The Performance Program operated under the provisions of the Medical Practice Act from October 2000 and from 1 July 2010, under the Health Practitioner Regulation National Law (NSW). As with all Council activities, the Program's primary objective is public protection. The Program is very specifically non-disciplinary in nature, and aims at early intervention and remediation following broad based assessment. This is generally achieved by placing binding, protective and remedial conditions on the doctor's medical registration.
Definition of Unsatisfactory Professional Performance
Unsatisfactory professional performance has a specific, statutory definition. A practitioner's professional performance is unsatisfactory if he/she practises below the standard reasonably expected of a practitioner of an equivalent level of training or experience.
Causes of Poor Performance
The causes of poor performance are many and varied. Professional isolation and inattention to continuing professional development are common contributing factors. On occasions, doctors present with adequate knowledge, but an inability to apply it in their day to day practice. This may be due to external 'distracters' such as illness and financial stress which may influence practitioner performance in the short or longer term.
How to notify the Council
The program relies on the notification of poorly performing practitioners to the Council. Many notifications come from employers, and it is important that internal solutions are explored prior to formal notification to the Council. There is no statutory requirement to notify the Council about a poorly performing practitioner. The Council also becomes aware of practitioners whose performance may be unsatisfactory as a result of patient complaints, particularly when a pattern is evident, or when there are multiple complaints.
Notifications must be made in writing and should be as detailed as possible. 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.
What the Council does
If the Council resolves to conduct a Performance Assessment, this will usually be conducted by three suitably qualified practitioners in the doctor's own environment, using the various assessment tools developed by the Program. Any resulting conditions that relate to the doctor's employment will be communicated to their employers. While this 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 a poorly performing doctor can be difficult. The NSW Department of Health has guidelines to assist public health facilities, but public sector employers should be aware that the doctor may also be working in the private sector, over which they have no jurisdiction or control. The Council's Medical Director can be contacted on tel. (02) 9879 2200 and is available to offer advice and assistance in individual cases.
