are trying to do is to up-skill Board members and staff about communication. We’ve changed the format of our letters a lot in recent times, for example.

One of the other things that makes both the notifier and the practitioner very distressed sometimes is the length of time that the notifications process takes. We’ve taken steps to improve that, [including] getting a more national approach to dealing with notifications. We now have offices that have particular expertise in certain types of notifications.

We’ve a national committee for assessing [notifications when they come in], which has led to a big improvement in the timeliness, particularly of very low level notifications. When the notification comes in, it is seen by committee members within a week or two. Low level notifications, where there is no risk to the public, can be closed there and then within a couple of weeks.

It also picks up on the ones that are serious and need investigation. The committee can send them off for investigation right then instead of going through other steps that we used to go through that meant matters would sometimes not even get into investigation for 2 or 3 months. Now, there can be an investigation within a month of arrival if this needs to be.

That committee has been running for just over 6 months and we’re seeing a turnaround in the numbers of open notifications for the first time, which is terrific.

InSight+: Let’s talk about the proposed changes to the Code of Conduct. The public submission period is closed, and you’ve had about 800 submissions. What does the timeline look like?

Dr Tonkin: [The number of submissions] surprised us a little because we didn’t think that the changes were particularly large, and in fact, most of what we’ve done in the last draft is to rewrite some of the previous sets of guidelines to make them clearer.

There are a couple of areas where I think there’s been significant misunderstanding of what we meant, which means we haven’t written it clearly enough. We’re looking to sort that out – we’ve got a working party on that and it’s nearly ready to come back to the Board … in the next couple of months. Then it will go out again for a targeted consultation round just to make sure that what we have written is not as open to misunderstanding as what’s there currently.

InSight+: Tell us about the National Training Survey.

Dr Tonkin: That’s a big piece of work for us this year. It’s modelled on the survey that the General Medical Council has been doing for 15 years or so now. It arose from the review of the intern year and some concerns about bullying.

We laid a bit of groundwork last year by adding a question for people to answer, which was, “Are you a doctor-in-training?” In the registration period in August and September, if they are a doctor-in-training, they will be given the option, not compulsory, of clicking the link to this survey, which will then ask them about their experience during their training.

The idea is to understand the quality of medical training better and to work with the Colleges and the other training bodies to try and improve medical training if it’s needed.

Our view is predominantly about the patient safety aspects – we know that patient safety is threatened when there is a poor culture in the workplace – bullying in the workplace, unacceptable behaviour and poor supervision. All of those things add to trainee stress, and patient safety is threatened when trainees are feeling stressed.

We’re hoping [the survey] will give both us and all the other stakeholders, including the employers and the Colleges, information about how training is going. If we can get a good response rate, we can get some solid data that will help employers and colleges and other training bodies to improve things where it’s needed.

I suspect the majority of training will be spot on. There might be some little pockets of difficulty that need to be dealt with. Knowledge is power and if we find that, then it’s possible for someone to do something about it.

We’re excited about the National Training Survey and we’re looking forward to seeing it roll out successfully the first time. That’ll be the big test.

InSight+: Where are things at with the Professional Performance Framework?

Dr Tonkin: That’s the other thing that’s big for us that’s going to take a while.

[As you know], it’s made up of five pillars. Some of them are moving ahead a bit faster than others as you might expect.

There’s been a working party for the Strengthening of Continuing Professional Development (CPD) pillar, which has produced a report which is going to the Board at our next meeting. A revision of the CPD registration standard has been drafted … and will come back to the Board in March.

The Active Assurance of Safe Practice pillar has the two elements of the age-related health check and the professional isolation, and we’re still sorting through how they might best be done. And we’ll be getting some external advice on how we do those things.

InSight+: Thank you so much, Anne. We very much appreciate your time.

Dr Tonkin: My pleasure, and thank you for the conversation.


