Our performance program
When a performance matter is referred to the Council we seek a response from the practitioner to the issues raised in the complaint. A Committee considers the response in conjunction with the initial complaint to determine whether further action is required. The Council may provide a copy of the response to the complainant.
There may be issues relating to the doctor's professional performance which need to be addressed. In this case, the doctor is referred to the Council’s Performance Program which addresses the doctor's care of real patients in a practice settings.
If areas of concern are identified, the performance pathway aims to protect the public from substandard clinical care, and assist the practitioner to practice in a safe and responsible manner.
In order to achieve these, conditions may be placed on a practitioner’s registration. For example, conditions may restrict the kind of work or procedures a practitioner can perform, limit their patient numbers or mandate meetings with a supervisor.
Possible outcomes
The Council deals with professional performance concerns under the direction of the Council’s Committees. This program is non-disciplinary in nature, instead aiming to protect the public and ensure doctors are practising in accordance with best practice.
When a performance matter is referred to the Council, a response to the issues raised in the complaint is sought from the practitioner. The response is considered in conjunction with the initial complaint to determine whether further action is required.
A Council Committee may decide:
- No further action may be required because the doctor’s response has satisfactorily addressed the issues raised in the complaint
- The doctor may be provided with advice about his/her professional responsibilities
- The doctor may be asked to attend a Council interview to discuss the complaint
- The doctor may be required to undergo a Performance Assessment.
How we assess performance concerns
Performance Assessment
Committee may refer the practitioner for a Performance Assessment. This is usually conducted by one or more suitably qualified peer practitioners, and is tailored to each practitioner and the issues raised in the complaint, while also taking other relevant risk factors and issues into account. As a result, it can take place either at the doctor’s practice or at the Council’s offices, and may include components such as an interview, medical records review, review of prescribing, observation of consultations or procedures and a clinical practice interview.
Following the assessment the peer assessors make recommendations to Committee about what action should be taken.
What is unsatisfactory professional performance?
The professional performance of a registered medical practitioner is unsatisfactory if it is below the standard reasonably expected of a practitioner of an equivalent level of training or experience.
Performance Review Panel
If the report of a Performance Assessment indicates a practitioner’s performance may be unsatisfactory, s/he may be referred to a Performance Review Panel. Performance Review Panels are conducted informally and in private. The Panel usually comprises two doctors and one lay member. The Performance Review Panel considers the report of the performance assessors, other relevant evidence and the practitioner as a whole.
The Panel then decides whether a doctor’s practice of medicine meets the standard reasonably expected of a medical practitioner of an equivalent level of training or experience.
If the Panel finds that a practitioner's professional performance is unsatisfactory, it may place conditions on his/her registration or recommend that the Committee does so.
Medical practitioners participating in the Performance Program must comply with all conditions on their registration, so the Council can be confident of their ability to deliver clinical care to an acceptable standard.
Case study - Performance Program
The Council received two complaints about Dr S, a practitioner who had recently arrived from overseas and who was working at a rural general practice. The complaints related to her care of an elderly man and a pregnant woman.
After reviewing the complaints, the Performance Committee resolved that Dr S required a performance assessment. This was carried out in her rural general practice. The assessors were concerned that Dr S’s clinical skills and prescribing were not at the level expected of a doctor of her training and experience. A Performance Review Panel concurred. The Panel put conditions on her registration including that she meet with a supervisor on a weekly basis and undertake a number of educational courses.
Over the next two years, Dr S completed the required courses and met with her supervisor weekly. Her supervisor reported that Dr S was taking an active role in her learning. Dr S remarked that she found the sessions very useful, particularly in preparing for her general practice exams. Two years after the complaints were received, Dr S had a Performance Re-Assessment and demonstrated a significant improvement in her clinical skills and prescribing.
She was able to exit the Performance Program and, in the same month, achieved her Fellowship of the Royal Australian College of General Practitioners.