Recently, the unexpected deaths of four young doctors in New South Wales has sparked investigation into a profession that is known to have higher rates of burnout, psychological distress and self-harm.
Experts have labelled the mental health mandatory laws as detrimental and dangerous, and warned doctors will be deterred from seeking help due to fear of losing their jobs and being reported to the Australian Health Practitioner Regulation Agency (AHPRA).
Under the existing Health Practitioner Regulation National Law a health practitioner has a legal obligation to notify AHPRA if he or she in the course of practising the profession forms a reasonable belief that another health practitioner is impaired or engaged in misconduct. It is not unexpected the stigma of mental illness has left doctors to deal with their struggles alone. For example, it was estimated at least 20 junior doctors have resorted to self-harm, which resulted in their death. AMA (NSW) president Brad Frankum blamed the competitive environment, intense scrutiny and extremely long work hours as major issues across the health system. However, the pressures involved in working at a hospital are not the only reasons behind why doctors are pushed into dark corners. According to a National Mental Health Survey of 12,252 doctors, there are six other barriers:
- Lack of confidentiality or privacy (52.5%);
- Embarrassment (37.4%);
- Impact on registration and right to practise (34.3%);
- Preference to rely on self or not seek help (30.5%);
- Lack of time (28.5%); and
- Concerns about career development or progress (27.5%).
Moreover, statistics reveal a quarter of doctors have had suicidal thoughts, and an alarming 21 per cent had been diagnosed with or treated for depression. Fortunately, this outstanding social problem has finally captured the government’s attention.
A Change Is Coming
A spokesperson for Health Minister Greg Hunt said to the Sydney Morning Herald the federal government will be working with state governments to “establish a common national standard to protect the mental health of doctors”. The legislative changes are expected to reflect the needs of doctors and remove barriers to healthcare access. Those within the profession, such as President of the Australian Medical Association (NSW) Professor Brad Frankum, are hoping for a “more compassionate system”. Currently, AHPRA’s investigation and notification process involves the sending of a suspension letter without notice, warning or support. Critics have condemned this process as inhumane, and called for the mandatory reporting laws to be scrapped.
There are also discrepancies between mandatory reporting legislation across Australia. Dr Kerry Breen identified there are inconsistencies in the wording. For example, Victoria’s legislation was “worded in past tense so no exception can be made for an impaired doctor who seeks help and voluntarily ceases to practise while receiving care”. In contrast, the NSW and Queensland’s legislation used present and future tense.
A Caring Profession Needs To Care For Itself
A proposal was put forth by the Australian Medical Association, beyondblue and international medical authorities to amend the laws using Western Australia’s exemption as a model. Generally, the exemption allows unwell doctors to freely access healthcare from their treating doctor without being the subject of a mandatory report. Avant’s Head of Advocacy Georgie Haysom said in an article adopting the WA legislation nationally will benefit both doctors and patients. “Even if mandatory reporting is a perceived barrier…The Western Australia amendment removes this added perception while maintaining the professional requirement to ensure patient safety,” she said. “We believe strongly that to properly look after patients, doctors need to look after themselves.
It is still too early to tell what changes the federal government will make. But rest assured the mandatory reporting laws is in the process of being reviewed to give health professionals greater healthcare access.
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