Building a culture of care: Separating fact from fear in mandatory notifications

Doctors are uniquely positioned when seeking healthcare as patients, with insights and professional experience which may assist or sometimes hinder accessing medical care. There are concerns amongst the profession that mandatory reporting may dissuade doctors from seeking help.

There has been significant media coverage in recent months on the impact of mandatory notifications on doctors’ mental health, and the negative impacts of the regulatory process on practitioners’ overall health and wellbeing. There has also been a conflation between doctors seeking healthcare, including mental healthcare, and mandatory notifications, which in NSW are two separate processes.

In NSW, the number of mandatory notifications received about medical practitioners is very small. Mandatory notifications are not weaponised against practitioners and there is no automated reporting system that alerts regulators when doctors seek mental health treatment. Treating practitioners are not required to notify regulators solely based on a practitioner seeking or receiving treatment for mental health concerns – if a practitioner is well engaged with treatment and does not pose a risk to the health or safety of the public, then mandatory reporting is not required.

Seeking healthcare of any kind in NSW does not equate to an impairment and does not mandate a notification to regulators. The Medical Council encourages practitioners to be in early regular contact with their treating teams to help avoid deterioration of health and minimise the risk of impairment. A notification is mandated in NSW only when a practitioner’s conduct, performance, or an impairment poses a significant risk to patient health and safety. Illness is not classified as an impairment unless the illness meets the very high threshold for impairment such as practicing while intoxicated or significantly departing from accepted professional standards and posing a substantial risk of harm to the public. It is crucial to recognise that seeking treatment for health concerns is not only encouraged, but also demonstrates insight and responsibility for one’s care.

So, what constitutes notifiable conduct? In NSW, notifiable conduct by registered health practitioners includes:

  • 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)
  • Placing the public at risk because of a significant departure from accepted professional standards

It is important to acknowledge that doctors who are subject to a mandatory notification in NSW, will be managed by a process which is fair and in accordance with the Health Practitioner Regulation National Law (NSW). If the notification is related to a health issue, the doctor may be referred for an independent health assessment by the Medical Council of NSW. It is acknowledged that this is a stressful time for doctors and their families and they are encouraged to seek support including advice from their treating doctors, trusted support networks and their Medical Indemnity Insurer.  It is important that doctors seek the medical care that they need from their own treating practitioners and that they do not self-treat or delay treatment for fear of notification.

The Medical Council would like to emphasise not only the importance of doctors seeking support for any health concerns, but reassure practitioners in NSW that in many cases a mandatory notification is not indicated.

Resources:

HPCA Mandatory Notifications

Ahpra – Making a mandatory notification

AMA – Mandatory reporting obligations

We encourage practitioners to be in early regular contact with their treating teams to help avoid deterioration of health and minimise the risk of impairment.