Mandatory reporting under the spotlight at AMA NatCon

The end of May saw the hosting of this year’s AMA National Conference in Melbourne where easily the biggest interest for doctors in training was the focus on doctor mental health. The AMA Council of Doctors in Training held an in-depth panel discussion on Doctors’ Health and Wellbeing, where we explored issues of workplace stressors, resilience and the role of accreditors in the oversight of the system. The most common theme of course was one of culture: we can’t change the trajectory that we’re on and the situation we find ourselves in without a concerted effort to change our culture. Such culture change isn’t possible without support from both doctors-in-training, our specialist supervisors and the management of the hospitals and practices that we work in. We also discussed the role of regulatory mechanisms such as the mandatory reporting on unwell practitioners to AHPRA, which we see as a significant barrier to those seeking help at early stages of their illness. The concept of suicide registers was discussed, and while it was clear that they aren’t the magic bullet to the problem, it’s hard to progress an issue when you don’t have good data on what the current situation is. Overwhelmingly, the panel supported the need for more research in this area. My thanks to the panel members for their insights and to the crowd for their insightful questions that allowed us to have such a meaningful discussion. 

Mandatory reporting got a much bigger spotlight when we raised an urgency motion calling for its urgent removal. Mandatory reporting is part of the AHPRA regulations and was designed to protect the public from unsafe doctors. However, in practice it is failing to achieve this and it is my belief that the harm the public are being exposed to from mandatory reporting is also costing us the lives of doctors across the country. Mandatory reporting requires a doctor who is treating another doctor who they believe to be impaired, to report that doctor to AHPRA. Then begins an opaque and clumsy investigation period where the livelihood of the doctor in questions is put at risk while their stress and anxiety continues to worsen. This does not apply in Western Australia, where after a hard fought battle in 2010 from the AMA WA, mandatory reporting was removed from the WA legislation. Queensland also sought partial exemptions in 2013 and NSW is currently having discussions around the removal of the same. At the National Conference, we raised a motion calling for the urgent removal of mandatory reporting across the country, and this was met with unanimous support from the conference attendees. Watch this space for more work from the Federal and State AMA branches on overcoming this barrier to a healthy medical workforce, building on the extensive work already done in this area by the AMA.