Update: New Requirements for Overseas Doctors, Social Media Guidelines and Rise of Polypharmacy

We highlight new initiatives on the requirements of Overseas Doctors coming to Australia, Newly published Social Media Guidelines for health practitioners and findings about the Rise of Polypharmacy among elderly Australians.

New Requirements for Overseas Doctors

New Social Media Guidelines

The Rise of Polypharmacy

 

New Requirements for Overseas Doctors

Under the Stronger Rural Health Strategy, the number of overseas trained doctors coming to work in Australia will be managed by directing them to areas of need.

The Initiative

Under the Stronger Rural Health Strategy, the growth of Australia’s medical workforce will be better managed by regulating the number of overseas trained doctors coming to work in Australia and directing them to areas of need around the country.

The aim is to divert doctors from over-serviced metropolitan areas to areas of workforce need, especially in rural and remote areas.

Through the Skilled Migration Program requirements, the number of overseas trained doctors entering Australia to work in primary health care will be reduced by 10% annually over a 4-year period.

This will be a gradual process to ensure the right balance of qualified GPs are available, while also providing opportunities for Australian trained doctors.

There is an estimation that approx $415 million will be saved over this period from better managing the total number of doctors entering the workforce and providing opportunities in areas of need.

The savings will involve slowing the growth in the number of overseas trained doctors joining the Australian workforce, and the associated reduction in Medicare and Pharmaceutical Benefits Scheme (PBS) billings.

Other costs of services from the growth in the supply of doctors that have not been managed well will also be reduced. These costs may include diagnostic, pathology and specialist referral costs.

Medical team of doctors at work in hospital

The initiative will be supported by a new planning tool, which will create a more effective distribution of overseas trained doctors to areas of need.

The number of visas to be granted through the skilled migration program over the four years will help to slow the growth in the number of overseas trained doctors entering Australia that want to work in metropolitan areas. Improved targeting of visas in regional Australia and reductions in the total intake from major metropolitan locations will also be considered.

The Department will work with Rural Workforce Agencies to ensure that overseas trained doctors are directed to suitable areas of genuine workforce need. They will assist in better managing the supply and pave the way for a more highly trained rural health workforce.

Concerns from Medical Professionals

The focus on distributing foreign doctors to remote areas has raised concern among medical professionals, the ABC reported.

Australian Medical Association WA mentioned that relying on more overseas-trained doctors to work in the rural areas could raise some concern about the quality of the medical training, which is often difficult to find out in depth.

Another potential concern is the 'ethical problem' of overseas doctors impacting the healthcare for people from the doctors’ country of origin by leaving and settling into a new life abroad.

Chair of the Midwest GP Network also agreed with the concerns. Mentioning that even though international doctors have served plenty of Australian's communities well, they should not be relied on to make up for the recruitment gap.

Some initiatives like rural clinical schools and structured regional placements in country general practices are already in place to attract Australian doctors. However, it is suggested that more could be done.

Encouraging kids from regional areas of Australia to go to medical school increases the chances of them working in their regional area after graduating.

Additionally, living and working in regional Australia should be more attractive to local doctors as well. A town's community should be able to support a young doctor's family, making sure the doctor has connections with the community and that they have enough support in their practice to work efficiently.

Doctor consultation with paediatric patient

In Support for the Initiative

Rural Health West is one of the rural workforce agencies that can issue Health Workforce Certificates to overseas-trained doctors. Chief Executive Officer Tim Shackleton said the new requirements would ensure better distribution of doctors across the country.

The State and Federal Governments have made significant investments in training more Australian students. By 2022, there should be more than 400 students graduating from medical school in Western Australia alone.

Federal Minister for Regional Services Senator McKenzie mentioned in the interview by the ABC that the initiative would allow the Government to better manage the distribution of the national medical workforce. The balance of qualified GPs across all of Australia's communities and the opportunities for Australian-trained doctors will immensely benefit from the initiative.

Questions?

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New Social Media Guidelines

A new guide was published for health practitioners to understand the obligations when using social media. Find out how not to make critical mistakes online.

The Australian Health Practitioner Regulation Agency (AHPRA) have published a new guide to help health practitioners understand the obligations when using social media.

When using social media, health practitioners should be aware of their obligations under the National Law, the Board’s Code of Conduct, the Advertising guidelines and other relevant legislation, such as privacy.

AHPRA believes that trust in a health practitioner is crucial. Whether social media activity can be seen by the public or is limited to a specific group of people, health practitioners have a responsibility to behave ethically and to maintain professional standards.

The guide does not aim to prohibit practitioners from engaging online or participating in social media; rather, it encourages practitioners to act ethically and professionally in any online setting.

Smiling doctor using tablet computer to go on social media

The guide reminds practitioners that when interacting online, they should be aware of the implications of their actions by:

  • Complying with confidentiality and privacy
  • Complying with their professional obligations as defined in their Code of conduct
  • Maintaining professional boundaries with individuals
  • Communicating professionally and respectfully with or about patients, other colleagues and their employers, and
  • Not presenting information that is false, misleading or deceptive, including advertising claims that are not supported by acceptable evidence.

A primary objective of the National Registration and Accreditation Scheme (the National Scheme) is to protect the public in these potentially alarming instances.

Harm may include breaches of confidentiality, defamation of colleagues or employers, violation of practitioner and patient boundaries or a disclosure of personal information to the public about both the patients and/or employers.