Poll

The Medical Board does a good job of guarding public safety and medicine's reputation
  • Strongly disagree (38%, 48 Votes)
  • Disagree (25%, 31 Votes)
  • Agree (17%, 21 Votes)
  • Neutral (16%, 20 Votes)
  • Strongly agree (4%, 5 Votes)

Total Voters: 125

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33 thoughts on “Medical Board wants your understanding, if not your love

  1. Dr Michael Gliksman says:

    Oh we ‘understand’ the Australian Medical Board alright: Punishment not Prevention; Guilty Until Proven Innocent; Malicious Complaints are Very Rare; Delay, Delay, Delay….. need I go on Dr Tonkin? And no Dr Tonkin, I have never been the subject of a patient complaint to the Australian Medical Board / AHPRA – not yet anyway.

  2. Anonymous says:

    When you hear a politician say that they are putting the interests of the community first you know immediately they are not telling the truth. Dr Michael Gliksman’s list of headlines put out by a government bureaucracy suggests just that. I have seen the Board cover their arses at the expense of innocent practitioners all too often.

  3. Anonymous says:

    The default position is torture first then investigate.
    I understand that the number of complaints to AHPRA is rising exponentially.
    It seems unlikely that they will ever have enough staff to keep up with the consumer complaint culture.
    No…Ive never had a complaint but I am missing a respected and excellent colleague who retired early after a totally baseless complaint.
    I dont trust them at all.

  4. Anonymous says:

    The Medical Board of Australia is digging its own grave politically with its pursuit of trivial, vexatious and malicious complaints. I recommend to all my colleagues to consider taking a long break as soon as they receive a complaint and spent the time lobbying their local Federal member as well as notifying the relevant State Health Minister and Federal Health Minister of their decision to stop working for a time or at least limit their hours.

    The whole process was designed to protect the public from what would otherwise be dealt with as criminal behaviour not chase down every minor whinge and complaint from disgruntled patients. Medicine is rotten with the smell of regulation and legislation, and the Medical Board knows that its main target group, medical practitioners, have their hands tied when it comes to defending themselves.

    My suggestion to those don’t want to take a break is to get a chaperone for every examination and charge the patient accordingly. For bulk billed patients this may mean a two-stage process of history and blood pressure on Visit 1 and examination with a chaperone fully documented for Visit 2. If Medicare chokes on this style then the second visit should be patient funded or else refer to the local hospital or a specialist. These functions are the way general practitioners are perceived by many patients and specialists in any case.

  5. Anonymous says:

    I chose to retire early because of what I saw as a baseless complaint (a male university student who “suddenly realised” that night that he had somehow not consented to a routine examination (abdomen and external genitalia not rectal examination). As a male I am highly insulted not just because I am heterosexual but the nature of his complaint was pernicious and scheming. My belief is that he tried to hit on the receptionist and she told him to take a hike hence I somehow became the target of his retribution. A right little creep. I suggest to all my colleagues not to trust university students for any form of examination and use a chaperone or refer before they hang you out to dry. As for the waste of space that is the Medical Board of Australia and their automatons in AHPRA they should all hang their heads in shame for what they are doing to our wonderful collection of highly trained medical practitioners.

  6. Randal Williams says:

    The Board should have the power to reject complaints which clearly are trivial or vexatious–currently it has no discretion to do so. Theoretically if a patient complained that I had kept them waiting for ten minutes, the Board would have to investigate it and go through the whole tortuous process. The fact that many complaints are eventually classified as ” no case to answer” is testament to this.

  7. Dr De Leacy says:

    I agree the sentiments of Dr Gliksman and I also have not been the subject of a complaint.
    Some thoughts for you to ponder buried within a few queries that perhaps you may consider answering.

    Firstly, please give a detailed account of the exact number of bureaucrats (situated both centrally in Canberra and in the States) now employed to ‘police’ medical practice in this country compared with the overall numbers employed when the State Boards ran the system?

