title: Reporting of health practitioners by their treating practitioner under Australia's national mandatory reporting law.
abstract: OBJECTIVE
  To describe the frequency, nature and outcomes of reports about health practitioners made by their treating practitioners under Australia's new mandatory reporting system.
  
  
  METHODS
  Retrospective case file review and analysis of treating practitioner reports received by the Australian Health Practitioner Regulation Agency between 1 November 2011 and 31 January 2013, and of the outcomes of the completed investigations of these reports to November 2014.
  
  
  METHODS
  Characteristics of treating practitioners and reported practitioners; nature of the care relationship; grounds for report; regulatory action taken in response to report.
  
  
  RESULTS
  Of 846 mandatory reports about medical practitioners, 64 (8%) were by treating practitioners. A minority of reports (14 of 64) were made by a practitioner-patient's regular care provider; most (50 of 64) arose from an encounter during an acute admission, first assessment or informal corridor consultation. The reported practitioner-patients were typically being treated for mental illness (28 of 64) or substance misuse (25 of 64). In 80% of reports (50 of 64), reporters described practitioner-patients who exhibited diminished insight, dishonesty, disregard for patient safety, or an intention to self-harm.
  
  
  CONCLUSIONS
  The nature and circumstances of the typical treating practitioner report challenge assumptions expressed in policy debates about the merits of the new mandatory reporting law. Mandatory reports by treating practitioners are rare. The typical report is about substance misuse or mental illness, is made by a doctor who is not the patient's regular care provider, and identifies an impediment to safely managing the risk posed by the practitioner-patient within the confines of the treating relationship.
authors.affiliation: Centre for Health Policy, University of Melbourne, Melbourne, VIC mbismark@unimelb.edu.au.
authors.forename: Marie M
authors.initials: MM
authors.lastname: Bismark
authors.affiliation: Centre for Health Policy, University of Melbourne, Melbourne, VIC.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Spittal
authors.affiliation: Centre for Health Policy, University of Melbourne, Melbourne, VIC.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Morris
authors.affiliation: Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford Medical School, Stanford, Calif, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Studdert
mesh_terms: D001315:Australia; D019221:Mandatory Reporting; D001523:Mental Disorders; D010815:Physician Impairment; D010817:Physician-Patient Relations; D010820:Physicians / Q000331:legislation & jurisprudence; D028743:Professional Misconduct; D012189:Retrospective Studies; D019966:Substance-Related Disorders