How do we psychiatrists stand re demographics and ‘offending’ Medical Board of Australia Report December 2019
December 28, 2019
i have been perusing the Annual Report of the Medical Board of Australia. The data in the report is worth mining. for comparison I have attached similar data regarding psychologists.
- There are 119,926 medical practitioners registered in Australia of whom 4,027 are psychiatrists.
- The psychiatrist/ population ratio varies between South Australia 1:5650 to Northern territory 1:9107 and the Australia wide ratio is 1:6298.
- The gender ration is female to male 41.1 – 58.9.
Notifications of medical practitioners to the Medical Board of Australia
- 6,970 notifications 2018/2019 = 5.9% of the workforce, 4801 notifications closed, no further action 73.8% (3,543) leaving 1,258 about which action was taken.
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| Medical Board of Australia – Registrant data |
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| Medical practitioners made up 16% of all health practitioners registered nationally (118,996 individual registered (2018/2019) medical practitioners in 2018/19; up from 115,113 in 2017/18).
Reporting period: 01 July 2019 to 30 September 2019 |
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| Table 1.1 Medical practitioners – registration type by state or territory |
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| Registration types |
Registration subtypes |
ACT |
NSW |
NT |
QLD |
SA |
TAS |
VIC |
WA |
No PPP |
Total |
| General |
802 |
12,966 |
596 |
8,560 |
2,754 |
769 |
10,008 |
4,195 |
914 |
41,564 |
| General (Teaching and Assessing) |
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10 |
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12 |
1 |
3 |
11 |
2 |
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39 |
| General (Teaching and Assessing) and Specialist |
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1 |
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1 |
| General and Specialist |
1,034 |
18,035 |
544 |
10,863 |
4,329 |
1,221 |
14,699 |
4,954 |
780 |
56,459 |
| Specialist |
200 |
2,273 |
131 |
2,580 |
635 |
249 |
2,214 |
1,584 |
552 |
10,418 |
| Provisional |
123 |
1,541 |
91 |
1,333 |
448 |
108 |
1,407 |
768 |
89 |
5,908 |
| Limited |
Area of need |
4 |
53 |
18 |
79 |
27 |
24 |
213 |
70 |
2 |
490 |
| Postgraduate training or supervised practice |
35 |
703 |
21 |
275 |
182 |
96 |
495 |
199 |
38 |
2,044 |
| Public interest |
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0 |
| Teaching or research |
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11 |
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5 |
2 |
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10 |
4 |
3 |
35 |
| Non-practising |
30 |
759 |
9 |
306 |
157 |
52 |
554 |
201 |
900 |
2,968 |
| Total |
2,228 |
36,352 |
1,410 |
24,013 |
8,535 |
2,522 |
29,611 |
11,977 |
3,278 |
119,926 |
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| Table 3.2 Medical practitioners – by age group |
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| Table 4.2 Medical practitioners – percentage by gender |
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| Gender |
ACT |
NSW |
NT |
QLD |
SA |
TAS |
VIC |
WA |
No PPP |
Total |
| Female |
47.2% |
43.5% |
50.7% |
42.1% |
42.8% |
43.5% |
44.2% |
44.4% |
40.3% |
43.5% |
| Male |
52.8% |
56.5% |
49.3% |
57.9% |
57.2% |
56.5% |
55.8% |
55.6% |
59.7% |
56.5% |
| Not stated or Intersex or Indeterminate |
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<0.1% |
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<0.1% |
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<0.1% |
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| Table 4.3 Medical practitioners – by area of specialist practice by gender |
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| Speciality name |
Female |
Male |
Not stated or Intersex or Indeterminate |
| Addiction medicine |
27.3% |
72.7% |
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| Anaesthesia |
32.0% |
68.0% |
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| Dermatology |
47.3% |
52.7% |
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| Emergency medicine |
36.0% |
64.0% |
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| General practice |
43.2% |
56.8% |
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| Intensive care medicine |
20.3% |
79.7% |
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| Medical administration |
33.7% |
66.0% |
0.3% |
| Obstetrics and gynaecology |
49.4% |
50.6% |
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| Occupational and environmental medicine |
20.5% |
79.5% |
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| Ophthalmology |
23.0% |
77.0% |
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| Paediatrics and child health |
52.7% |
47.3% |
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| Pain medicine |
25.7% |
74.3% |
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| Palliative medicine |
59.8% |
40.2% |
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| Pathology |
44.3% |
55.7% |
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| Physician |
32.1% |
67.9% |
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| Psychiatry |
41.1% |
58.9% |
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| Public health medicine |
42.2% |
57.8% |
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| Radiation Oncology |
43.1% |
56.9% |
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| Radiology |
27.3% |
72.7% |
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| Rehabilitation medicine |
48.6% |
51.4% |
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| Sexual health medicine |
57.6% |
42.4% |
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| Sport and exercise medicine |
23.0% |
77.0% |
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| Surgery |
12.2% |
87.8% |
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| Grand Total |
37.0% |
63.0% |
0.0% |
Level of compliance with standards
- 96.8% compliant: fully compliant with the registration standards
- 0.9% compliant (education): compliant through education in one or more standards
- 0.2% non-compliant: non-compliant with one or more standards
- 2.2% no audit action required: during the audit period, practitioners changed their registration type to non-practising, elected to surrender their registration or failed to renew their registration
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Specialty
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ACT
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NSW
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NT
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QLD
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SA
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TAS
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VIC
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WA
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AUST
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Psychiatrists
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74
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1174
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27
