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New plan to find poor performing doctors

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Screening for at-risk doctors and strengthening CPD are two key points highlighted in a new expert report released by the Medical Board of Australia.

The consultation and discussion paper were released on Wednesday, proposing a new approach to revalidation of doctors in Australia.

Board Chair, Dr Joanna Flynn AM said in a statement: “Regulation is about keeping the public safe and managing risk to patients. Part of this involves making sure that medical practitioners keep their skills and knowledge up to date.”

The proposal has two main parts.

    1. Strengthened CPD – a ‘smarter not harder’ approach that will be evidence based to drive practice improvement and better patients outcomes.
    2. Identify and assess at risk and poorly performing practitioners – an accurate and reliable way to screen practictioners at risk of poor performance will be developed. The report identifies that doctors more at risk include age (from 35 years, increasing into middle and older age), the male gender, number of previous complaints and time since last complaint. Other risk factors include getting qualification in some countries of origin, certain specialties, those who don’t respond to feedback, those who have an unrecognised cognitive impairment, doctors practising in isolated areas, doctors who do low levels of high-quality CPD activities and who have had a change in scope of practice.

According to Dr Flynn: “Most of the practitioners in the at-risk groups will be able to demonstrate that they are performing satisfactorily, just as most people who are screened in a public health intervention do not have the disease for which the screening program is testing.

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Those who have been found to be under-performing would then go through a ‘tiered, multi-faceted assessment strategy’ which would be scaled to match the perceived level of risk. There could be peer review and feedback processes or a more thorough evaluation for those considered to be seriously under performing.

Remediation would also depend on the nature and level of risk, although according to the report, “there is little information about long-term outcomes of remediation on doctors’ subsequent performance.” There will be continued research to confirm the efficacy of remediation interventions.

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The Medical Board is now consulting about the proposed changes and want to hear from the medical profession about their thoughts.

“We want a system in Australia that is practical, effective and evidence-based, and we want to hear what the community and the medical profession think about the approaches proposed by the expert advisory group,” Dr Flynn said.

Options on the revalidation page include:

      • have your say in the online discussion
      • take a short survey to provide your views on the approach
      • send your written submission by email or mail
      • read submissions made by others

The consultation closes on 30 November 2016 and the final report is expected by mid 2017.

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