Articles and Case Studies

Ahpra notifications – one doctor’s journey

07 Dec 2020

Nerissa Ferrie

by Ms Nerissa Ferrie

Gradual burnt matchsticks

Medico-legal advisers frequently hear the anger, fear and doubt doctors may experience in the face of a notification from Ahpra. Some allegations are more difficult to handle than others, but any matter that progresses past the initial investigation stage can extend the timeframe for resolution, and therefore the anxiety it creates.

Ahpra released some helpful resources1 in 2018 to explain the notification process and link practitioners to the support services available to them. While this information helps to normalise the process, each individual doctor will deal with the situation differently.

 

Below is a first-hand account written by one of our longstanding Members.

I am an obstetrician and gynaecologist working in both private and public practice at a large tertiary teaching hospital.

Last year, I received notification from Ahpra that I was being investigated following a patient complaint. I was accused of making inappropriate sexual comments and failing to ensure a patient’s privacy.

The complaint related to a brief consultation 12 months prior in a public gynaecological outpatient clinic.

The patient had made an informal complaint to the hospital about two months after I had seen her. My head of department made me aware that the patient had complained about my manner, and my failure to properly cover her during an examination. The patient was seeking an apology and financial compensation.

I examined the patient’s chart and noted that a nurse chaperone had assisted me throughout the minor procedure.

At the time, I suggested that the head of department contact the nurse chaperone for further clarification as I had no personal recollection of the consultation. I did not accept the allegations due to my invariable practice of preserving a patient’s modesty. However, I offered the patient a conditional apology for any unintentional distress as a gesture of goodwill. I also suggested that her care be transferred to one of my colleagues. The head of department subsequently advised me that the complaint had been investigated by the hospital and they considered the matter closed.

I was therefore shocked to receive a notification from Ahpra many months later. I immediately contacted MDA National for advice. In compliance with Ahpra regulations I advised my employer, and any hospital that I had admitting rights to, that I was being investigated.

I felt humiliated.

I responded to the complaint with MDA’s assistance, explaining that I had no recollection of the consultation. I outlined my usual practice during a consultation and examination, and I explained the role of nurse chaperones during this process.

I reassured Ahpra that following the complaint, I had reviewed my usual practice to ensure that I was complying with AMA, MDA and hospital guidelines regarding patient–doctor boundaries and conducting intimate examinations, and I was conforming to the Medical Board’s Code of Conduct. I was confident that I was compliant and up to date.

About six months after my response, I received notification from Ahpra that they proposed to issue me with a caution.

I was devastated.

I started to question my competence, and I could barely sleep for more than two hours without waking and worrying about the case. I became very wary of each patient encounter. COVID-19 and telehealth came as a welcome relief at the time, as I no longer needed to see patients face to face.

With assistance from MDA, I responded to Ahpra’s proposal to caution, strongly denying any wrongdoing. I provided testimonials from medical and nursing colleagues, and I asked for the opportunity to present in person to the Medical Board.

Permission was granted, and I subsequently had a Zoom hearing with the Medical Board and my MDA representative.

Several weeks later, I received notification from Ahpra of its decision ‘to take no action in relation to the matter’. A few months on, I remain somewhat distrustful of patients and their motives.

I appreciate that Ahpra has a role in protecting patients and upholding the ethics of the profession, but it felt like my guilt was assumed and everything that the complainant alleged was true – however implausible or unlikely.

We are really grateful to our Member for his candour. Doctors often feel alone and avoid talking to family members or trusted colleagues for fear of having their reputation diminished by virtue of a notification.

 

Dr Deacon’s article on page 18 discusses Ahpra statistics in more detail. It’s important to note that the majority of notifications are resolved with no further action against the medical practitioner – but this is cold comfort when you’re the one being investigated.

 

You should never ignore a notification, but nor should you let it cloud your judgement to the point that you’re no longer effective as a doctor. Trust, communication and mutual respect are vital in any good therapeutic relationship, and we find many notifications arise due to a misunderstanding or miscommunication.

 

If you receive a notification from Ahpra, don’t panic. Contact MDA National immediately so we can help you respond and support you throughout the process.

 

Reference:

  1. Ahpra & National Boards. Further information: https://www.ahpra.gov.au/Notifications/Further-information.aspx

Communication with Patients, Confidentiality and Privacy, Complaints and Adverse Events, Doctors Health and Wellbeing, Medical Records and Reports, Regulation and Legislation, Anaesthesia, Dermatology, Emergency Medicine, General Practice, Intensive Care Medicine, Obstetrics and Gynaecology, Ophthalmology, Pathology, Practice Manager Or Owner, Psychiatry, Radiology, Sports Medicine, Surgery, Physician, Geriatric Medicine, Cardiology, Plastic And Reconstructive Surgery, Radiation Oncology, Paediatrics, Independent Medical Assessor - IME
 

Library

My Career Journey with Dr Nick Coatsworth

Dr Nick Coatsworth is an expert in health policy, public administration and a practising infectious diseases physician. He held a national role in the Australian response to COVID-19 as Deputy Chief Medical Officer of Australia, becoming one of the most recognised medical spokespeople during the pandemic. Nick engaged the Australian community through a variety of media platforms most notably as the spearhead of the national COVID-19 vaccination campaign. Dr Micheal Gannon, Obstetrician & Gynaecologist, sits down with Dr Nick Coatsworth to discuss Nick's medical career journey, and what insights and advice he has for junior doctors. MDA National would like to acknowledge the contributions of MDA National staff, Members, friends and colleagues in the production of the podcast and note that this work is copyright. Apart from any use permitted under applicable copyright law, you may not reproduce the content of this podcast without the permission of MDA National. This podcast contains generic information only, is intended to stimulate thought and discussion, and doesn’t account for requirements of any particular individual. The content may contain opinions which are not necessarily those of MDA National. We recommend that you always contact your indemnity provider when you require specific advice in relation to your insurance policy or medico-legal matters. MDA National Members need to contact us for specific medico-legal advice on freecall 1800 011 255 or email advice@mdanational.com.au. We may also refer you to other professional services.

Podcasts

09 Jun 2022

Career complications and contending with uncertainty

Among the many challenges of the COVID-19 pandemic for junior doctors is how to respond to medical training impacts and career uncertainty. In this podcast, Dr Caroline Elton (a psychologist who specialises in helping doctors)and Dr Benjamin Veness (a Psychiatry registrar) share advice for coping with medical training and career delays, disruptions and unknowns.

Podcasts

10 Aug 2020