Views on mandatory reporting of impaired health practitioners by their treating practitioners: A qualitative study from Australia

This study explores the views and experiences of health sector professionals in Australia regarding a new national law requiring treating practitioners to report impaired health practitioners whose impairments came to their attention in the course of providing treatment. We conducted a thematic analysis of in-depth, semi-structured interviews with eighteen health practitioners and four medico-legal advisors from Australia’s six states, who each had experience of applying the new mandatory reporting law in practice. \ud \ud Interviewees perceived the introduction of a mandatory reporting law as a response to failures of the profession to adequately protect the public from impaired practitioners. Mandatory reporting of impaired practitioners was reported to have several benefits: it provides treating practitioners with a “lever” to influence behavior, offers protections to those who make reports, and underscores the duty to protect the public from harm. However, many viewed it as a blunt instrument that did not sufficiently take account of the realities of clinical practice. In deciding whether or not to make a report, interviewees reported exercising clinical discretion, and being influenced by three competing considerations: protection of the public, confidentiality of patient information, and loyalty to their profession.\ud Overall, competing ethical considerations limit the willingness of Australian health practitioners to report impaired practitioner-patients under a mandatory reporting law. Improved understanding and implementation of the law may bolster the public protection offered by mandatory reports, reduce the need to breach practitioner-patient confidentiality, and help align the law with the loyalty that practitioners feel to support rather than punish their impaired colleagues