What has brought this about?
The Medical Board of Australia (the Board) are proposing that doctors aged 70 and older undergo regular heath checks to support their health and to prevent patient harm.
In the Board’s Consultation Regulation Impact Statement1, it is noted that studies suggest that the effect of age on a doctor’s outcomes are variable, but that on average their ability to provide good medical care to their patients as required by Section 3 of the Code of Conduct for Doctors in Australia (the Code) declines with increasing years in medical practice. The Board notes that ageing is associated with declines in cognition, sensory and motor abilities, knowledge and adherence to standards of care and these age-related changes can affect clinical performance and the ability to provide safe patient care.
Recent data from AHPRA has also revealed that the rate of notifications with respect to doctors over 70 has almost doubled since 2015. Notifications for doctors between 70-74 have risen more than 130% since between 2015-2023, and for doctors over 80 has risen more than 180% between 2015-2023.
Doctors over 70 are reportedly 81% more likely than younger colleagues to be the subject of a notification to AHPRA for any reason (not just impairment).
What is being proposed?
There are three pathways being considered, as follows:
- rely on the existing process requiring doctors to maintain their physical and cognitive health as part of their obligations pursuant to the Code. The Code at Section 11 states that good medical practice includes doctors having their own GP and seeking independent, objective advice when they need medical care2.
The Board does not consider option one to be the best opinion.
- require a detailed health assessment of the ‘fitness to practise’ of doctors aged 70 years and older, every three years for doctors from the age of 70 and annually for doctors from the age of 80 that would specifically assess each doctor’s fitness to practice.
These health assessments, undertaken by a specialist occupational and environmental physician, would include an independent clinical assessment of the current and future capacity of the doctor to practice.
There would be no requirement to report the outcome of the assessment to the Board or AHPRA, unless the doctor has been found to pose a substantial risk to the public that is not being managed. The doctor would be asked to declare in their annual registration renewal that they have completed the appropriate fitness to practice assessment. As they do now, they would also need to declare whether they have an impairment that detrimentally affects, or is likely to detrimentally affect, their capacity to practice medicine.
The Board recognises that this option would be lengthy and costly.
- require general health checks for doctors aged 70 and older every three years, and yearly from 80 years of age. This would not be a detailed ‘fitness to practise’ health assessment, but would provide information about the doctor’s health and an opportunity for early intervention.
The Board is flexible about who will perform the health check. It could be the doctor’s regular GP, another GP or another specialist.
The results would not be shared with the Board. The tool used to achieve the objections of this option would be an approved registration standard that requires late career doctors to have regular health checks. As they do now, the doctor would also need to declare whether they have an impairment that detrimentally affects, or is likely to detrimentally affect, their capacity to practice medicine.
The Board considers option three to be the best option.
The Board invited submissions in response to the proposed options by stakeholders and the public, which closed on 4 October 2024. At the time this article was written, submissions were not yet available and were to be published soon on the AHPRA website here: Medical Board of Australia – 2024.
In due course, the submissions in response provided by stakeholders and the public will assist in the preparation of the final decision regulation impact statement, which will inform whether to proceed with one of the above proposed options.
Watch this space.
This article was written by Leonie Beyers, Partner, and Tarisha Gunaratnam, Solicitor.
2 Medical Board of Australia – Good medical practice: a code of conduct for doctors in Australia
