1. Dr John Carnie Chair, Health Committee, Victorian Medical Board
The Role of Regulation
Dr John Carnie
Chair, Health Committee, Victorian Medical Board

2. Health Practitioner National Law
Objective is to provide for protection of the public
Regulatory Principles of National Scheme
Timely and necessary action
Minimum regulatory force to manage risk

3. Who is at risk ? AMA 2011 and Beyondblue 2013
Female doctors and young doctors
Rural/remote practice
Excessive hours, insufficient leave
IMGs
Aboriginal/Torres Strait doctors
Occupational risks (BBV exposure)
Medico-legal processes

4. Support Services AMA Vic peer support service
AMA Vic doctor support service
AMA First Response (workplace bullying)
VDHP (2001) – private, non judgemental

5. Mandatory Notifications
Practising while intoxicated (alcohol/drugs)
Sexual misconduct
Impairment causing substantial risk of harm
Significant departure from professional standards
Note – possible impairment of practitioner one of the grounds for voluntary notification

6. Exemptions from Mandatory Notification
Professional indemnity insurers
Disclosures in the course of legal proceedings
Provision of advice for the preparation of legal advice

7. Restrictions and health monitoring
Independent health assessments
Limits on hours worked
Limits on after-hours/on-call work
Limits on prescribing or access to drugs
Treating doctor reports
Work supervisor reports

8. Substance abuse monitoring
Breath alcohol testing – supervised test at commencement of shift
Urine drug screening – random tests at variable frequency, preliminary screen and confirmatory tests
Hair testing – usually 3 monthly

9. Return to normal work
Gradual reduction in frequency of reports (supervisors and treating drs)
Gradual increase in hours of work and inclusion in on-call rosters
Reduction and eventual cessation of UDS and hair tests (Group 1 to Group 5).

10. Summary
The role of regulation is to protect the public from risk of harm from an impaired doctor, but the application of the principle of minimum regulatory force seeks to improve the well being of doctors, by enabling them to return to full time, unrestricted practice when it is safe to do so.