November 2024 Newsletter

Message from the President

Welcome to the 2024 end of year issue of the Optometry Council of NSW newsletter. This is my fifth message to you as Council President and I’m pleased that my colleagues and I continue our role protecting the public of NSW. We’ve had a change in Council membership with Mr Albert Lee being appointed in 2023 to fill a casual vacancy.

The Council continues to work with the HPCA and HCCC to manage complaints about optometrists and it’s pleasing to note that as a profession we’re well respected by the public. The number of complaints remains steady with 32 in the last financial year, which represents 1.45% of the 2,205 optometrists in NSW.

It's time once again for optometrists to renew their registration with Ahpra. As part of renewal, we must all review our obligations under the National Scheme and affirm our adherence to the published standards and guidelines.

Last year in collaboration with the NSW division of Optometry Australia, the Council produced a series of educational podcasts and webinars. These resources are designed to remind and inform all NSW registrants of their professional responsibilities as well as share some insights into the regulation and complaints process here in NSW. If you haven’t had a chance to watch or listen to these productions, you can do so via the links below.

Access webinars and podcasts here.

I’d like to take this opportunity to wish all of you a safe and happy time in the upcoming festive season!

Derek Fails

President, Optometry Council of NSW

Boundary Crossing

Have you heard of the term ‘boundary crossing’? What is it? What might it mean for optometrists working with patients?

The Shared Code of Conduct¹ describes professional boundaries in Principle 4, Clause 4.9, as constituting a clear separation between professional conduct meeting the health needs of a patient, and the practitioners' personal views, feelings, and relationships which are not relevant to the therapeutic relationship.

It is important to know when acts are inappropriate to avoid boundaries being crossed. 

What is a boundary violation?

A boundary violation can range from unethical behaviour of a sexual nature with a patient, criminal behaviour such as sexual assault, or any behaviour that blurs professional and personal relationships with patients. Other types of inappropriate conduct which could constitute boundary crossings include accepting or receiving gifts, unexpected physical contact, inappropriate conversations or questions, social media interactions and sexual harassment. Sexual harassment (as noted by the Australian Human Rights Commission, 2014) is considered to be any sexual conduct that a reasonable person would anticipate would offend, humiliate or intimidate the person harassed.

Recent years have seen a rise in reports of boundary violations at healthcare practices.

Data² from 2022-2023 revealed a staggering 223% increase in the three years prior, for complaints about boundary violations by health practitioners. Less than 1% (9 of 4090) involved optometrists.

Working with patients requires respect, trust, effective communication and culturally safe practice. A commitment to these expectations encourages safe and effective engagement and safeguards against any behaviour that violates patient boundaries.    

The behaviour checklist below is modified from Luke Arundel’s training module, which can be found in the December 2023 issue of mivision education.³ 

Professional boundaries for practitioners

Practitioners who fail to behave ethically and professionally pose a very serious public safety risk. That why it’s so important to have professional boundaries that enables good care that protects both the practitioner and patient. To help safeguard your practice and your patients, please make sure you: 

• raise genuine concerns about any existing risks to patient safety to the appropriate authority
• pre-emptively seek advice from your National Board, professional body or other relevant bodies if you are unsure about your obligations or conduct
• demonstrate and advocate public safety in the professional environment
• recognise the inherent power imbalance in the patient-practitioner relationship and maintain professional boundaries when engaging with patients
• understand where professional boundaries may be perceived to be crossed in your own professional setting (i.e. proximity) and seek to avoid those situations by communicating and obtaining consent
• never exploit your professional position to establish or pursue a sexual or otherwise inappropriate relationship with anybody under your care; this includes those close to the patient, such as their carer, guardian, spouse, or the parent/carer/guardian of a child patient
• recognise that sexual and other personal relationships with people who have previously been your patients may also be inappropriate, depending on the extent of the professional relationship and the vulnerability of that previous patient
• do not express personal beliefs to patients particularly where it may reasonably cause them any distress, or unease.

References

1. Refer to Ahpra’s Shared Code of Conduct
2. Refer to Ahpra’s Jul 2023 Sexual Misconduct Complaints Report
3. Arundel L. Crossing the Line: Maintaining Your Professional and Personal Boundaries. Mivision Education. 1^st December 2023. 

Understanding your personal responsibilities as a registered health practitioner

A reminder that the Optometry Board of Australia maintains a list of registration standards that are available here. These cover areas including:

• CPD
• Criminal History
• English Language
• Professional Indemnity
• Recency of practice

 Codes and Guidelines

There are several codes and guidelines also provided by the Optometry Board of Australia to help guide your work as an optometrist:

• Code of conduct
• Advertising a regulated health service  
• Guidelines for mandatory notifications

Checklist for practitioners handling feedback and complaints

To help practitioners manage feedback and complaints a checklist has been developed by Ahpra, the National Boards and the Australian Commission on Safety and Quality in Health Care, in consultation with stakeholders and consumers.

The checklist aims to better equip practitioners to handle patient complaints and to resolve issues quickly and effectively when they are first raised.

Tell us what you think

Please send us an email if you have a particular comment or suggestion about this edition.