Clinical Cardiovascular
The Mental Health of Doctors
Written by Dr Sara Bird
Wednesday, 27 April 2011
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By Dr Sara Bird, Manager, Medico-Legal and Advisory Services, MDA National

The beyondblue report of August 2010 (see inset) indicates there are significant barriers to medical practitioners seeking their own health care. One possible barrier ­– fear of being reported and thereby risking livelihood - has been reinforced by the recent introduction of the mandatory reporting legislation. However, the Medical Board of Australia’s guidelines indicate that the threshold to be met to trigger a mandatory notification of a medical practitioner is high. As well, in WA only, the national legislation has been amended so that health practitioners who are providing health services to other health practitioners are exempted from the mandatory notification requirements.

 

In part, the WA amendment was introduced to try to reduce any perception that medical practitioners should be fearful of seeking their own medical care, in that treating doctors are not legally required to report their health practitioner patients. However, in all other situations in the course of practising their profession, WA medical practitioners are required to report ‘notifiable conduct’ involving their colleagues. 

It is important that the new legislative mandatory notification requirements involving ‘notifiable conduct’ are not seen as an additional barrier to medical practitioners obtaining their own health care.

For the purposes of the legislation, impairment is defined as a person who has ‘a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect the person’s capacity to practice the profession’. Importantly, the practitioner’s impairment must place the public at risk of substantial harm for the threshold for mandatory notification to be met. In other words, making a mandatory notification is a serious step to prevent the public from being placed at risk of harm and should only be taken on sufficient grounds [2]. 

In reality, this legislative requirement is no different to the longstanding ethical obligation of medical practitioners to act if they believe a colleague’s actions are putting patients at risk of harm. 

Medical practitioners are encouraged to contact their medical defence organisation for advice if they are uncertain about their obligations under the mandatory reporting legislation.

References

[1] The Mental Health of Doctors – A Systematic Literature Review. Available at www.beyondblue.org.au

[2] Medical Board of Australia: Guidelines for mandatory notifications. Available at www.medicalboard.gov.au 

 

 

 

beyondblue Report

‘The Mental Health of Doctors – A Systematic Literature Review’ [1] found that:

  • Depression and anxiety disorders were identified in medical students and practitioners at rates comparable with the general population.
  • While alcohol use amongst medical practitioners was lower compared to the general population, higher rates of prescription drug use (e.g. sedatives) were observed and self prescribing was common.
  • In Australia, medical practitioners have a higher suicide rate compared with the general population, with female medical practitioners more than twice as likely to suicide as females in the general population.
  • A significant proportion of medical practitioners (including 34% of medical students) reported that they would not seek help for depression. Barriers for help seeking included concerns about stigma in the profession, embarrassment, possible impact on career development and concern about being allowed to continue to practise as a medical practitioner.
  • There is limited research around the mental health of medical practitioners in the Australian context, with no studies examining Indigenous or rural and remote medical practitioners.