The Victorian branch of the Australian Medical Association (AMA) will table a motion at the AMA National Conference later this month calling for a Royal Commission into the Australian Health Practitioner Regulation Agency (AHPRA).
Dr Mukesh Haikerwal, former president of the Federal AMA and member of the AMA Victoria Council, said InSight+ the motion was presented to the Federal AMA and would be on the agenda of the conference which will take place from July 29-31.
The move comes in the wake of AHPRA’s decision to impose restrictions on Western Australian GP Dr David Berger over his alleged behavior on Twitter. There have been concerns among leading doctors who use social media that freedom of speech is at risk.
Dr Berger has been a vocal, outspoken and sometimes sarcastic critic of governments, top health officials and health authorities for inaction and alleged ignorance of evidence regarding the current COVID-19 pandemic.
Dr Berger should receive education “about professional conduct and courtesy towards colleagues and other practitioners, including the use of social media in accordance with Good medical practice: a code of conduct for doctors in Australia”, according to AHPRA. Dr Berger was allegedly the subject of an anonymous complainant who objected to his manner of speaking.
said Dr. Haikerwal InSight+ the call for a Royal Commission follows the “incompetent” 2011 Senate inquiry into AHPRA.
The motion from the Victorian AMA State Council states:
“The following are some of the areas of concern that should be addressed by the Terms of Reference of the Royal Commission:-
There is a presumption of innocence in the investigation of all practitioners.
The objectives of the National Registration and Accreditation Scheme under the National Act be amended to mandate that AHPRA has a duty of care to the Registrant and in particular to minimize the mental health impacts and financial effects on the health practitioner under investigation.
The identity of health practitioners under investigation is protected to minimize potential loss of reputation and opportunity.
AHPRA and the Medical Board of Australia must provide confidential support from an independent mental health professional to any health practitioner under investigation.
A requirement that all investigations be completed within 6 months, except in exceptional circumstances.
Treating practitioners will be exempt from mandatory reporting obligations, in accordance with Western Australian legislation, to ensure that injured practitioners can seek appropriate medical attention without fear of mandatory reporting.
AHPRA staff require and should receive training to understand the forensic environment and, in particular, addiction medicine and toxicology.
The sensitivity of urine drug and hair screening should be matched to other professions to avoid false positives and thus possible unintended consequences.
All investigations should involve specialist medical professionals with relevant expertise in the matter under consideration.
In the interest of quality assurance, AHPRA is mandated to conduct an annual survey of health practitioners and to make these results public.
For a doctor whose medical registration has been canceled and this period has already passed, their registration should be restored no later than 3 months after this time.
All reprimands published by AHPRA are reviewed after 5 years.
All inquiries to and from Health Practitioner Compliance or Investigation Officers are received and responded to within 7 days.
Physicians subject to mandatory urine and hair drug screening protocols should clinically review their screening process after 4 months.
Any notification that is considered as annoying by the Registrar, must be urgently reviewed by the Review Committee and if it is considered as such, then the Complainant is officially sanctioned.
At any and all evaluations of a physician, the practitioner shall have the right to be personally present and legally represented. They, or their legal representative, must have full and unfettered right to plead their case. The decision of the review to then be notified to the doctor within 14 days.”
Leading health figures, including the editor-in-chief of Medical Journal of AustraliaProfessor Nick Talley AC, have called for more clarity from AHPRA about the conduct of doctors on social media.
Speaking on ABC PM program last Tuesday, Professor Talley said:
“Obviously there are examples of behavior that would be completely unacceptable. On the other hand, there are also gray areas. The concern is that sometimes those gray areas are being interpreted in ways that may not be appropriate, that may prevent conversations that really need to happen, that may prevent important public health debates because practitioners are too afraid to engaged. There is no doubt that [David Berger case] has sent shivers down the spines of those who engage in social media.”
Dr. Andrew Miller (@dram)), said an anesthetist and former president of the WA branch of the Australian Medical Association InSight+ that doctors were “obliged” by regulators, AHPRA and the Medical Board of Australia to protect their patients and public health.