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803
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310
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76
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1106
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368
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4027
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Population
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426,700
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8,089.500
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245,900
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5,095,100
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1,751,700
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534,300
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6,594,800
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2,621,700
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25,364,000 |
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Ratio
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1:5766
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1:6890
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1:9107
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1:6245
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1:5650
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1:7030
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1:5962
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1:7124
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1:6298
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Ratio of Psychiatrist to Population by State and Territory
Medical Practitioner notifications
- 5,359 notifications lodged with AHPRA
- 10 notifications were made about students
- Australia-wide, including Health Professional Councils Authority (HPCA) in NSW and Office of the Health Ombudsman (OHO) in Queensland data, 6,970 registered medical practitioners – or 5.9% – had notifications made about them
- 4,801 notifications were closed
- 5.8% had conditions imposed on registration or an undertaking accepted
- 3.6% received a caution or reprimand
- 0.5% registration suspended or cancelled
- 0.1% fined
- 16.1% referred to another body or retained by a health complaints entity (HCE)
- 73.8% no further action taken
- Immediate action taken 170 times
- 339 mandatory notifications received
- 234 about professional standards
- 895 medical practitioners monitored for health, performance and/or conduct during the year
- 1,043 cases were being monitored at 30 June
- 104 on the grounds of conduct
- 182 for health reasons
- 207 for performance
- 77 prohibited practitioner/student
- 473 for suitability/eligibility for registration
- 160 criminal offence complaints were made and 143 closed
- 83 new matters related to title protection
- 3 to directing or inciting unprofessional conduct or professional misconduct
- 68 to advertising breaches
- 6 to other offences
- Matters decided by a tribunal: 55
- Matters decided by a panel: 22
- Decisions appealed: 30
Most common type of complaint
| Clinical care |
Medication |
Communication |
Behaviour |
Documentation |
Other |
| 56.2% |
10.2% |
6.1% |
5.2% |
4.8% |
17.6% |
Sources of Notifications
| Patient, relative or member of the public |
Health complaints entity HCE(see below) |
Other practitioner |
Board’s initiative |
Employer |
Other |
| 60.5% |
20.7% |
7.7% |
2.0% |
1.8% |
7.3% |
From the AHPRA website
Under the National Law, AHPRA works with health complaints organisations in each state and territory, to decide which organisation should take responsibility for and manage the concern raised about a registered health practitioner. See: www.ahpra.gov.au/Notifications/Further-information/Health-complaints-organisations.aspx
What is a ‘Mandatory Notification’?
According to the Medical Board of Australia website
Mandatory Notification
All registered health practitioners have a professional and ethical obligation to protect and promote public health and safe healthcare.
Health practitioners and their employers, as well as education providers, also have mandatory reporting responsibilities under the National Law.
Education providers, registered health practitioners and their employers must tell us if they have formed a reasonable belief that a registered health practitioner has behaved in a way that constitutes notifiable conduct.
Notifiable conduct by registered health practitioners is defined as:
- practising while intoxicated by alcohol or drugs
- sexual misconduct in the practice of the profession
- placing the public at risk of substantial harm because of an impairment (health issue), or
- placing the public at risk because of a significant departure from accepted professional standards.
The threshold for a person or organisation to make a mandatory notification is high. This means they need to have a reasonable belief that a practitioner has behaved in a way that constitutes notifiable conduct and that their belief is based on reasonable grounds.
Mandatory reporting exceptions for health practitioners
There are specific exceptions to mandatory reporting for all practitioners in Australia that relate to the circumstances in which the ‘reasonable belief’ is formed, for example in the medico-legal context.
In Western Australia, there is no legal obligation for treating health practitioners to make mandatory notifications (raise concerns) about patients (or clients) who are also health practitioners in one of the regulated health professions.
Comparing this data with that for Psychologists
Psychology board 2018/2019
- 37,783 psychologists
- Up 3.9% from 2017/18
- 5.1% of all registered health practitioners
- 0.6% identified as Aboriginal and/or Torres Strait Islander
- 80.0% female; 20.0% male
- 535 notifications lodged with AHPRA1
- Australia-wide, including Health Professional Councils Authority (HPCA) in NSW and Office of the Health Ombudsman (OHO) in Queensland data, 741 registered psychologists – or 2.0% – had notifications made about them
- 518 notifications closed
- 10.0% had conditions imposed on registration or an undertaking accepted
- 10.8% received a caution or reprimand
- 1.2% registration suspended or cancelled
- 8.5% referred to another body or retained by a health complaints entity (HCE)
- 0.2% surrendered registration
- 69.3% no further action taken
- Immediate action taken 20 times
- 69 mandatory notifications received
- 50 about professional standards
- 142 psychologists monitored for health, performance and/or conduct during the year
- 144 cases were being monitored at 30 June
- 28 on grounds of conduct
- 16 for health reasons
- 31 for performance
- 18 prohibited practitioner/student
- 51 for suitability/eligibility for registration
- 123 criminal offence complaints were made and 109 closed
- 105 new matters related to title protection
- 3 to practice protection
- 13 to advertising breaches
- 2 to other offences
- Matters decided by a tribunal: 13
- Matters decided by a panel: 3
- Decisions appealed: 5
Most common types of complaints
| Clinical care |
Documentation |
Confidentiality |
Communication |
Behaviour |
Other |
| 24.7% |
12.7% |
11.0% |
10.7% |
10.3% |
30.7% |
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