For most general practitioners (GPs) practising in Australia and who adhere to the Medical Board of Australia’s (Medical Board’s) code of conduct, there will not be any concerns regarding their safety to practise. It is inevitable, however, that there will be some GPs who are underperforming, where patient safety may be compromised, and who will require some form of support or assistance in order to address the performance concerns.
It is the individual GP’s responsibility to ensure their safety to practise. Practices and employers of GPs also have a duty of care to the public (patient safety) as well as the GPs in their employ (GP safety). The practice, having knowledge of the GP and their work, is ideally placed to monitor performance and address concerns as they arise. If this is to be done effectively, it is important that appropriate practice policies and procedures are in place and are implemented with fairness and transparency, and that all GPs receive induction and are familiar with the policies and procedures.
Managing underperformance is also termed ‘remediation’. It is a process that begins with identifying a concern, followed by investigation, assessment, decision making and, finally, implementing a management plan. A range of possible interventions, or remedial activities, may be implemented, from simple advice and support through to formal supervision and retraining. These interventions encompass:
- reskilling or retraining – the process of addressing deficits in knowledge, skills and/or behaviours to enable the GP to practise safely
- rehabilitation – the process of supporting the GP with any ongoing health issues and/or disability, to
- surmount the difficulties that hinder them from practising safely
- assist with making adjustments in the workplace to enable them to practise safely.
This guide makes recommendations only.
It relates to those GPs with performance concerns who are:
- post-Fellowship and in active practice
- working towards attaining Fellowship (but not in an Australian General Practice Training [AGPT] Program) and with performance concerns that are not related to the Fellowship exam.
It outlines a process for identifying and addressing the needs of underperforming GPs in order to facilitate their return to, and ensure their adherence to, safe practices.
- practices and practice managers in having effective processes in place for identifying and managing underperformance
- medical educators, investigators, assessors and supervisors in managing performance concerns.
For remediation of general practice registrars in the AGPT program, refer to The Royal Australian College of General Practitioners’ (RACGP’s) A guide to managing performance concerns in general practice registrars.
For GPs re-entering practice, refer to the RACGP’s A guide to re-entry to general practice.
A guide to performance management and support for general practitioners also outlines the role of the Australian Health Practitioner Regulation Agency (AHPRA) regarding performance concerns that have been brought to its attention. It is important to understand that AHPRA is the regulatory body with respect to doctors’ conduct and any investigation by AHPRA does not preclude or impede an investigation by the practice in which the doctor in question works.