Receiving a notification

Case study

Dr Patel is a general practitioner working in a suburban mixed-billing practice, servicing a diverse patient population with high appointment demand.

He receives an Ahpra notification from a 32-year-old female patient who attended the practice on three occasions over a two-month period for ongoing abdominal discomfort, bloating, intermittent diarrhoea, and persistent fatigue.

The patient works full-time and reports significant disruption to her daily functioning. Each consultation was booked as a standard 15-minute appointment, and Dr Patel was managing a full clinic on each occasion.

In the notification, the patient alleges that Dr Patel failed to appropriately investigate her symptoms and did not take her concerns seriously. She states that she repeatedly described worsening fatigue and difficulty concentrating, but felt these concerns were minimised and attributed to stress and lifestyle factors without adequate explanation.

Concerns were also raised about his communication style – describing Dr Patel as rushed, using medical terminology without clarification, and not providing clear advice about when to return or what symptoms should prompt further review. She reports feeling dismissed, and leaving consultations uncertain about the management plan.

The patient later consulted a different general practitioner, who ordered a broader panel of investigations including iron studies and coeliac serology. These tests indicated iron-deficiency anaemia and coeliac disease, and she was referred to a gastroenterologist for further management.

In her complaint, the patient states she believes the investigations should have been initiated earlier, and the delay contributed to ongoing symptoms, anxiety, and reduced trust in medical care. She seeks acknowledgement of her experience and reassurance that similar issues will not occur for other patients.

Medico-legal discussion

The word ‘notification’ can make your heart sink, but there are plenty of practical steps you can take if one comes your way.

Anyone can lodge a notification with Ahpra about a medical practitioner, and Ahpra receives it on behalf of the Medical Board. Most notifications are made by patients or family members. Although the National Law imposes mandatory reporting obligations on health practitioners, employers and education providers, most notifications are voluntary.

Following receipt of a notification, Ahpra may contact the practitioner for a brief discussion. While this may seem benign, it is prudent to advise Ahpra that you wish to first speak with your medical defence organisation before providing a verbal response. Your case manager at MDA National can then consider the pros and cons of a verbal response versus a written response, and can advise you accordingly.

Ahpra may also offer you the opportunity to have a case discussion which can generally be in lieu of, or in addition to, a written response. Again, advice should be sought from MDA National on the best way forward.

While the Medical Board can decide to take no further action in relation to a notification without obtaining a practitioner’s response, this is not common. A response will generally be sought from a practitioner at the outset, irrespective of whether a notification appears to have any proper grounds.

Understandably, this can be a source of great frustration for doctors who can feel unfairly targeted and perhaps perceive Ahpra to be “taking sides” with the notifier. This is not the case, and is generally simply Ahpra providing a practitioner an opportunity to respond in accordance with the requirements of procedural fairness.

Most notifications end with the Medical Board taking no further action and closing the matter. Where a notification raises concerns about a practitioner’s conduct, the way they practise, or their health, the Board may decide to investigate or ask the practitioner to complete a performance or health assessment.

A considered and reflective response to the notification is invariably a doctor’s best opportunity to defend their performance or conduct. Despite the understandable dissatisfaction of being the subject of regulatory scrutiny, there are invaluable opportunities to learn from the experience. We receive consistent feedback from Members that further education offered by us and voluntarily completed by them has helped them in their broader practise of medicine.

Outcome

In responding to Ahpra, Dr Patel focused on providing a factual, reflective and professional response. He outlined his clinical reasoning at each consultation, acknowledged that alternative investigations could reasonably have been considered earlier, and reflected on how his communication may not have met the patient’s expectations. He avoided defensive language and expressed insight into how a patient might perceive brief consultations as dismissive, even when the clinical care is appropriate.

Dr Patel also identified steps taken since the complaint, including improving documentation of shared decision-making, allowing additional time for complex presentations, and undertaking further training in patient-centred communication. He completed several online courses offered by MDA National and provided certificates of completion to Ahpra with his written response.

Dr Patel was relieved to receive a letter from Ahpra acknowledging his response and advising that no further action would be taken in relation to the notification.

Seek advice

If you are the subject of an Ahpra notification, call our Medico-legal Advisory Services team on 1800 011 255 or email advice@mdanational.com.au so we can provide you with support and expert advice.

Ahpra and the Medical Board: Facts and Figures

Extracted from the Medical Board of Australia’s Annual Report 2024/25

• 12% increase in notifications about medical practitioners in 2024/25 – compared with a 14% increase across all registered health professions.
• 6.1% of medical practitioners were the subject of a notification in 2024/25.
• 61% of notifications closed in 2024/25 resulted in no further action.
• A slight decrease in the number of medical practitioners subject to mandatory notifications, from 27.4 per 10,000 medical practitioners in 2023/24 to 26.6 per 10,000 in 2024/25.
• Wide variation in mandatory reporting across states and territories, with a 160% increase in NT, a 127% increase in ACT, and a 17% decrease in SA.
• The Medical Boards took “immediate action” 374 times – down 11% from 2023/24. The biggest decrease was in NSW, where immediate action was taken 3 times, down from 10 in 2023/24.
• 73% of “immediate actions” led to regulatory action – such as conditions, undertakings, or suspension of registration.
• 97% increase in notifications received about boundary violations nationally, with NT having a 1,200% increase.