PSR Newsletter, July 2022
Message from the Director Announcing the appointment of an acting Director
This is my last newsletter as Director before I transition into a new role as Dean of Medicine at Curtin University in Western Australia later this month.
I would like to again thank all PSR staff and Panel members for their assistance over the past five and a half years. The Agency has increased both the breadth and depth of activity, expanding beyond individual and into corporate reviews. The Agency is well regarded by the Department and Government, with a proposal and matching budget commitment to expand PSR powers into compliance of hospital admission regulation.
I would like to formally acknowledge Dr Di Dio who has been appointed as acting Director of PSR. Dr Di Dio has been a member of the PSR Panel for many years and chaired several PSR Committees, he was also appointed to the Determining Authority for three years. He is the current PSR medical officer and has been a prolific peer reviewer of general practice cases at the Director stage for over a decade. He is an experienced general practitioner in Canberra with strong ties to the AMA, being a former ACT AMA Chair and current Federal Board member. I wish him well in the new role.
Professor Julie Quinlivan
Agency activity summary for the quarter
In the period from 1 April 2022 to 30 June 2022 the Agency received 36 new requests (including 3 practitioners who had previously been referred). The Agency finalised 22 requests. This comprised:
- 18 ratified section 92 agreements
- 4 effective final determinations
- no section 91 ‘no further action’ outcomes
A total of $5,456,234 in repayment directions were made from the finalised matters.
Of the finalised matters, 16 involved some form of disqualification.
In this period 4 new peer review Committees were established and 7 practitioners were referred to AHPRA either due to significant patient safety concerns or non-compliance with professional standards.
A recent area of concern has been imaging in medical and chiropractic services.
Clinicians should be mindful that X-rays cause exposure to radiation, and every X-ray request should be clinically indicated to either confirm a diagnosis or progress management. Imaging should be confined to the body part identified by history and examination. Imaging is not a substitute for a history and examination. Finally, undertaking multiple X-rays for screening purposes, or at each visit, may cause patient harm.
The PSR has recently seen cases where X-rays have been ordered without a prior history or examination being recorded.
Consent for surgery
Another recent area of concern has been the failure to secure consent for surgical procedures. If a practitioner plans to perform several surgical procedures at one time, then each procedure should be discussed, and patient consent secured.
In some recent cases at the PSR, practitioners have routinely billed patients for multiple surgical procedures when the medical records, consent forms and hospital documentation did not indicate that consent was secured for the additional billed surgical procedures.
Practitioners are reminded that if a major surgical procedure is billed, then smaller procedures that are integral to, or part of, the larger procedure cannot also be billed as every MBS service is a complete service.
Finally, practitioners are reminded that current concepts of consent include a discussion of all relevant treatment modalities and their advantages and disadvantages, as well as patient specific concerns. Consent is a patient-oriented process.
New appointments to the Professional Services Review
Every five years the PSR Panel undergoes a renewal. This massive task involves national advertising, interviews, media and regulatory checks, and formal consultation with the AMA and relevant professional Colleges to secure a Panel of practitioners to act as peer reviewers in PSR matters.
This process commenced in July 2021 and was completed in May 2022 when the Minister signed Instruments of Appointment for 109 PSR Panel members (including 44 PSR Deputy Directors) as well as for 14 Determining Authority members.
The Panel and Deputy Director appointments were effective on 30 May 2022 for a period of five years and the Determining Authority appointments were effective on 1 July 2022 periods of three or five years depending on the member.
In addition to the five yearly renewal process, the PSR also must occasionally seek new Panel members when new disciplines are referred for review. We are currently processing several appointments in new areas including pathology, psychology, dual qualified anaesthesia and pain medicine specialists and obstetrics and gynaecology.
The current lease on the PSR premises expires in 2022 and work has been underway to seek new premises. This work is ongoing, but in the meantime an extension of the current lease has been secured to ensure any move will be easily facilitated.
Panel and Determining Authority Training 2022
In May and June, the Professional Services Review hosted training for the Panel and Determining Authority members in various cities.
PSR Panel training involved an annual privacy update as well as a talk from Hayley Bennet, Barrister about the process of decision making, linking it to fast and slow cognitive processes.
PSR Determining Authority training included a focus on exploring submissions and drafting decisions.
If you have any feedback from this training, including ideas and requests for next year, please email firstname.lastname@example.org
Federal Court Outcomes
There were no Federal Court outcomes for PSR in this quarter.
PSR publishes a monthly summary of case outcomes on its website. Each summary provides some idea of the person under review's practice profile (in comparison to their peers) and this helps explain why they were referred to PSR for review. In addition, the summaries detail the items investigated, the findings (in the case of a Committee) or the agreement reached between the person under review and the Director (PSR), and the sanctions applied.
View all case outcomes
Continuing Medical Education (CME)
Any Panel members or consultants who have completed work for PSR and require evidence for continuing medical education points, please contact Megan Kilby at email@example.com