Doctors disciplined for professional misconduct in Australia and New Zealand, 2000–2009

Abstract

Objectives: To describe professional discipline cases in Australia and New Zealand in which doctors were found guilty of professional misconduct, and to develop a typology for describing the misconduct. Design and setting: A retrospective analysis of disciplinary cases adjudicated in five jurisdictions (New South Wales, Victoria, Queensland, Western Australia and New Zealand) in 2000–2009. Main outcome measures: Characteristics of the cases (setting, misconduct type, patient outcomes, disciplinary measure imposed), characteristics of the doctors involved (sex, specialty, years since qualification) and population‐level case rates (by doctor characteristics). Results: The tribunals studied disciplined 485 doctors. Male doctors were disciplined for misconduct at four times the rate of their female colleagues (91 versus 22 cases per 100 000 doctor‐years). Obstetrics and gynaecology and psychiatry were the specialties with the highest rates (224 and 178 cases per 100 000 doctor‐years). The mean age of disciplined doctors did not differ from that of the general doctor population. The most common types of offences considered as the primary issue were sexual misconduct (24% of cases), illegal or unethical prescribing (21%) and inappropriate medical care (20%). In 78% of cases, the tribunal made no mention of any patient having experienced physical or mental harm as a result of the misconduct. Penalties were severe, with 43% of cases resulting in removal from practice and 37% in restrictions on practice. Conclusions: Disciplinary cases in Australia and New Zealand have features distinct from those studied internationally. The recent nationalisation of Australia's medical boards offers new possibilities for tracking and analysing disciplinary cases to improve the safety and quality of health care.

Outcomes of notifications to health practitioner boards: a retrospective cohort study

“…These include patient volume, type of practice, history of disciplinary actions and, for doctors, performance issues during training and the country of their primary medical degree. Previous studies have identified associations between these factors and disciplinary outcomes [10, 12, 15, 28]. …”

Disciplined doctors: Does the sex of a doctor matter? A cross-sectional study examining the association between a doctor's sex and receiving sanctions against their medical registration

“…The data available did not provide the reasons or the category for why a sanction had been imposed, but a more detailed evaluation of the reasons for referral to the GMC may go towards explaining the sex difference observed. In their research, Alam et al 4 and Elkin et al ,10 demonstrated not only that male doctors were more likely to be subject to disciplinary action, but also that the main offence for which a doctor was being disciplined was sexual misconduct. It is possible that male doctors are more likely to commit an offence involving sexual misconduct than their female colleagues, which may go towards explaining the sex difference seen in these populations.…”

“…However, the majority of these studies have been performed in the USA,6 – 9 Canada,4 Australia and New Zealand,10 where the medical and legal systems differ from those of the UK, and therefore we felt that their findings may not be applicable to the UK population of doctors. These studies’ main objective was not necessarily to explore the association between doctors’ sex and disciplinary action.…”

The Pattern of Opioid Management by Australian General Practice Trainees

“…Regulators have responded in various ways. Of disciplinary cases where doctors have been sanctioned by tribunals, 25% involve inappropriate prescribing, mainly drugs of dependency . In the USA, the Centers for Disease Control and Prevention is currently establishing prescribing norms to identify and intervene in cases of patients or providers who fall outside these norms .…”