Letters from Ahpra – don’t panic, don’t ignore

The complaint

Dr Lim was partway through a busy morning in his general practice when he received a phone call from Ahpra advising that a notification had been received about him. Dr Lim was very shaken by the phone call and afterwards could not recall exactly what he had been told, except that he would soon receive a letter from them. He thought the matter must be serious because they had called him, and he expected the worst.

In due course, Dr Lim received a letter from Ahpra. The complaint was from the mother of a child whom he had seen earlier in the year.

I took my baby to Dr Lim as she was obviously unwell with a fever and crying. He told me there was nothing wrong with my baby, and she didn’t need antibiotics. Two days later, she was no better and I took her to another doctor who said she had an ear infection and needed antibiotics. Dr Lim should have done his job properly and given her antibiotics.

Dr Lim reviewed his notes from the consultation and found them to be thorough. He had clearly documented his findings, including his examination of the baby’s ears which were not red. He had also suggested that the mother bring the child back for another review if she was not improving in 24 to 48 hours.

Dr Lim contacted MDA National and we assisted him with providing a response to Ahpra. He provided an explanation of his assessment, explaining that at the time he saw the child there was no sign of an ear infection, and it was likely that the ear infection developed after he had seen the child. Ahpra decided to take no further action.

Notifications to Ahpra

In the National Scheme, a concern raised about a registered health practitioner or student is called a notification. Ahpra manages notifications in partnership with the National Boards. Anyone can notify about a doctor’s health, performance or conduct. In our experience at MDA National, difficulties with communication are often a contributing factor.

Ahpra has changed the way doctors first hear about notifications, and the first contact may be a phone call – as it was for Dr Lim. The fact that it’s a phone call does not mean Ahpra considers the matter to be especially serious or trivial.

Data from the Ahpra 2018/19 Annual Report:¹

• There are 118,996 registered medical practitioners in Australia.
• 6,970 registered medical practitioners (or 5.9%) had notifications made about them – based on Australia-wide data, including HPCA and OHO.
• Overall, 1.7% of all health practitioners were the subject of a notification (which meant doctors received more notifications than other health practitioners).
• Of those notifications, 73.8% had no further action taken.
• The most common source of a notification is a patient, relative or member of the public. Notifications are also received from other health practitioners and employers of doctors.

Most common type of complaint:

• Clinical care 56.2%
• Medication 10.2%
• Communication 6.1%
• Behaviour 5.2%
• Documentation 4.8%
• Other 17.6%

Responding to a notification

However trivial or without basis a complaint may seem to a doctor, a notification from Ahpra should always be responded to. We strongly recommend that you contact us immediately upon receiving a phone call, complaint or notification from Ahpra (or any other regulatory body) so that we can support you in a timely manner and guide you through the process. We can help you draft a response, ensuring all issues of concern are addressed objectively and appropriately.

Following preliminary assessment, the medical practitioner will be notified of what further action, if any, will be taken. This may include:

• taking no further action
• investigating the notification
• requesting a health assessment or a performance assessment of the practitioner
• referring the matter to a health or performance panel hearing
• referring the matter to a tribunal hearing
• issuing a caution
• accepting undertakings
• imposing conditions on the practitioner’s registration
• taking immediate action on the practitioner’s (or student’s) registration.

Receiving a phone call or letter from Ahpra can cause an emotional reaction and stress for many doctors. But remember that receiving a complaint is fairly common for doctors, and most notifications are dismissed with no further action.

Reference:

1. Australian Health Practitioner Regulation Agency. 2018/19 Annual Report: ahpra.gov.au/publications/annual-reports/annual-report-2019.aspx