    Secondly, please give a valid reason why the registration fees doubled with the evolution of AHPRA (which now includes anti-scientific quacks of all descriptions) with absolutely no improvement in service for a medical practitioners who fund it.
    Thirdly, please detail the exact cost to the taxpayers (not just doctors) of this country of the massive bureaucratic blow-out in terms of Commonwealth Public Service benefits (eg Superannuation etc etc.).

    Fourthly, Why does every newly appointed health bureaucrat in this country immediately look to the GMC in the UK as though that organisation actually provides some sort of magical blueprint of excellence. Having worked there during its draconian transformation it was my experience that, almost without exception, every senior doctor there couldn’t wait to reach the age of 55 so as to retire on full-pension. ‘Revalidation’ run by the UK bureaucrats is just an appalling nightmare with not even the slightest nod to external Quality Processes/Circle Management principles addressing its own processes. I am unaware of any published credible independent evidence that GMC processes of the last 20 years have made any improvement overall to patient outcomes within the massive bureaucracy that is the NHS.
    Finally, why doesn’t your organisation (unfortunately not mine) as a constitutional and legal requirement so to provide balance, fairness and justice in equal measure, also provide legal support for all the targeted medical practitioners who subsequently wish to launch a response legal action against vexatious complainants. Please lobby the government to amend your terms of reference on this score and you may engender some respect for your medical colleagues.
    I do understand the difficulties of your position Dr Tonkin given that it really is quite impossible to rationally defend the operation of a ”Star Chamber’ to its victims. Unfortunately it is also the innate function and indeed rule of all Canberra Bureaucracies (and I have worked there myself) to expand their scope of practice and hence staff numbers (valid or otherwise) or to wither financially at the hands of the treasurer.
    I simply cannot imagine or indeed currently know of any other profession (eg Lawyers) or craft being subject to what medical practitioners are required to jump through at the present time.
    I’m afraid that rejoicing in shortening the turnaround time for processing complaints is not a way to inspire goodwill given the current grossly unfair nature of it all.

  8. Anonymous says:

    I completely agree with the previous comments. And I have not had a complaint against me either. I have had three colleagues who have been through hell with the system. There is no transparency and all were treated as guilty until proven innocent. Importantly there is a far too cosy relationship between the complaints bodies and the medical indemnity insurers who run a nice little club. It is far too easy for people to complain. Complainants should be required to sign a statutory declaration at the very least as any complaint has such a massive impact yet vexatious complainants are not held to account in any way.
    I would love to be able to put my name to this but I have no trust in the system at all.

  9. Anonymous says:

    Dr Tonkin’s comments are not reassuring. Doctors would seem to have really instilled severe insecurity in whichever politicians / parts of government have created the present level of regulation that continues being imposed; and it does not look likely that any amount of logical reasoning or appealing for the West Australian model (I am a West Australian, lucky for me) will achieve anything,

    It is really a divide and conquer strategy, there is such jealousy of the medical profession. How can doctors feel comfortable communicating with each other when there is a constant fear of being reported to AHPRA, and conversely, the treated doctor fearing the potential consequences of not reporting a possibly mentally unwell colleague?

  10. Eric Asher says:

    It seems little has changed since my own wee visit to the (then) NSW Medical Board some decades ago.
    The referring Consultant even made money out of it later in his book.
    What is alarming is that the folly of the witch-hunt, driving good doctors out of the Profession is not, as I thought, a uniquely UK folly.
    Like the earlier importation of the criminal classes of Britain for form our fine antipodean society, the nation seems pleased to ape the heavy handedness of the General Medical Council in UK.
    On the other hand, as the former UK Home Secretary Mr Blunkett wryly remarked: ” The innocent have nothing to fear”.

  11. Philip clarke says:

    My problem at the hand of the board is the lack of natural justice, (never mind even the appearance) something the lawyers seem to understand but the judge and jury take umbridge with if the complainant dare bring this up. Like the star chamber of old, you must be guilty, if you weren’t guilty you wouldn’t be here, but you are.

