Appendix 5. Case studies

Part 1: Dr GPT is pregnant and is planning to take maternity leave. She is not sure about how much time to take off.

Question

What options are available to Dr GPT and what implications will this have to her registration?

Part 2: Dr GPT had planned to only take 12 months’ leave; however, unexpectedly, she fell pregnant again. She has been absent from practice for three years now, and she is planning to return to work as soon as she can. The practice that she was working at indicates that they are happy to have her back.

Questions

What should Dr GPT do to prepare for her return to work?
What should the practice do?

Dr GPU had worked in general practice for a short period of time and then left to pursue a writing career. While that career has been very successful, he has decided that he would like to work in general practice again. He recognises that his skills are rusty and that many changes have occurred in clinical practice over the time that he has been away from it. It has been 20 years since he last worked as a GP.

Questions

How should Dr GPU prepare for his return to practice?
What would be an ideal time frame?
Why would anyone want to employ an ex-GP?

Dr GPV returned to general practice after having recovered from a significant mental illness. The conditions imposed on her return by AHPRA are that she only work under supervision and that she undertakes a mentoring program to assist her with her clinical skills. The mentoring entails regular monthly sessions with direct observation of, and feedback on, her consulting, along with monitoring of her progress. Dr GPV has a supportive supervisor in the practice. She engages readily in the mentoring sessions which she says are very beneficial. After 12 months, however, the mentor determines there is very little improvement in her clinical skills. Dr GPV feels that this assessment is harsh. She takes a break from practice, then returns to work for a period of time, after which she decides to cease clinical practice altogether because she finds it very stressful.

 

Observations and questions

Health issues and clinical skills concerns often go hand in hand and do impact on each other. The supervision and mentoring assisted Dr GPV to return to practice and feel supported at the same time. It also provided a means for monitoring her safety to practise. Dr GPV lacked insight and had difficulty accepting her deficiencies whenever they were pointed out to her. With the assistance of her mentor she was eventually able to recognise and accept that she would never achieve the required standard of practice. She also came to the realisation that she couldn’t afford to have a mental breakdown again. When Dr GPV took the short break from practice these things were already in her mind and she was starting to think about what she would do if she stopped practising.

Is this case a success story or a failure?

The supervisor’s terms of engagement are to support and monitor Dr GPV’s clinical capability and progress. If a serious critical incident occurs, is the supervisor vicariously liable?

If Dr GPV had not accepted the feedback that her performance was less than satisfactory, what can the practice do?
 

Dr GPW is a recovering alcoholic and has a history of depression. He applies for a job at your practice. You are the prospective employer and Dr GPW presents for an interview with you. Consider the following two scenarios:

Scenario 1: Dr GPW is quite open about his past history. He speaks about his recovery and why he feels he is ready to start work.

Scenario 2: Dr GPW does not divulge any details of his past history. He says simply that he has had a ‘health problem’, has taken time off because of it, has now fully recovered and is ready to start work again. He points out that prior to leaving practice he was a very capable and respected GP.

Questions for each scenario

Do you have any concerns?
What questions do you have for Dr GPW?
You decide to give Dr GPW the job. What will be the terms of engagement? What supports will be provided for him in the workplace?

Dr GPX is a young GP who has been diagnosed with multiple sclerosis (MS). To date, she has been managing at work although she has been taking a few days off here and there because she tires easily. Because her condition has been deteriorating, she now takes six months’ leave from the practice for ‘personal reasons’. The practice does not know that she has MS and that the time off is to undergo a new treatment. The six months extends to nine months. The treatment is not successful and Dr GPX now also has difficulty walking (weakness in one leg). Dr GPX would like to return to work but she is apprehensive.

Questions

What are the issues for Dr GPX?
What are the issues for the practice?
What is required for the return to work plan to be successful? Who can assist with this plan?

Dr GPY’s registration has been suspended for 12 months because of inappropriate narcotic prescribing. He was working as a solo GP in a country town but because that work was very stressful, he decided that he would be better off working in a group practice with more ‘sensible’ hours. His suspension is due to finish in two months’ time and he applies for a job at your practice.

Questions (as the prospective employer)

What are your concerns?
What questions do you have for Dr GPY?
You decide to give Dr GPY the job. What will be the terms of engagement? What supports will be provided for him in the workplace?

Consider this alternative scenario: Dr GPY had been deregistered for professional misconduct and has been away from practice for eight years. He has recently applied for re-registration, and AHPRA has imposed high-level restrictions on his practice. He applies to work at your practice.

Questions (as the prospective employer)

What are your concerns?
What questions do you have for Dr GPY?
You decide to give Dr GPY the job. What will be the terms of engagement? What supports will be provided for him in the workplace?

Dr GPZ was recently assaulted in the waiting room of the clinic that she worked at by a patient high on drugs. The assault was unprovoked and random. Fortunately, she did not sustain any serious physical injuries; however, she was mentally traumatised. She takes a period of time off work and consults a psychologist.

Questions

If you were Dr GPZ, how would you be feeling?
Apart from the psychologist, what else would be helpful for Dr GPZ? How should she prepare for her return to work?
How should the practice manage her return to work?