Wednesday, October 04, 2023

Australian Medical Doctors May Need to Arm Themselves with a Law Degree

Australian doctors have expressed displeasure with medical regulatory bodies like Ahpra and the TGA, stating that doctors with different views are being targeted and suspended. TrialSite interviewed some doctors who served in the system and who were suspended unfairly for expressing differing opinions. They emphasized that to be fully protected in the Australian health system, doctors may need to be well-versed in the law before they start practicing.

The Australian Health Practitioner Regulation Agency (Ahpra) regulates medical practice in Australia. Some doctors fear that people anonymously use Ahpra as a weapon against them. There are also concerns that external bodies in the United States like the Federation of State Medical Board (FSMB) may influence the International Association of Medical Regulatory Authorities (IAMRA). The IAMRA is responsible for effective medical regulation worldwide. They achieve this by providing guidance to the medical profession and bolstering scientific, educational and collaborative activities in the field.

What does the FSMB do?

Founded in 1912, the FSMB is a body or association representing state medical licensing in the U.S. Its CEO, Dr. Humayun Chaudhry, is regarded as one of the most influential physicians in the U.S. He released healthcare policies that were approved by the American Medical Association and authored research papers on how to boost vaccine usage. In April 2022, the FSMB adopted a misinformation policy and released a manifesto to be heavy-handed with doctors spreading misinformation. This raised suspicions, especially among vaccine-hesitant doctors, as there appeared to be a seeming connection between Dr. Chaudhry's effort to influence the vaccine-hesitant and “boost vaccine usage” and his strict approach towards doctors expressing hesitancy or spreading opposing information about the vaccines.

Pressured by regulatory bodies

Interestingly, medical authorities from different countries, including Australia, formed an international arm in September 2000, IAMRA. The IAMRA– a non-profit–supports medical regulatory bodies globally. In June 2004, the IAMRA said that it was separate from the FSMB. However, Chaudhry was IAMRA secretary and FSMB CEO at the same time in 2020.

Before the FSMB's adoption of the misinformation policy, the IAMRA had hosted webinars in 2020, to address ethical concerns among doctors and educate them on ways to combat COVID-19 misinformation. An Australian doctor, who would prefer to stay anonymous, said, "... in 2021, as I said, their agenda was to be heavy-handed with all doctors who spread misinformation."

Ahpra wields a strong authority in Australia. As such, a few doctors were concerned that the FSMB may have influenced decisions at Ahpra because its current CEO, Martin Fletcher, was a director at the IAMRA until the end of 2022. He was one of the panelists in a global webinar educating regulators on how to respond to the challenge of vaccine-hesitant doctors.

Were these concerns justified?

The Therapeutic Goods Association (TGA) and Ahpra are at the forefront of fighting COVID-19 misinformation, and they continually advocate for the dissemination of the right information on vaccine safety.

In 2023, Ahpra released a 2021 survey result reflecting the distrust among doctors of its regulatory services. Doctors in Australia had the most negative views compared with other health practitioners, and only 35% of doctors had positive reviews of Ahpra.

Part of the result said, "Distrust was undercut by practitioners’ personal views of how the COVID-19 pandemic was handled, but also related to perceived unfairness and injustice of Ahpra and the Boards’ processes."

In October 2021, the TGA suspended a medical doctor for using ivermectin on a patient with severe COVID-19 symptoms. The patient had initially sought treatment at another hospital but had only been told to wear a mask and isolate, without receiving any early treatment. As the patient’s condition had worsened after returning home, they had sought treatment from the doctor instead of going back home due to concerns about being unable to say goodbye to their family if they were to pass away.

A junior doctor in that hospital then made a complaint, stating that there was a case of polypharmacy and encephalopathy.

Speaking with TrialSite, she said, "I wanted to find out what happened to my patient, so I called this doctor up… She basically said to me that she didn't know why she made a complaint against me and that her boss was the one who actually told her to make the complaint."

The junior doctor’s supervisor was Associate Professor Naren Gunja, a toxicologist at the Westmead Hospital. She mentioned that she’d tried speaking to him, but he didn’t listen to her.

"So, I did a bit of research and discovered that he actually went to the media and spoke about a case of ivermectin overdose in a patient that he had treated at casualty," she continued.

“I couldn’t understand why Dr. Gunja, a toxicologist, chose to warn the public about the risk of ivermectin. It is well known that taking ivermectin in combination with other medications can effectively treat COVID-19, and the occurrence of ivermectin overdose is rare.”

The ivermectin overdose case went viral from September 1 to September 3, 2021, after Gunja had spoken to the media, advising the public to ignore online claims that ivermectin was a cure for COVID-19. And on September 10, 2021, the TGA banned ivermectin as an off-label treatment for COVID-19.

According to our source, a second complaint came from an anonymous source with the pseudonym – John Smith. Eventually, the evidence presented in the complaint was traced back to Ahpra. All these contributed to her suspension in October 2021.