  12. Anonymous says:

    I received a communication from AHPRA requesting details about another medical practitioner who had consulted me.
    When I asked if I was breaking any law or regulation if I provided that practitioner with a copy of what I sent AHPRA I was told to consult my medical liability insurance provider or a lawyer.
    I was NOT impressed with AHPRA’s expertise or professionalism.

  13. Anonymous says:

    I agree entirely with Dr Gliksman.
    As to “Dr Tonkin: We’ve done some research ourselves. The numbers of practitioners who actually said they didn’t trust the Board were pretty low”……what utter rubbish. Maybe Dr Tonkin asked a few psychophants or some junior doctors on the record but I suspect if you polled the average Doctor anonymously you would get a very different response.

  14. Phil McGeorge says:

    I think the survey above says it all, the majority disagree with the statement “The Medical Board does a good job of guarding public safety and medicine’s reputation”. It seems obvious the Board and AHPRA need to find out why this a majority view, especially when they view that few people are the subject of a “Notification”. So why do the majority of doctors feel so disappointed.

    In the area of Medical regulation AHPRA has FAILED miserably. We now have the Boards of Optometry, Nurses and Pharmacists, simply changing their Scope of Practice to include medical practice and prescribing with only a weekend course. So too, could the National Boards of Chinese Medicine, Chiropractic, Osteopathy, Paramedicine or Physiotherapy. We could soon see Podiatry extend to the hip and other areas of Orthopaedic Surgery and Rheumatology, Psychology becoming Psychiatry etc. In the US, it is already a reality with Osteopathy a medical qualification, Optometrists performing laser eye surgery, and Podiatric Surgeons doing hip and knee replacements.

    And meanwhile the Medical Board of Australia does NOTHING to prevent a “licensed Charlatan” from practicing medicine, whilst spending its time energy and resources harassing doctors over a rude receptionist or other petty squabbles.

  15. Dr H. de Toulouse-Lautrec says:

    The basic problem is systemic :

    The Legislation that empowers the Board (with powers of The Supreme Court) provides the Board no discretion to NOT investigate rubbish notifications. Instead it obligates the Board to at least bring a doctor to account. Every single one.

    “Psychiatric patients deserve the same protections as others!” is axiomatic on the surface, but think about the variability in the threshold of reporting. The Board should have the power to benevolently ignore.

    Then there is the vexatious complaint not based on any service principle, but emotions emanating from a reaction to the doctor’s manner.
    For example, I received a Notification that I had tried to look intimidating, based on the fact that I straightened up in my chair during the debate of an issue in the consultation. This was reported to the Board that I was “trying to make himself look taller.”
    I’m tempted to break tangentially into comedy here.
    Have a guess how many hours were wasted properly considering and answering the detail of the Notification? Including copying the medical file for their inspection regarding any unrelated issues? (none). How many months it took?
    Must have given that worker’s comp patient suitable gratification.

    But is this what the Board is for? Are you serious?

    We need a political legislative fix. The Board should be able to wisely ignore.

  16. Anonymous says:

    Disturbingly, I had to report two practitioners of wrong doings and treating patients in harmful ways just to cover their arses. That investigation took more than six months. Not unexpectedly, the wrongdoers lied, but worst of all, AHPRA used the response of these two practitioners to produce a notification about me! This shows:
    1. AHPRA is an inefficient government investigational bureaucracy
    2. AHPRA will not properly investigate real concerns but ends up trying to cover their own arses
    3. Dangerous practitioners are not only exonerated but supported by AHPRA
    4. It is far too dangerous to think that AHPRA will act in the safety of the public when their own public appearance is placed at risk!
    Judging by the number of anonymous replies, it seems that no-one trusts the board or AHPRA!

