The Impaired Registrants Health Program has been operating under the provisions of the Medical Practice Act and more recently under the Health Practitioner Regulation National Law, since 1992. In that time, more than 350 impaired practitioners have participated in the Program and approximately 220 practitioners have exited, having consolidated their recovery and fulfilled the Council's monitoring requirements.
As with all Council activities, the program's primary objective is public protection. The program is very specifically non-disciplinary in nature, and although a period of suspension may be required, a strong, secondary objective of the program is maintaining the doctor in safe, supported and monitored practice.
Definition of Impairment
Impairment has a specific, statutory definition. A medical practitioner is impaired if they have a physical or mental impairment, disabilty, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect their capacity to practise medicine, or for a student, the students capacity to undertake clinical training. Illness does not necessarily eqauate to impairment. If an unwell doctor is insightful and practices within their residual capacity, then they are not necessarily impaired for the Board's purposes. Psychiatric illness and drug and alcohol abuse are likely to be of concern to the Board.
How to notify the Council
The program relies on the notification of impaired practitioners to the Council. The Board is happy to receive some self-notifications, although most come from colleagues, employers and treating doctors. The Council believes that there is a profound professional and ethical obligation to make an early notification. There are also three situations in which it is a statutory requirement that medical practitioners notify the Australian Health Practitioner Regualtion Agency (AHPRA) about an impaired practitioner or student. The Council would appreciate receiving a copy of the notification in these situations:
1. the medical practitioner is aware that another practitioner is practising medicine while intoxicated by drugs or alcohol;
2. the medical practitioner has placed the public at risk of substantial harm in the practitioner's practice of the profession because the practitioner has an impairment;
3. the medical practitioner is aware that a medical student has an impairment that, in the course of the student undertaking clinical training, may place the public at substantial risk of harm.
Practitioners may wish to view AHPRA's Guidelines on mandatory notification for further information concerning these situations.
Medical superintendents must also notify the Council by telephone by the next business day and by post within 7 days of practitioners and medical students who become involuntary patients, forensic patients or correctional patients within their facilities.
Health notifications must be made in writing. Those providing notification to the Council should be aware that the doctor who is the subject of the notification must, as a matter of natural justice, be given a copy of the notification and any additional material that is provided. The Council cannot act on the basis of an anonymous notification. Nor can the Council anonymise or withhold the notification from the subject doctor.
Given that the subject doctor will eventually be aware of the source and content of the notification, it is usually best to personally advise them that a notification is going to be made, and offer them the opportunity to self-notify.
What the Council does
On receipt of a notification, the Council will arrange to have the doctor assessed by a Council-nominated practitioner. If there is evidence of impairment, an Impaired Registrants Panel will be convened and registration conditions agreed. Any conditions that relate to the doctor's employment, eg withdrawal of their prescribing authority or restriction of working hours will be communicated to their employers. While the Council's process is not lengthy, it may be necessary to take immediate action at a local level if there is immediate concern for patient safety.
Further advice
Managing an impaired practitioner can be difficult, and most individuals and organisations have little relevant experience. The Council's Medical Director can be contacted on tel. (02) 9879 2211 and is available to offer advice and assistance in individual cases.