Additionally, in February 2021, the COVID Medical Network came under intense scrutiny from the TGA for endorsing the off-label use of hydroxychloroquine in treating COVID-19 infection.

The COVID Medical Network (CMN) is a group of doctors in Australia who have reservations about COVID-19 vaccines and have voiced their dissatisfaction with the government's pandemic response. Instead of recommending vaccines, they prescribe alternative medications like ivermectin and hydroxychloroquine to address and curb the effects of COVID-19 infection.

This may explain why a doctor had to publicly renounce and dis-endorse the group within seven days to regain medical registration after being urgently suspended for having a link on her website to the CMN website.

A case of corruption among regulatory bodies

In October 2022, the Australian government made over 30 changes to the national law guiding the regulation and registration of doctors. This also included disciplinary action against doctors who had broken the law. It was called the Health Practitioner Regulation National Law and Other Legislation Amendment Act 2022.

This law gave Ahpra the power to release a public statement regarding a practitioner who is under assessment or investigation if there was a "reasonable belief" that the practitioner's behavior, performance or health could seriously endanger public safety. Some doctors fear that Ahpra or the TGA could use this law as a means of bullying.

According to our first anonymous source, Ahpra weaponized the reasonable belief concept to take down medical doctors with different beliefs.

She implied that Ahpra could influence the subjective state of mind of the medical board by making statements about a doctor with no medical basis. "It has so much power. They can target any doctor they like. All it needs to do is to have an anonymous complaint against a particular doctor, and that doctor could be urgently suspended without verification of the facts."

People have complained that Ahpra bullies and has numerous scandals. After three Senate, a state inquiry into Ahpra’s conduct and according to recent polls, many doctors, the Royal Australian College of General Practitioners (RACGP) and the Australian Medical Association (AMA) remain unhappy with Ahpra’s framework. Ahpra is an agency with a five-year contract with the National Board to carry out administrative duties like notifications and collection of subscriptions.

The regulatory power lies with the Board, not Ahpra, and one anonymous doctor said that the Board was negligent in renewing its contract with Ahpra, knowing the level of incompetence of Ahpra officials. She added that perhaps the Board liked this arrangement, as most complaints are deflected away from the Board and directed against Ahpra.

The TGA was also accused of hiding vaccine side effects like myocarditis from the public, making people doubt its authenticity. They also allegedly concealed the death of several previously healthy children from vaccine side effects, as they were afraid it would promote vaccine hesitancy.

To curb corruption among regulatory bodies like the TGA, the Australian government introduced the National Anti-corruption Commission (NACC) in July 2023. Ahpra and the Medical Board are not answerable to either the state, federal parliament or the NACC. Many doctors believe they should be accountable.

Do doctors need a law degree for protection?

During TrialSite's conversation with the sources, they hinted that the insurance company lawyers meant to protect doctors were actually supporting the medical council and Ahpra. If this is true, doctors may need to become experts in law to make the right choices when getting advice from lawyers, especially if they end up in such a situation.

When TrialSite inquired if the medical board's actions would make doctors anxious about reporting adverse effects and other related matters, they firmly responded that the board's actions had caused underreporting. Apparently, doctors were afraid of saying or doing anything that would earn them a suspension.

Even so, some doctors have challenged the system and are legally smart about it. An example is Dr. William Bay, an Australian doctor in Queensland and the leader of the Queensland People’s Protest (QPP). TrialSite has previously reported on Dr. Bay's protests against the COVID-19 vaccines in Australia. He had previously received a suspension for disrupting an Australian Medical Association conference. He then took legal action against the medical board and Ahpra, aiming to have the suspension revoked. At the time of authoring this article, Dr. Bay was still waiting for the final verdict from the Court.

Dr. Gary Fettke, an orthopedic surgeon, also faced a four-and-a-half-year legal case initiated by Ahpra starting in 2014 for giving nutritional and weight loss advice to his patients. The case was challenged along legal and procedural grounds, and then, using the National Health Practitioner Ombudsman’s Intervention (NHPO), was reviewed independently.

Speaking to TrialSite, Fettke said, “Nonetheless, we had to become 'expert' in the National Law, as the Indemnifiers are not supportive of preserving your practicing rights, nor reputation.” Additionally, he added that because these insurance company lawyers were mainly responsible for financial liability, they found it safer and cheaper to side with Ahpra.

These are examples of people who may have understood their legal rights as doctors.

Final thoughts

To treat patients in the best way possible, doctors in Australia may need to learn to navigate the legal system strategically. While this may not apply universally, Ahpra's survey indicates decreased confidence in the system among practitioners. So, beyond relying solely on medical defense insurance providers in Australia, doctors may require additional safeguards to function effectively within the healthcare system. Of course, from another perspective—the top down, government and medical establishment’s point of view doctors should simply line up and follow the guidance.




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