  17. Paddy Dewan says:

    There is a symposium intended to unit people to change the legalistic paradigm in medicine. We hope to see those interested in protecting patients AND the practitioners on 13th April in Melbourne – at a conference of the Healthcare Excellence Institute Australia – with the theme FIRST SEEK TO UNDERSTAND. Senator Jonathon Duniam will open the meeting following his role on the Senate Committee that reviewed the role of AHPRA as a tool of the bully. Details are listed on the website – http://www.healthcareexcellenceinstitute.com.au

  18. Dr Chris Kear says:

    Successive Goverments have reduced Medicare rebates in real terms and brought in ridiculously complex and punitive overseers, hand picked from their friends. Less pay, more accountability, and accountability badly managed by politically motivated bodies, to boot.

    It’s about time we told these regulators to piss off, or better still, got together and took these bodies to court to make them answerable for all the pain and suffering they are causing our Medical Professionals. We need some test cases to establish sensible and timely processes to deal with complaints. God knows we pay these overseers enough, they ought to be able to work quickly and deal with matters effectively as soon as a problem crops up.

  19. Anonymous says:

    There seems to be a recurrence theme here. The medical board has a long way to go before it demonstrates that it understands that the way to take care of the public is to take care of the medical profession ; an outstandingly talented and well motivated splinter of society. Also strange that we need to have this conversation in view of the current airtime given to bullying.

  20. Anonymous says:

    A medical expert is queried by a vexatious complainant, then investigated by a non-medically trained AHPRA investigator, who proposed immediate suspension on the medical expert for deficiency in medical knowledge and skills by the non-medically trained AHPRA director, then summoned to the ‘Medical Board’ with a panel of medical practitioners who are not expert in the field of the medical expert but have the power to suspend or place any form of disciplinary action against the medical expert on the basis s/he is somehow guilty of malpractice. Now, that is a Star Chamber which I witnessed myself…and so many of my fellow colleagues have endured it.

    The only little consolation I have about Dr Tonkin’s interview was her admission that ‘One of the things that we are trying to do is to up-skill Board members and staff about communication’. With such poor communication skills themselves, how on earth can they be given so much power to impose on other highly qualified doctors to do communication course just so that the Board members can save face and cover their arse!

    Perhaps Dr Tonkin can urge the Health Minister to call for a Royal Commission, and have another round of public interview.

  21. Anonymous says:

    I want to know (1)why AHPRA/MBA permitted remote prescribing to Registered Nursing staff by ‘Skype’ of Botox and Dermal Fillers when AHPRA in its consultation paper on new guidelines for cosmetic practice recommended face-to-face consultation with the prescribing doctor. Almost all of the professional medical and surgical institutions in Australia supported AHPRA’s recommendation that Option 3, which included face-to-face consultation, be the basis, as recommended by AHPRA, for new guidelines. The consultation paper not only recommended face-to-face consultation, it cited the GMC move to ban remote prescribing for cosmetic procedures (non-essential, elective, private billed) in the United Kingdom six months earlier because of the risk to the public. Last year, one woman was left with permanent loss of vision in one eye as a result of a delegated treatment authorised by remote prescribing (ABC Four Corners). There is probably a second case now. And now we see a consultation paper focusing on medical practitioners only, regarding complementary and unconventional ‘medicine’ when the TGA is the lawful authority for medicines and devices in this country NOT the MBA. (2) Why is the MBA wasting valuable resources on this when the TGA is the lawful entity that is adequately authorised to manage these issues that the MBA know nothing about, which is clear from the questions they are asking in the consultation paper?

  22. Anonymous says:

    I am appalled about the practices AHPRA has in regards to their investigations. If their methods in gathering and presenting their evidence were employed in a “real” court of law, I doubt many of their rulings would be upheld. As it currently stands, they protected by the legislation as a big faceless organisation. They are the judge, jury and executioner – with the practitioner having no grounds for appeal with zero transparency. When complaints are made doctors and other medical professionals are forced to fund their own medical defense – which can run into hundreds of thousands of dollars. Often it is a competition of who has the deepest pockets.

