President's Message

I am delighted to bring you a jam-packed issue which I hope you find both interesting and valuable.

As we all know, effective communication with our patients is integral to safe professional medical care. Yet our most recent annual report data suggests poor communication is the second greatest cause of performance-related complaints to the Council. In this issue, we examine informed consent and share tips on how to reduce your risk of a complaint. We also discuss the implications of low health literacy in patients in our article Does your diagnosis get lost in translation?

STOP PRESS: Drug scammers target doctors

More than 10 doctors across the state have been caught up in an elaborate scam that sees doctors duped by a call from someone purporting to be a pain specialist or the patient presenting a fake referral for pain medication. During the consultation with a new patient, the doctor typically receives a call from the specialist advising that the patient has a terminal diagnosis and needs a prescription for Oxycodone (an S8 drug).

The “pain specialist” is not a registered medical practitioner.

The consequences for doctors who have been caught out by the scammer are very serious. This scam is a reminder to all practitioners if you have any doubts about who you may be speaking with or receive a suspicious referral:

- check the specialist's credentials on the Ahpra register
- independently verifying the specialist's phone number
- calling the specialist medical practice purporting to be the author of a potential fake referral and confirming that your patient is a current patient of theirs.

Podcast: Setting the record straight

The latest in our popular podcast series has just been released. Medical records: are you doing the right thing for your patients? explores medical records from both a practitioner and a patient perspective. Our host, Dr Martine Walker chats with special guests Dr Patrick Clancy, senior medical advisor at Avant and Dr Candace Newberry, GP for over 30 years and Medical Council hearing member for six years. Medical records are often at the heart of complaints to the NSW Medical Council. This podcast examines the importance of good record-keeping in ensuring quality patient care, what medical notes should include with examples of poor and good practice.

What’s more, it's now easier than ever to listen to podcasts you may have missed. Listen to previous episodes on the Medical Council show page.

Do you know the three Ws when it comes to compound medicine?

In recent years there has been an increase in complaints about compounded medicines supplied by community pharmacies. These complaints relate to three W’s – who is making it, where (and in what conditions) is it being made and what exactly is in the compound medicine? 

Most complaints about compounded medicine in NSW are handled by the Pharmacy Council, but in some cases, medical practitioners are involved, which is when the complaint can be referred to the Medical Council. 

Informed consent: make it meaningful

Ensuring patients have given their informed consent to a course of medical treatment is integral to safe medical practice and is embedded in everyday language as a doctor. ‘Have you consented the patient?’ is a question many of us have asked or heard. It is a revealing one – it implies the consent is something done to the patient by the practitioner as opposed to the patient fully understanding and consenting to their treatment. 

Unfortunately, the Medical Council continues to receive too many complaints about doctors where it is clear the patient has not given their informed consent to a particular course of treatment or surgery. These types of complaints are avoidable. In this article, we discuss how to avoid this risk of complaint and ways to improve communication with a patient so that their consent is voluntary, active and informed.

Does your diagnosis get lost in translation?

According to the Australian Commission on Safety and Quality in Healthcare, almost 60% of adult Australians have low health literacy, which means they may not be able to effectively exercise their voice when making healthcare decisions.

This is even more difficult for those patients whose first language is not English with some patients being proficient in English, but not able to understand the medical jargon, and some speaking very little English if any. Either way, not properly understanding the outcomes of a consult may result in the patient minimising the impact of their health condition so they end up more acutely unwell, endure long hospital stays and have an increased risk of readmission.     

Did you know?

Did you know that just over 50% of complaints about doctors to the Medical Council relate to clinical care? 

Information from our most recent annual report is available online. This includes infographics summarising our regulatory activities in 2019/20 and links to the NSW Health Professional Councils Authority combined report for all councils. 

Spotlight on: Council Based Assessments

If a complaint has been made about a medical practitioner, they may receive a letter from the Medical Council requesting they participate in a Council based assessment (CBA).  This process involves medical peers, appointed by the Council assessing the clinical concerns raised in the complaint based on a range of information, including insights from the practitioner.

Council based assessments are conducted as an interview. They can include a discussion of the doctor’s background and training, current practice, personal situation and health, plans for the future as well as a detailed discussion of the complaint and the concerns it raises. Often, a selection of the practitioner’s medical records is reviewed, and several practical scenarios are discussed with the practitioner. Wherever possible CBAs take place remotely via videoconference.

The CBA process is not disciplinary but allows the Council to effectively assess some types of performance-related complaints while ensuring the practitioner is involved in discussions about the issues raised in the complaint and have the opportunity to provide their perspective and views.

The introduction of Council based assessments in 2019 has helped reduce the time some doctors are waiting to have performance complaints about them resolved and a decision reached by Council delegates. This is a positive step in reducing the stress on doctors who come to the attention of the Council where clinical care forms the basis for the complaint.

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