“Article 7.3 and 7.4 i Good medical practice: a code of conduct for doctors in Australia says we are required to protect, defend and advance the health and well-being of patients, communities and populations,” said Dr Miller.
Article 7.3 Health advocacy
There are significant inequalities in the health status of different groups in the Australian community. These inequalities come from social, economic, historical, geographical and other factors. Aboriginal and Torres Strait Islander people in particular bear the brunt of huge social and health inequality.
Good medical practice involves using your expertise and influence to identify and address health care disparities and to protect and advance the health and well-being of patients, communities, and individual populations.
Article 7.4 Public health
Physicians have a responsibility to promote community health through disease prevention and control, education, and screening. Good medical practice includes:
7.4.1 Understanding the principles of public health, including health education, health promotion, disease prevention and control, and control.
7.4.2 Participating in efforts to promote community health and awareness of your obligations in disease prevention, screening and notifiable disease reporting.
“Sometimes you have to do it in a way that gets attention,” Dr Miller said.
“Sometimes you have to get into trouble and offend some people to change the status quo – or it’s not effective advocacy. Anything else is abrogating our responsibilities.”
Dr. Tim Senior (@timsenior), said a GP with the Tharawal Aboriginal Medical Service InSight+ that he hoped he would be able to defend his social media presence if ever questioned by AHPRA.
“I’d like to think I could argue, based on their social media guidelines, that I’ve always put my patients first,” he said.
“It is absolutely legitimate to argue and discuss the contested health policy. It is entirely appropriate for physicians to be involved in these discussions because of our expertise, because we are citizens, and because we see the effects of health policy directly on our patients.
“It is one of our duties to protect vulnerable patients and sometimes that will result in some conflict.”
Last week, Victorian Health Minister Mary-Ann Thomas confirmed she would not accept the advice of the state’s acting chief health officer, Ben Cowie, who recommended masks be made compulsory in education settings. early and retail.
According to AusDocAHPRA said Dr Berger was guilty of undermining confidence in “public health messages” about COVID-19.
“Dr Berger has made comments that disagree with politicians, government bodies and public health organisations, pharmaceutical companies and other medical professionals. He has done so by using inflammatory and derogatory language,” AHPRA was quoted as saying.
Dr Miller questioned AHPRA’s strategy.
“If AHPRA hopes to maintain trust in health authorities, then shutting down these types of debates on social media will have the opposite effect,” he said. InSight+.
“To say that we can’t criticize health authorities or public health settings, logically, in my opinion, could damage public trust,” he said. “Does this compliance mandate extend to non-pandemic health policies?”
“There is no information available about who complained about Dr Berger’s tweets. This cloak of anonymity is necessary for vulnerable complainants, not those with power and agency in the debate, who may be arming AHPRA as part of a tactical political response, for all we know.
“If AHPRA is acting as just another arm of the political administration that picks and chooses what medical advice to follow and then tries to silence dissent, then that is not fair and in my view could amount to bullying.
“It’s really important to know how they decide who to investigate and who to exonerate, and whether they are consistent and even surrendered – should only vocal critics of government policy be re-educated? Are prominent medical apologists for the government immune?”
Other prominent doctors on Twitter have been more cautious about AHPRA’s action.
Dr. Eric Levi (@DrEricLevi), a pediatric otolaryngologist and adult head and neck surgeon from Naarm Melbourne, has almost 48,000 Twitter followers and is an advocate for his patients and good medical practice.
“I’m on Twitter to learn, engage, dialogue and educate people through an accessible social media platform,” Dr Levi said. InSight+.
“As doctors, we have the right to express our opinions, just like everyone else. I also believe we have a responsibility to direct public health information through social media, which is a very powerful tool.
“But the way that opinion and information is given is important.
“It has always been true that doctors are held to a higher standard,” Dr Levi said. “Yes, we can express our opinions, but we have to do it respectfully.
“We’ve worked hard to earn that respect and we’re privileged because of it.”
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