    Here is a link to a senate inquiry in 2016. If you think things have changed you would be mistaken. https://www.youtube.com/watch?v=Elx_CiNM2Tw

    AHPRA needs a clean out. Too many good medical professionals are being unduly punished and suffering with no avenue to defend themselves about this big faceless organisation. And no one is listening. We need a Royal Commission.

  23. Arlene Taylor says:

    Prof Anne Tonkin is clearly either putting on a ‘pretty performance’ or grossly unaware of how the Board she is chair of operates and behaves. Kangaroo courts. Decisions made based on no evidence. Gross violations of practitioner privacy during AHPRA’s witch-hunts. I challenge (and summons) Prof Tonkin to appear in my own NCAT appeal against conditions. It’s your perfect test case: A practitioner with no history of clinical error (identified), no complaints about practice or performance, but with a mental health history. Notably, a mental health history contributed to by oongoing, endless, harrassment from the Medical Board and AHPRA. If Anne Tonkin is really interested as to why practitioner’s fear their registration if seeking help for mental illness then she should come and see what it’s like. David vs Goliath (and Goliath’s whole family).
    Prof Tonkin: Me vs Your Board (15-17 April, NCAT, Sydney) – will you have the integrity to come?

  24. Anonymous says:

    Several things: I have been subject to a notification and ‘punitive measures’. I have also served for some years on a different State Medical Board and ‘know the ropes’ The adversarial process prevents the ‘truth’ and any mitigating factors to be fully examined. Doctors have very little clue about legal procedure which may lead to board members committing bias, pre-emptory decisions and making extraordinarily punitive and non-sensical decisions.
    The Code of Conduct is akin to a curate’s egg. Compared to the GMC its section of Informed Consent is infantile. There is no standard for how one assesses a patient’s decision-making capacity despite that very procedure being a relevant part of consent. No proscribed training in under-graduate or post-graduate medicine also. No standard about procedure or recording such assessment in any health profession registered in APHRA or otherwise. There are some State department of Health staff protocols on the subject, not all States and no idea if they are used, but they range from a readable but inadequate 2 pager to a superb academic but totally non-functional document of 80 pages (QLD).
    From experience in Palliative Care there may be many alternative, non-standard treatments which can be extraordinarily helpful to patients. And the drivers of this push to eliminate alternative treatments are Private Insurance and Big Pharma. How many really useful standard medical treatments exist for CFS? And why is the not the Board investigating why so many homebound CFS sufferers are finding GPs refusing to do home visits.?? This makes a joke of Health Care Rights to Access. The patients and family fear being cut off from medical help if they complain. Whilst the Board seeks out ‘Big Topic” perpetrators, systemic problems run riot. The one case at a time does not answer this problem, but a systemic problem is still medical conduct problem!!!

  25. Anonymous says:

    Is the conduct of AHPRA and the Medical Board bringing our medical profession into disrepute? How can the public trust & respect a profession that has so many scandals (like bullying its juniors and harming its members with such degree of inhumane punitive action, injustice or indifference) to properly self-regulate and manage our healthcare? No wonder people are calling for a royal commission.

  26. Randal Williams says:

    three suggestions Dr Tonkin and the Medical Board

    1. Do whatever is necessary to gain the ability to dismiss trivial / vexatious complaints
    2. make their investigative processes more transparent and in shorter time frames
    3. personally telephone every doctor who is the subject of a complaint to explain the process and offer support during the ( often prolonged) investigation

  27. Anonymous says:

    AHPRA needs to be overhauled

    The trauma that they inflict can be worse then the actual complaint.

