Medical boards are not addressing the problems within their own profession

Imagine that you are baking when your 15-month-old daughter reaches out and burns her hand on the oven door.

You rush her to your local GP, a woman in her late 50s, who quiets the toddler with an injection for pain, and another for nausea, before dressing her burn.

Hours later you find your baby dead in her cot. You and your daughter have just become the victims of a drug-impaired doctor.

The Morphine injection that your child was given was ten times the recommended paediatric dosage, while the accompanying Maxolon injection was five times greater than normal.

Your GP was charged with manslaughter. She served six months of a five-year sentence, made retrospective to the date of the incident, and was released last November. She may already have applied to have her license re-instated.

This is a real case. Although the GP was known to be substance-impaired for at least two years; and had been monitored by her medical board for that period, she was permitted by that same medical board to remain in clinical practice. During this two-year period her identity was kept secret, under medical board legislation, in order to protect her anonymity.

Your right to freedom of fully informed choice of a treating physician has been usurped by a medical board apparently more concerned with protecting its doctors, than protecting the patients of its doctors.

There can be no doubt had you known of this doctor's impairment and board monitoring history; and had you also known about the three ampoules of Pethedine which were unaccounted for at her surgery that morning; you would have exercised your better judgement and taken your child to another doctor, one who was drug-free and competent.

But because of legislated secrecy, you had none of this vital information available. In every State there is medical board legislation in place prohibiting the release of such information to the public.

Throughout Australia, it is conservatively estimated that there are 5,000 substance-impaired doctors working in surgeries and operating theatres at any given time. This translates to one in ten registered practitioners.

Can you be sure that your family doctor is not one of them? No.

And it will further surprise you to find that there are no pro-active initiatives by any of our medical boards to identify, treat, and rehabilitate doctors who are over-using alcohol, abusing drugs or under psychiatric treatment. Only doctors who self-report or are reported by others will be monitored and subjected to monthly urine screening by their medical boards.

And they will continue to treat and perform surgery upon their patients.

To put these figures into perspective, from a pool of at least 5,000 impaired Australian doctors, our medical boards have less than 500 currently under monitoring.

Surely such apathy and denial impacts negatively upon the health of their affected doctors.

Failure by our medical boards to openly address the issues of doctors' psychiatric or addiction illnesses infers an occupational stigma and shame which says more about the mentality of the boards themselves than their impaired members.

According to a British medical study undertaken on this subject, 60 per cent of all doctors reported to their medical boards for disciplinary action had problems involving alcohol, drugs, or both.

In addition, US research has shown that five to six per cent of physicians account for more than 50 per cent of all medical negligence litigation. These tended to be impaired, under-performing, and re-offending physicians.

These high-risk doctors undeniably perpetuate an enormous liability for medical insurers.

But it is not the insurers who hold the authority to remove these high-risk doctors from patient contact. Only the medical boards and their practitioner tribunals can accomplish this.

Sure, the insurers know the identity of our impaired and 'frequent flyer' physicians. It is they who are meeting the repeated awards and settlements to the aggrieved plaintiff/patients of these doctors.

And it is the medical insurance industry, and our best and most competent doctors, who are carrying the can for the ostrich mentality of our medical boards, by way of increased indemnity premiums for all doctors, and not just the industry's under-performers.

It stands to reason that if five percent of impaired and under-performing physicians account for fifty percent of all medical litigation, this offending five percent should be removed from all patient contact and diagnostic screening; thereby reducing overall medical litigation by half.

The current medical insurance circus has seen medical associations blaming governments; governments blaming insurers for poor investment choices; insurers and doctors blaming patients and lawyers for litigious mentalities; and patients blaming insurers and doctors for fiscal greed and poor work practices.

Our medical insurers and our safest doctors should not be forced to subsidise the insurance premiums of those whose clinical practice skills are consistently known to be sub-standard. These 'frequent flyers' need to be identified by their boards and re-trained to an acceptable standard of clinical competence.

But our medical boards have remained conspicuously silent throughout.

It can no longer be considered acceptable for our medical boards to ignore such glaring professional flaws as alcohol abuse, drug addiction, or psychiatric impairment. Flawed doctors are in dire need of early intervention, psychological support, and medical treatment. Such treatment already exists and has proven successful in assisting impaired doctors but medical boards must take steps to identify problem doctors and immediately move them into other safer, non-patient areas of medicine until fully rehabilitated.

The introduction of random drug testing into medicine through the pro-action of our medical boards would be a desirable and long overdue patient safety strategy. So why is this obvious need not being addressed?

Public expectation is that the medical profession should be subject to, at minimum, the same codes of safety that pre-exist within other professions, industries, sports, schools, jails, and on our roads. Shane Warne was banned from his profession for 12 months - but he does not supervise the health and well-being of other Australians.

What our medical boards need to realise, is that impaired doctors are also patients - with incidental medical degrees. They cannot become empowered to receive support and rehabilitation until our medical boards cease ignoring them and encouraging them, through neglect, to remain in hiding.

Every patient has the right to expect that our medical boards are policing the safe performance of their doctors. And this means that every patient should be able to assume that all board-registered physicians are sober, drug-free, and competent.

Unfortunately for us, they are not.