Health practitioners are traditionally reluctant to make mandatory notifications for various reasons. These include a fear of becoming a part of a drawn out legal process, a perception that they are dobbing in their peers, or breaking the trust of their patient. It can be a challenging dilemma. However, health practitioners are often well placed to identify other colleagues who pose a risk to patients.
Under the Health Practitioner Regulation National Law (NSW), health practitioners (including pharmacists) and their employers, as well as education providers, must tell AHPRA if they have formed a belief that a practitioner has behaved in a way that constitutes notifiable conduct.
Notifiable conduct by a registered health practitioner is:
- practising while intoxicated by alcohol or drugs
- sexual misconduct in the practice of the profession
- placing the public at risk of substantial harm because of an impairment (health issue), or
- placing the public at risk because of a significant departure from accepted professional standards.
There was a recent case involving a pharmacist in a difficult situation, with a medical practitioner attempting to self-prescribe diazepam. The medical practitioner had used a family member’s name on the prescription, and as the pharmacist asked questions about the prescription and the patient's history, the medical practitioner's behaviour alerted suspicion, prompting the pharmacist to check the AHPRA register. They subsequently discovered there were conditions on this medical practitioner’s registration which did not allow them to prescribe this medication. Following this, a mandatory notification was made.
The pharmacist was initially reluctant to make the notification due to a perception that they would become further involved in the matter. However, discussion with another colleague helped to dispel that concern. Most of the time a mandatory notification does not require the practitioner making the notification to provide any further correspondence to the regulatory authority, but for more serious matters, further information may be sought.
In this case, the medical practitioner had breached conditions on their registration. They had a history of drug seeking behaviour, and had obtained previous supplies of diazepam in this manner. Had this pharmacist chosen not to make the notification, it is likely that the medical practitioner ’s behaviour would have continued unabated. The medical practitioner was a risk to himself, and would also pose a risk to public if practising whilst intoxicated. By making the notification, the medical practitioner was able to be directed to an appropriate pathway to resolve their issues. Remediation is the more common outcome for these matters, as the aim is to bring the medical practitioner back up to a level where they can practise again.
To read the COAG Health Council Communiqué, click here.
- Bismark M, Spittal M, Pleuckhahn, Studdert, D. Mandatory reports of concerns about the health, performance and conduct of health practitioners. MJA 2014; 201: 399-403