    We need a strong union to protect drs,medical staff.
    It’s sad that the dictatorship is nameless,faceless and has absolutely no account ability

  28. Anonymous says:

    AHPRA is not there to protect drs

    Remember that at your peril

  29. Anonymous says:

    I have been subject to notification working as a General Physician many years ago.No further action was warranted. A report was written by a dietitian fourteen weeks after the interview and contained meaningless and incorrect sentences; this document was later used and treated as a factual account of the interview.

    A decade later, three more complaints, within three months, from the same country town. The GP delegates firstly assumed the truth of the complainant’s statements. Little reference was made in their report to my evidence, (where it was, it was often completely contrary to what I had said). All the red flags suggesting collusion and the vexatious nature of the complaints and complainants were ignored.
    Like many others who have contributed to this conversation, I was assumed guilty from the onset. In this setting, at the Tribunal, the legal representatives suggested ‘appeasement’ and to acknowledge fault as a ‘communication issue’.

    “You wouldn’t be here if there wasn’t an issue” I was told by my legal rep. Yes, the issue is the vexatious nature of the complaints, the from my perspective, but I was not to talk to this issue.

    My two GP’s delegates made a critically incorrect medical observation, in their report (that an inspection of the vulva/vaginal area would not tell the examiner if the labia/vagina was dry or atrophied) that ultimately lead to criminal charges being brought against me. During the Trial, the four “Crown Experts” agreed with me that these changes are visible and relevant in symptomatic women.

    The delegates have no “skill set” to be the arbiters of fact and are mostly judging in areas outside their expertise. Their behaviour at the meetings is a form of bullying and in my experience of the process, akin to a kangaroo court or star chamber. How can non doctors or doctors with no expertise in the “accused’s” special area of interest be expected to give a quality opinion?
    Despite two subpoenas being issued within the context of my trial, the Health Care Complaints Commission consistently refused to release pertinent information. From my perspective, through an MOU with the Police, the HCCC actively encouraged a police prosecution.

    Effectively, the complaints process through the HCCC has, in my case, been “weaponised”. Aided by a process that is characterised by an extreme lack of due diligence and/or critical attention from the delegates at the meetings. This in turn has enabled medical practice to be easily “criminalised”, such I was charged with touching pubic hair during an abdominal examination, charged with palpating an abdominal scar and other routine medical examinations were criminalised. The Police were determining what does and does not constitute proper medical purpose. This was with the aid of what I would call a “Sham Expert” sourced by the HCCC, who provided a redacted report on the complainants,directly to the police. It was far from transparent.

    This is a sickening turn in the story of modern medicine. Flamed by social media and a Press rabid for ‘News’, many good and fine Doctors are having their lives, their work, their reputations traduced and discarded by an incompetent Medical Council and an all too zealous HCCC.

    It begs many questions.
    How is the HCCC funded? In the same way as private prisons ie: “bums on seats” – the more prisoners, the more funding?
    How can the HCCC and Medical Council justify statements from disgruntled patients that are emailed at anytime of night or day without the need for them to be ‘statutory declarations’, particularly as these complaints have the ability to utterly traduce a Doctor?
    How does the relationship between HCCC and medical insurers work?
    It would appear that both sides win from a Doctor being handed over to the criminal justice system.

    Perhaps most appalling of all, as shown repeatedly by the users of this site, the need for anonymity for fear of the retribution that must surely come.

    Not one Doctor felt free to support me during the last three years – certainly not publicly – and the College did not one thing.
    My Insurer wrote advising me that they no longer would support me as the matter had been criminalised,.
    The s150 meeting with the Medical Council – despite being told that it would not be used in a trial (long before I ever knew that I would be embroiled in one) was used time and again by either delegates at the meeting, or others who through the HCCC and their MOU with the Police, used the transcript against me.

    Far from being an “interview” or a meeting between equals, my experience was the delegates were in judgement and opinion, before I had even spoken. I believe this, in the first instance, is referred to as “information bias”. If such information continues to be used to promulgate the bias, without critical appraisal as to its relevance/merits, then it becomes, as it did in my case, “confirmation bias”.

