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Episode 14

Returning to work

Show notes

Welcome to Generally Speaking, the conversation for all GPs.

Join GPs Dr Gill Singleton and Dr Billy Stoupas as they discuss some of the most pressing topics and issues surrounding the operations of a general practice.

This time, Dr Stoupas and Dr Singleton get the story on remediation and returning to work following extended leave. They are joined by Dr George Zahrias, Senior Medical Advisor for Education Progression at the RACGP. He is a specialist in the field of remediation and recently led the creation of a suite of documents, A guide to performance management and support for general practitioners, which provides guidance for performance management concerns at any point of a GP’s career.

09 September 2020 - 04:08 PM | 18 min 34 sec

(00:21) Dr Singleton and Dr Stoupas set the scene in relation to why a GP might be out of their practice for an extended period of time and what remediation might look like.

Introduction of Dr George Zaharias

(001:59) Dr Zaharias explains his interest in remediation and how he came to be the go-to guy for support in the field. He goes on to explain a bit about what remediation actually involves. It’s not just the performance management, but includes the support in assisting a doctor to improve their skills for whatever reason.

(03:22) Dr Zaharias outlines the various components of the remediation suite of documents for which he led the development of. One involves issues surrounding general practice registrars, the second includes information around the Practice Experience Program (PEP). There is a part dedicated to international medical graduates in Australia, and a documentation concerning the return to work or re-entry to general practice.

(04:36) Dr Singleton refers to part of the document which is pitched at GPs who are faced with remediation. Dr Zaharias outlines some of its details, beginning by explaining that it is also pitched at practices. The reason for this is because there are a number of doctors, not just GPs, who are investigated by the medical board if their skills are not quite as they should be. The documents are there to help those who are looking for a medical educator to assist them or to provide the support that is needed when dealing with remediation.

(06:21) Dr Stoupas asks about some of the scenarios that might lead to a GP being out of practice for an extended period of time. Dr Zaharias explains that any situation where a doctor or a GP hasn’t been working for a period of time, particularly if that period is longer than three years, will lead to the practitioner being required to fulfill certain requirements stipulated by the Medical Board of Australia to return to work. The reason being that the Board needs to insure the safety of practice.

(07:16) Dr Stoupas and Dr Singleton put a few scenarios to Dr Zaharias for his feedback and instruction on what would be required to re-enter general practice. From extended travel, to parental leave, to a temporary change of career, they ask for his counsel on what the Medical Board would require. Dr Zaharias responds with details ranging from maintenance of annual continuing professional development (CPD) points, to meeting standards for recency of work, to the creation and submission of a plan for re-entry if the leave has been extended beyond three years. Dr Zaharias emphasises that maintaining CPD and registration through planning and awareness of what is required is the best approach. But he concedes that this might not be possible in the instance of an illness or other circumstances that stop someone from working.

(12:28) Dr Zaharias answers Dr Stoupas in relation to his question about the sort of practice that a GP might return to after an extended period of leave. He explains that this is entirely up to the returning GP but that it may well prove to be difficult. Finding a suitable practice, as well as someone who is willing to take on the responsibility of supervising a returning GP, may be easier said than done. Dr Zaharias also takes on a question about working overseas and he acknowledges that if a doctor fulfils the requirements in another territory, that is fine. That experience would be taken into consideration by the Board when returning to work in Australia and does make a difference to someone who’s not worked in medicine at all for a number of years.

(13:37) Dr Stoupas and Dr Zaharias sum up with the message that if you are thinking about coming back into general practice or medicine after a long break, you really need to plan ahead and be familiar with the requirements of the Medical Board. 

(14:20) Dr Singleton follows up with some questions around mandatory reporting and returning to work after a significant illness. Specifically she asks if remediation could be triggered after a mental illness or an issue surrounding addiction.

(14:45) Dr Zaharias answers that it certainly could because it would be investigated by the Medical Board. They would consider past history, when the practitioner stopped working and if there were any serious concerns or issues. The Board might decide that an individual needs to have treatment or some education or mentoring. Mentoring is something that the RACGP can assist with and is one of the recommendations in the guide. If a GP is uncertain or is feeling anxious or insecure about returning to practice, then linking up with a mentor is a good idea to get that extra support.

(16:39) Dr Zaharias wraps up with the message that if you are considering leaving work for a substantial period of time, be aware of the requirements surrounding returning to work. Then when preparing to return, get started early to allow for the process to take some time. 

(17:18) Dr Singleton notes that the safety of the community is at the heart of the remediation process and that GPs should be reminded to look out for each other and to flag early on if they’re struggling or need support.

  • The RACGP’s Guide to performance management and support for general practitioners suite is available on the RACGP website
  • The suite is divided into five main documents, primarily designed for medical educators and supervisors who are managing performance concerns, with the exception of A guide to re-entry to general practice. The others are:
    • A guide to managing performance concerns in general practice registrars – for doctors in a general practice training program
    • Practice Experience Program (PEP): Remediator guide – for GPs working towards attaining Fellowship but not in a training program, either in the PEP or on their own
    • A guide to understanding and managing performance concerns in international medical graduates – for GPs who have trained overseas and who are in the PEP or a general practice training program
    • A guide to performance management and support for general practitioners – for any practising GP or doctor in training, or practice manager to manage performance concerns that may bring them to the attention of Australian Health Practitioner Regulation Agency (AHPRA), and to improve clinical practice and processes
  • More detail on professional support over the general practice continuum can be found here

‘One of the recommendations in the guide is that if somebody is uncertain, is feeling a little bit anxious or insecure about starting back, then linking in with a mentor is probably not a bad idea to get that extra support.’

‘The main message would be that if you are considering leaving work for a substantial period of time, be aware of the requirements about returning to work so that you’re clear about them. Then when you are preparing to return to work you can actually start acting on it in a timely manner, so that the time the processes take is not exceedingly long.’

– Dr George Zaharias

  • If you would like to learn more about Dr George Zaharias’ experience and insights, or would like to connect, visit his LinkedIn here
  • If you would like to learn more about Dr Gill Singleton’s achievements and insights, or would like to connect, please visit here.
  • If you would like to learn more about Dr Billy Stoupas’ achievements and insights, or would like to connect, please visit here.
Resources referred to in the Generally Speaking podcast and on the website are views of the hosts and not necessarily endorsed by RACGP.

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