Views on mandatory reporting of impaired health practitioners by their treating practitioners: a qualitative study from Australia. Issue 12 (19th December 2016)

• Record Type: Journal Article
• Authors: Bismark, Marie M; Mathews, Ben; Morris, Jennifer M; Thomas, Laura A; Studdert, David M
• Is Part Of: BMJ open. Volume 6:Issue 12(2016)
• Publication Date: 2016-12-19
• Subjects: MENTAL HEALTH -- MEDICAL ETHICS -- MEDICAL LAW; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2016-011988
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To explore the views and experiences of health sector professionals in Australia regarding a new national law requiring treating practitioners to report impaired health practitioners whose impairments came to their attention in the course of providing treatment. Method: We conducted a thematic analysis of in-depth, semistructured interviews with 18 health practitioners and 4 medicolegal advisors from Australia's 6 states, each of whom had experience with applying the new mandatory reporting law in practice. Results: Interviewees perceived the introduction of a mandatory reporting law as a response to failures of the profession to adequately protect the public from impaired practitioners. Mandatory reporting of impaired practitioners was reported to have several benefits: it provides treating practitioners with a 'lever' to influence behaviour, offers protections to those who make reports and underscores the duty to protect the public from harm. However, many viewed it as a blunt instrument that did not sufficiently take account of the realities of clinical practice. In deciding whether or not to make a report, interviewees reported exercising clinical discretion, and being influenced by three competing considerations: protection of the public, confidentiality of patient information and loyalty to their profession. Conclusions: Competing ethical considerations limit the willingness of Australian health practitioners to report impaired practitioner-patients under a mandatory reporting law. Improved understanding and implementation of the law may bolster the public protection offered by mandatory reports, reduce the need to breach practitioner-patient confidentiality and help align the law with the loyalty that practitioners feel to support, rather than punish, their impaired colleagues.