When it comes to prescribing, doctors often find themselves treading a complex path through what can be a clinical, ethical and legal minefield.
Prescribing irresponsibly can cause harm. Prescribing responsibly, including choosing not to prescribe, can be a source of patient dissatisfaction and complaint. In fact, prescribing generates about 12% of all complaints to the Council, according to our in-house statistics. It is a greater generator of complaints than disrespectful communication, inadequate medical record keeping, the crossing of physical or sexual boundaries or concerns about a doctor’s own health.
Complaints about prescribing are also increasing; on average by 20% annually for the past four years. The main complaints relate to the prescribing of drugs of addiction, inappropriate or non-evidence-based prescribing, and refusal to prescribe.
Not infrequently, some of these complaints actually reflect well on a doctor. Being complained about by a ‘doctor shopper’ to whom you have refused to prescribe an opioid is obviously a good thing. The Council easily recognizes this, as the assessments of all complaints about doctors brought to our attention are assessed by clinically active medical practitioners.
"a lack of professional rigour around prescribing standards may result in increasing pressures to engage in inappropriate prescribing practices."
But some prescribing habits do not reflect well on either the individual practitioner or the profession as a whole. In some instances, a lack of professional rigour around prescribing standards may result in increasing pressures to engage in inappropriate prescribing practices. Sadly, time and time again we have seen this slippage come to eventually result in professional crisis.
The stories, ideas and tips on this newsletter are drawn from our experience with complaints about prescribing. I hope that they may be of assistance to you.
After more than 10 years involvement with the former NSW Medical Board and the Medical Council of NSW, I reached the statutory limit on my term of service on 30 June.
I would like to thank all those who have assisted me over my time as President, in particular my Council, the Executive Officer Ms Caroline Lamb, and all of the Council staff at Gladesville.
I would also like to extend a sincere thank you to the more than 30,000 medical practitioners in NSW who continue to provide high quality care and breathe life into our Code of Conduct in the hundreds of thousands of teaching, research and clinical-care episodes we collectively engage in every day.
His Excellency General The Honourable David Hurley AC DSC (Ret’d), Governor of New South Wales, has appointed Associate Professor Richard Walsh as the next President. His Excellency’s much quoted maxim of ‘the standard you walk past is the standard you accept’ is a value that I found myself often referring to when calibrating Council discussions and ‘right-touch’ regulatory oversight of the profession.
I extend to Richard and the new Council my very best wishes as they continue effecting their protective responsibility of ensuring appropriate professional standards in the delivery of care by medical practitioners and safeguarding the continued confidence of the public in our honourable profession.
Greg Kesby, outgoing President, Medical Council of NSW