ScrubSpace
| Doctors and bad sexual relationships |
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| Friday, 28 March 2008 | |
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That's the puzzling statistic that those setting up the new national medical registration system, approved this week, should keep at the forefront of their minds. The key test patients will apply to the new regime will be whether it protects them from dodgy doctors. As the case of Bega doctor Graeme Reeves has shown, the current system has some serious failings. One of those failings is that it is more likely to protect you from doctors who want a sexual relationship with patients, or who prescribe drug addicts addictive drugs, than from clinically incompetent medicos. When only a handful of doctors have lost their right to practise because of poor medical skills, it should indicate that poor practice is a rare thing. Unfortunately, what it really means is that our medical board appears to take a hard line on sexual and drug misconduct and a softer line on doctors who do their jobs badly. It is worth remembering that Reeves, who allegedly mistreated hundreds of patients, was not deregistered when a 1997 inquiry investigated nine complaints including the death of a baby and a patient in his care. He was allowed to continue practising but was ordered not to do obstetrics work - an order he ignored. And, when he was deregistered in 2004, it was not because of the standards of his management of patients but because he had breached the 1997 order not to practise obstetrics. The Medical Board's annual report states that it considers that a complaint should be referred for investigation when there is evidence of unethical, reckless, wilful or criminal behaviour in either clinical or non-clinical domains. In all other circumstances, public protection can be achieved through the application of non-disciplinary and educative responses, such as referring complaints to the board for consideration through the performance or health programs, conciliation, or assisted resolution with a complaints resolution officer. Denying a doctor the right to practise is serious, because it means denying him or her the livelihood they have invested over a decade training for. But the cases of Reeves and Queensland surgeon Dr Jayant Patel have shown a soft approach to bad medical practice can have disastrous outcomes. The Health Care Complaints Commission dismissed 53 per cent of the 1155 complaints made against doctors last year. Only 17 complaints were referred to the Medical Tribunal, which deregistered six of the doctors and imposed conditions on the practice of another 10. These are the cases of medical mismanagement that come to light. What sheltered Reeves was the fact that most of his alleged victims were too ashamed to make a complaint in the first place. And although Reeves had such a reputation among his medical colleagues that State Parliament was told his nickname was Chopper Reeves, none of his colleagues blew the whistle on him. The Australian Medical Association is opposing the national medical registration system established this week, with AMA president Rosanna Capolingua saying doctors don't want a national registration system. What they do want is a national register of doctors, and for each of the states to have the same regulations and processes to register doctors. Having a single bureaucracy to run this national register will be more bureaucratic than having eight state and territory bureaucracies doing the same thing, Dr Capolingua said. But she did say one thing this week that made sense: "Let me tell you that I do not agree with the profession protecting their own, any time. "When there is a doctor that we are concerned about, it is actually our ethical, professional commitment to do something about that." Dr Capolingua said she believed any new national registration system should give doctors who want to dob in their mates a way of doing so. We need to be finding an avenue for complaint or for investigation, she said. The majority of medicos do a terrific job, but the reputation of the profession is dragged down by isolated cases of doctors not up to the job. Surely the AMA can see that the benefit of a rigorous new national registration system is that, by weeding out the bad apples, it will protect the reputations of the decent doctors. |
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