Informed, engaged communities for health

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Lowitja knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Lowitja knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021

Towards proactive medical regulation – preventing fires as well as putting them out

Marie McInerney writes:

Earlier this year the United Kingdom’s medical regulator took the “nuclear threat option” and threatened to remove junior doctors – who make up one-third of staff – from a leading London hospital if it did not address concerns about under-staffing and risks to patient safety.

pichosapitalThe move forced the North Middlesex University Hospital Trust in London to inject a “huge input of resources, borrowing staff from other hospitals, to try to deal with the crisis that could have caused harm to patients”, Professor Terence Stephenson, chair of the General Medical Council (GMC), told the 12th International Medical Regulation Conference in Melbourne last week.

The GMC has now put almost 80 sites under what it calls its “enhanced monitoring system”. This means “undertaking active monitoring of the trainee environment to ensure they and patients are being kept safe”, according to a spokesman. Here, for example, is its notification about concerns with the Emergency Department at the North Middlesex University Hospital Trust.

UK media have reported the move as part of efforts to prevent a repeat of the Mid Staffordshire scandal in which shocking standards of care in the early 2000s resulted in hundreds of patient deaths and “appalling and unnecessary suffering”.

Media reports said the GMC had put hospitals on notice this year after “finding alarming levels of bullying, handover systems so poor that desperately ill patients got ‘lost’ and left at risk of serious harm during weekends, unmanageable workloads and bed shortages in intensive care.”

They quoted GMC chief executive Niall Dickson as saying: “We are here to protect patients, not doctors… We are not part of the medical establishment, as we might have been seen in the past.”

Speaking about the action against the North Middlesex University Hospital Trust, which had argued that the GMC couldn’t “use the trainee tail to wag the system dog”, Stephenson told the conference: “We said we had ‘the nuclear threat option’.”

He was speaking during a plenary session on risk-based regulation, which discussed growing (but contested) moves by regulators to use research and data so they are not just responding to unsafe practice or casting their prevention work too widely, but can predict risk and prevent harm in the first place.

It’s also known, session chair Dr Anna van der Gaag quipped, as: “Find the doctor before the lawyer does”.

The session also heard from research being done by Dr Marie Bismark, as part of a risk-based regulation collaboration with the Australian Health Practitioners Regulation Agency (AHPRA), that identified past behaviour as a major predictor for future complaints, and tracked different impairments in doctors across their lives and careers.

Digging deeper into coronial data as part of the collaboration, Bismark also published research recently in the Medical Journal of Australia showing that the risk of dying by suicide for women working in medicine was more than twice that in other professions (more about her work follows below).

Stephenson explained that the GMC differs from many other national regulators – and therefore had greater fire power in its move against the the North Middlesex University Hospital Trust – after taking on responsibility for the quality of training of junior doctors in 2010 in the wake of the Mid Staffordshire scandal.

He outlined three examples where the GMC uses the “shed loads” of data gathered from its annual survey of around 55,000 postgraduate and undergraduate trainees, which attracts a response rate of around 95 per cent and is the biggest training survey in the world.

He said medical trainees are the “canaries in the coal mine” for health care – their experiences acting as red flags to system or team failures.

Stephenson said the GMC last year launched a “very targeted proportionate intervention” in 12 different hospitals – six departments of surgery and six of obstetrics and gynaecology – in response to “persistent, egregious” reporting by trainees of bullying and harassment.” See some case studies here about the action, and more about the way the GMC gathers risk information.

He said: “All the evidence shows us that departments where there is bullying and harassment are dangerous for patients and bad for doctors so we went into those, in partnership with hospitals, to try to prevent this deteriorating situation where either harm would come for patients and doctors and there would be ‘fitness to practice’ issues.”

A third example was where the GMC provides a ‘Welcome to the UK Practice‘ free half-day learning session to help doctors new to the UK to understand cultural and ethical issues in practice. It was, he said, preventive action that should be the responsibility of hospitals.

“But if they’re not doing it, we will,” he said. “A cent spent on prevention is worth a dollar spent on cure.”

Not a crystal ball

While some regulators like AHPRA have adopted risk-based regulation as a guiding strategy, concerns were expressed at the conference about it being a “probabilistic model” that risks antagonising huge numbers of medical practitioners with the “false positives”.

Responding to such concerns, Dr Marie Bismark, from the Centre for Health Policy at the School of Population and Global Health at Melbourne University, said she looks on data as “a red flag, not as a crystal ball”.

She said an understanding of risk factors can “help to triage notifications (and) identify practitioners and notifications that merit a closer look”.

She pointedly compared risk-based regulation with other screening programs “that doctors are very familiar with”, such as for cardiovascular conditions and bowel cancer. Equally, she said, there was “no point doing it unless we have an evidence-based intervention that will make a difference.”

Bismark outlined three case examples from her research work, which is being funded by AHPRA and the National Health and Medical Research Council, to illustrate the benefits of using data to “confirm intuitions, dispel myths, and reveal the unknown”.

She said analysis of 19,000 patient complaints in Australia shows that around three per cent of doctors account for 49 per cent of complaints.

“So Gerry Hickson [a US expert on poor physician practice] is right: there is a medico-legal cloud over all doctors, but it certainly rains more heavily on some than others,” she said.

The study is confirming the now accepted evidence that older male medical practitioners, and particularly surgeons, are most likely to attract complaints from patients or their peers.

But Bismark said that one other factor predicts complaints more than any other: past behaviour.

After two years of follow up , a doctor with one previous complaint has around a 20 percent chance of another complaint. By five years, it’s 40 percent.  After two years of follow-up, a doctor with five previous complaints has around an 80 percent chance of another complaint. By five years, it’s more than 90 percent.