    To see Reports going back decades, cut and pasted into further meetings between myself, the HCCC and the Medical Council has thrown up the very real possibility that the entire system is flawed, run by bureaucrats who are disinterested in the medicine and just focused on administration. Problems/complaints become a number and Doctors are just the other number that match the complaint. Neither is much cared for by either HCCC or the Medical Council.

    The Medical Council is ineffective in protecting doctors who are innocent, hasn’t the power to intercede on behalf of the accused, just impose conditions/penalties; it occurs to me that the medical fraternity is truly lacking a UNION to support them openly without fear or favour. The Health Professionals Australia Reform Association should receive funding as this body is attempting to bring shine light into the complaints process and I urge everyone to inform themselves of HPARA.

    In the time that it has take my matter to be blown out of all proportion by the Media and the Police call out for victims, I know of at least six other Doctors who are facing similar issues – all being publicly shamed, named, business closed and in a few truly tragic cases, the life of the Doctor lost – being utterly overwhelmed by the circumstances.

    Not every Doctor who is accused of sexual assault is guilty.
    We live in a society where the moment the allegation is made, innocence is ignored. This makes all doctors, particularly men extremely vulnerable. Young male doctors in training have already determined that some examinations,broadly defined as intimate,will not be undertaken by themselves.
    The Crucible looms large. But as every witch hunt has ever demonstrated, the mob can just as easily turn on its own and all will be deemed to be guilty.
    There needs to be a concerted “pushing back” against the insanity of many of these processes.

    Perhaps Doctors should ignore the Medical Council and go straight to NSW Civial and Administrative Tribunal. In that way arbitration would occur before those trained to adjudicate the facts. The flawed “processes” of both the Medical Council and the HCCC has led on many occasions to the ruination of many fine careers and tragically too many lives.

    I do not trust the process at work within the HCCC and the MC. I am unwilling to disclose my identity.

  30. Bruce Hocking says:

    Last year I was “deregistered” by APHRA thanks to their bureaucratic practices. Earlier in the year My email/ISP provider had ceased operation and I changed to a new provider. I arranged on the old site information regarding my new email address. Later that year I received a letter from APHRA saying I had been “deregistered” for failing to reregister. What had happened was APHRA only sends renewal notices by email – and cleverly uses a “do not reply” mailing address so it does not have to be client responsive. Therefore my automated reply went unread. However APHRA instead of sending a postal reminder to reregister waited and only sent a a letter saying I had been deregistered for failure to reregister. I was unable to practice for a week while this was sorted out.

    APHRA must use every means possible to communicate with practitioners and understand their reasons before seeking to deregister them. Why is it good enough to send a letter stating deregistration and not a letter asking why reregistration has not occurred? This is simply bureaucratic contempt for practitioners.

  31. Philip Clarke says:

    With the email only – you have to specifically ask AHPRA to send material by mail.

    Given all these comments (above) Who watched AHPRA who can we complain to about the boards behaviour? Who oversees the behaviour of the board?

  32. Anonymous says:

    The only complaint avenue about AHPRA or the board’s behaviour is the national health practitioner ombudsman and privacy commissioner (NHPOPC) and they just happen to be funded by …… you guessed it – AHPRA.
    So much for independence and accountability. They merely support the incompetent arrogance that ahpra and the board show towards both doctors and notifiers.
    Neither ahpra or the board are interested in actually doing their job in a timely and competent manner, their primary stated role being to protect the public from serious offenders.

  33. Anonymous says:

    The medical board and speaking particularly to the medical practitioners on the board, extend no understanding or respect to colleagues. They sit in the ivory tower of their secret society accountable to no one.
    Passing judgement on medical practitioners most of whom are just trying to do a good job without upholding professional standards of their own, rather hypocritical. Our esteemed chair does not even bother to acknowledge or respond to concerns from colleagues.

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