It can often be extremely difficult to remove or change information on social media once it is published. Even if a person deletes their content on social media, any information available online can be circulated widely and rapidly. Therefore, it is imperative that healthcare providers are careful about what they like or post online, regardless of where in the world they are or what kind of language and online profile information is used.

More importantly, National Boards like a lot of employers in various industries may consider punishing social media use in the practitioners' private lives if it raises enough concerns about their code of conduct to continue holding registration.

Privacy concern folder

Below are some important points from the social media guidelines:

  • Patient confidentiality

Take strong care when sharing information online, including in comments sections or photos, to NOT disclose any personal patient information. Double-check what is in the background of a photo before sharing it and make sure that the information you share does not unintentionally disclose personal information about individuals - patients and colleagues.

  • Cultural awareness, safety and patient beliefs (social & clinical)

As a health practitioner, your views on clinical issues are influential to patients. If your social media reflects or promotes personal views about social and clinical issues then it might impact a patient’s sense of cultural safety or it could lead to a patient or colleague feeling judged, intimidated or embarrassed.

  • Professionalism

Codes of Conduct emphasise that practitioners must always treat patients with respect and communicate effectively, courteously, professionally and respectfully with and about other health care professionals. This also strongly applies to comments made online and in social media. Grievances are best to resolve privately.

Public Health statement with doctors instruments

  • Public health messages

While people may have personal beliefs about some public health initiatives, it is recommended to make sure that any comments you make on social media are consistent with the standards and guidelines of your profession and do not contradict public health campaigns and messages. A health practitioner who shares information online which contradicts the best available scientific evidence may breach their professional responsibilities with the National Boards.

  • Advertising

The Advertising guidelines explain the advertising requirements in the National Law. The National Law and Advertising guidelines also apply to social media. For example, false claims about the effectiveness of a treatment on a Facebook site that advertises a doctor's services or their clinic is misleading and considered a breach of section 133 of the National Law. Advertising in social media using a testimonial is also a breach of the National Law.

Questions?

What are your thoughts on the use of social media by healthcare professionals? We would love to hear from you.

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The Rise of Polypharmacy

36.1% of Australians aged 70-plus are estimated to be affected by continuous polypharmacy and qualified pharmacists are relied on to help make the right decisions.

A study published this year on Polypharmacy among older Australians was published in the Medical Journal of Australia, examining the rate and impact of polypharmacy on older Australians during the 2006-2017 period.

It was revealed that nearly 1 million Australians aged 70 and older are being affected by continuous polypharmacy - which is the concurrent use of multiple medicines by patients and very commonly the elderly.

Other important factors such as gender and age of participants were also highlighted:

  • The rates were higher among women than men (36.6% vs 35.4%)
  • The rates were highest among those aged 80–84 years (43.9%) and 85–89 years (46.0%)

The Australian Pharmacist also defined that polypharmacy is the use of five or more medicines daily by a patient. However, the authors mentioned that there is a lack of universally accepted definitions for polypharmacy and different definitions around the number of medications used up to 5 or more.

Female doctor and elderly patient with walking stick

The study analysed a 10% random sample of PBS data for people in the 70-plus age group, who were dispensed medicines between 1 January 2006 and 31 December 2017.

The researchers estimated continuous polypharmacy by counting the number of unique medicines dispensed during time periods of 1 April – 30 June and 1 October – 31 December in each calendar year. This helped them to determine the number of people affected and any changes in prevalence.

One of the primary objectives was measuring and reporting the prevalence of continuous polypharmacy of 5 or more unique medicines. It later broadened the scope to the impact of continuous polypharmacy of 10 or more unique medicines.

The author, UWA Centre for Optimisation of Medicines Dr Amy Page, noted that the medicines they looked at did not include OTC medicines; vitamins, supplements or herbal medicines; or any medicines that were not funded by the PBS.

Dr Page highlighted that it is important to realise that polypharmacy may be appropriate for some people. The use of medications is particularly important for symptom control and disease progression in elderly patients. However, appropriate medication therapy is strongly required. Under-treatment means potential benefits of useful medications may be missed out on, while over-treatment puts older patients at increased risk of harm.

The study concluded that taking multiple medications may be necessary, but it needs to be carefully assessed by a medical professional and balanced against the potential risks of the individual patients.

People’s awareness and understanding of the potential risks with taking multiple medications should be increased, especially by the health professionals and to the general public.

Nurse and elderly patient walking outside

This is why pharmacists play an important role in ensuring the appropriate use of medications, especially for elderly patients. They can support and educate people to make appropriate decisions about non-prescription medications as well.

The strength of the study is based on a nationally representative sample of PBS prescribing data for elderly Australians. It is one of the first to investigate patterns of polypharmacy across all older Australians rather than in specific categories of groups.

Some limitations of the study include the exclusion of medicines that do not require prescriptions, complementary and alternative medicines, and medicines dispensed on private or non‐subsidised prescriptions.

Additionally, the study did not have data on patient‐specific health parameters. Therefore, it was difficult to assess whether individual medicine regimens were therapeutically appropriate.

As a result, more research looking into these areas and the strategies for reducing medicine use are much needed.

Medical Research keyboard

Questions?

What do you think about the findings of the research? We would love to hear from you.

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