 

bismarkuseBismark said her second example busts the myths put forward by some that the introduction of mandatory reporting of concerns about doctors in Australia “would open the floodgates” to nurses, midwives and other practitioners unfairly levelling accusations of poor practice.

She quoted one doctor who wrote to a newspaper to express his indignation:

I liken a nurse reporting a physician to someone who plays a little chess deciding to report to authorities the likes of an international grand master for their choice of opening moves”.

Rather, she said, her analysis of more than 800 mandatory reports found that nurses are more likely to make reports about other nurses, doctors about other doctors and so on.

bismark2
Dr Marie Bismark

In fact, she said, inter-professional reports are so rare that there should be concern that “even though nurses are very well placed to be able to identify poorly performing doctors, there appear to be significant barriers to coming forward to regulators with those concerns”.

Her final case study was to illustrate the importance of digging deeper after preliminary analysis of AHPRA data found very little difference in the level of notifications of physical or mental impairment, including substance abuse or dependence, between older and younger doctors.

When researchers looked more closely, they found “strikingly different” patterns of health impairment concerns along the life course: with mental health issues dominating the picture among new graduates, moving to a pattern of alcohol and drug misuse in middle age, and then, finally, a “sharp increase” in cognitive decline and physical illness over the age of 65.

Focus on bullying and discrimination

In response to a question, Bismark said that potential links between patient complaints and concerns with bullying, harassment and discrimination in the health professions was “a really ripe area for exploration” by regulators in the context of patient safety.

In separate sessions, the conference delegates heard of work being done by the Royal Australasian College of Surgeons after an expert review found discrimination, bullying and sexual harassment were rife among surgeons in Australia and New Zealand, as well as a culture of fear and reprisal that made it “career suicide” to make a complaint.

RACS CEO David Hillis said the organisation was getting some “push back” from hospitals and its fellows against the Action Plan it has launched to drive cultural change in the profession, saying he still often hears comments that trainees in particular have to “toughen up”.

“I’d say it’s the consultants who need to learn how to cope with the stress and their workload,” he said, adding that major cultural deficits are a link between revelations about the profession in Australia and New Zealand and medical scandals like at MidStaff in the UK.

The RACS review was sparked by the revelations of Melbourne neurosurgeon Caroline Tan whose career was derailed after she spoke out about sexual assault. It revealed “a profound lack of leadership and ownership” of the problem and little confidence that medical colleges, universities, hospital human resources departments or medical regulators would address it, Hillis said.

“I get confronted by outright denial or grief reactions from members of the medical profession who say ‘it doesn’t happen in my patch’. But it does, and it particularly occurs in surgery,” he said.

He acknowledged that it’s very difficult for senior clinicians to learn how to take a stand: “You spend 30 years walking past it, how do you suddenly say to your colleague, ‘You can’t say that, that’s sexual harassment’.” But he said role modelling has a profound impact.

The RACS vision for change is not only a commitment to a safe workplace and learning environment for the profession, but that every patient has a right to expect their health care is not being compromised by discrimination, bullying and sexual harassment, he said.

The RACS announced last week that it had signed its first Action Plan agreement with a tertiary education partner – the University of Otago Medical School in New Zealand. Health organisations committed to the plan so far include Ramsay Health, Monash Health, St Vincent’s Health and Metro South Health in Queensland.

Prevention, partnership and problem solving

Chairing a session on risk-based regulation, Dr Anna van der Gaag, Chair of the UK’s Health and Care Professions Council, recalled a rallying cry from Harvard University’s Professor Malcolm Sparrow at the 2014 IAMRA conference, when he urged delegates to think beyond the “traditional style of enforcement” in regulation.

Instead of being reactive, adversarial and incident-driven, he urged prevention, partnership and problem-solving to find more innovative forms of risk reduction and harm prevention.

AHPRA CEO Martin Fletcher said Sparrow had been hugely influential for AHPRA’s work on becoming a risk-based regulator, trying to move from “just holding rich data” to actually learning from it, while respecting how sensitive it is. That has led APHRA to invest in staff skills not traditionally held by a regulator: in statistics, epidemiology, research and maths.

Van der Gaag said most regulators were more comfortable with traditional approaches: setting standards, keeping a medical register, and investigating complaints.

“But there is much less focus by us on the impact of complaints on those who are involved, why they arise in first place, what can be done to prevent then, and indeed why there are fewer complaints from certain groups…the young, old, and people with disabilities,” she said.

“Are we like firefighters in the station waiting for fires to break out, or working with our communities to reduce the risk of fire breaking out in first place?”

annadvg

See also Marie Bismark’s blog post from the 2014 IAMRA conference on the seven qualities of highly effective regulators.

These are: 1. Clarity about purpose; 2. Agility to use the right regulatory tool for the purpose; 3. Trustworthy; 4. A willingness to question, a desire to learn, and an openness to new evidence; 5. The humility to recognise that none of us operate alone, that there is much to be learnt from others, and that there are some problems that regulation alone cannot solve; 6. The ability to make fair, independent and unbiased decisions; 7. Proactive – they look upstream for opportunities to prevent harm before it occurs.

More reports from the Twittersphere

complaintspanel

surgeonscheck9check8check7

check4

check3check2check10

dartondatafaulkner

hardestthing

Focus on listening

stephensontraineesurveys

listen


• Journalist Marie McInerney is covering #IAMRA2016 for the Croakey Conference News Service.

Bookmark this link to follow the coverage.

iamra_logo

 

 

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#BackToTheFire
#GiantSteps21
#Govern4Health
#HealthReImagined
#HearMe21
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
Croakey Professional Services
#BetterCareCOVID
#CommunityControl
ACSQHC series
Healthdirect Australia series 2019
Lowitja knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#JusticeCOVID
#LookingLocal
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
Testing Croakey News category 1
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
<