International Briefs

Keep perspective and seek help: That's the message of a new video launched by the Australian Health Practitioner Regulation Agency (AHPRA) that helps physicians better understand and cope with the pressure of being under regulatory review.

In the video, an Australian physician provides a first-hand account of the challenges he faced — including self-doubt and anxiety — when a family filed a complaint with Australian regulatory authorities against him, due to a poor medical outcome.

The video notes that many physicians will be subject of a complaint — known as “notification” in Australia — and that, while in the majority of cases no formal action is taken against them, the experience of being under review can impact physicians on many levels.

The featured physician notes, for example, that after he was informed of being under review, he tended to “catastrophize” the situation in a way that impacted his medical practice and psychological well-being. He recalled experiencing anxiety and depression.

AHPRA CEO Martin Fletcher said the video series aims to share Australian physicians' experiences, recognizing what are common reactions, while pro-actively encouraging physicians to focus on putting the situation in perspective and seeking support.

“Many practitioners have told us that they would have benefited greatly from hearing the voice of other practitioners who had gone through this experience — and come out the other side,” he said. “They have also told us that when they are the subject of a notification, they immediately think they will lose their registration and their livelihood — that it's a catastrophe.”

“We understand that practitioners may feel this way. However, our data show a different story,” Mr. Fletcher said. “While we have a clear focus on patient safety, many notifications end without the need for regulatory action and are often closed following initial assessment, without the need for an extended investigation.”

In the video, the physician — a surgeon — describes his feelings of guilt and anxiety after notification, noting that as time went on, his worries increased, and that he found it difficult to maintain a realistic perspective about what was likely to occur. He reflects on the value of speaking with family and friends, as well as the support of a psychologist.

Medical Board of Australia Chair Dr. Anne Tonkin said the latest video highlights the importance of getting support during the notifications process.

“We know that many health practitioners will receive one or more notifications during their career. For the vast majority, no regulatory action will be taken,” Dr. Tonkin said. “It's important — although difficult — to try to keep in mind what are the likely outcomes.”

The Royal Australasian College of Surgeons (RACS) has commented on the new video as a resource to help practitioners.

“This new AHPRA video is a great way to encourage surgeons to be open and honest about their experience during a notification process,” said RACS President Tony Sparnon.

To watch the video, visit https://vimeo.com/352841282.

You can also learn more about the video series and how the Australian notification system works by visiting the Medical Board of Australia website at www.medicalboard.gov.au.

Source: Medical Board of Australia news release, August 22, 2019

Australia's physicians-in-training have been given the chance to tell medical educators, employers, governmental agencies and regulators what they think about that country's system of medical training.

The Medical Training Survey — which was conducted in August and September 2019 — asked Australia's more than 30,000 physicians-in-training about the quality of their training and to identify issues that could impact on patient safety, including environment and culture, unacceptable behaviors and the quality of supervision.

The anonymous, confidential, online survey was organized and funded by the Medical Board of Australia and the Australian Health Practitioner Regulation Agency, and administered by an independent survey provider, which will analyze the data collected and develop reports of the results.

According to the Medical Board of Australia, survey results will be used to improve medical training in Australia and be reported publicly, while protecting individual privacy.

“We want every doctor in training in Australia to do the survey, so we get a clear picture of what is going well and how the training provided now can be improved,” said Medical Board of Australia Chair Dr. Anne Tonkin. “The survey will be good for trainees in the short term and good for patient safety in the longer term, as we strengthen the training of doctors who provide medical care to us all,” she said.

The survey was made available to all physicians-in-training in Australia, ranging from interns, hospital medical officers and resident medical officers to postgraduate trainees, international medical graduates and others.

While some specialist colleges and jurisdictions already survey their trainees, the Medical Training Survey brings together the views of trainees from every medical discipline and every state and territory in Australia.

For the first time in Australia, the survey “will start to build a comprehensive, national picture of the strengths and weaknesses of medical training across states and territories, medical disciplines and stages of training,” Dr. Tonkin said. “We will have a clear and comparative baseline for continuing improvements.”

Source: Medical Board of Australia news release, July 25, 2019

The Medical Council of Canada (MCC) has launched a comprehensive review of its governance structure aimed at ensuring efficiency and effectiveness as it regulates Canada's physicians.

The MCC will embark on the review with KPMG, a Canadian management company that specializes in audit, tax and advisory services.

The KPMG-led governance review will include an initial planning and data collection phase, during which KPMG will interview MCC management, governance leaders, various committees and key external stakeholders. The governance review is expected to take approximately a year. KPMG will analyze the extensive information it gathers and will present a detailed report with its recommendations to the MCC.

“The MCC is an organization that is constantly changing, and we need to make sure that our organizational structure is keeping up with dynamic shifts in our environment,” said MCC Executive Director and CEO Maureen Topps. “It is best practice to review an organization's governance structure periodically to ensure that it remains effective.”

Source: Medical Council of Canada Echo newsletter, June 2019