title: Views on mandatory reporting of impaired health practitioners by their treating practitioners: a qualitative study from Australia.
abstract: To explore the views and experiences of health sector professionals in Australia regarding a new national law requiring treating practitioners to report impaired health practitioners whose impairments came to their attention in the course of providing treatment.
  
  
  
  We conducted a thematic analysis of in-depth, semistructured interviews with 18 health practitioners and 4 medicolegal advisors from Australia's 6 states, each of whom had experience with applying the new mandatory reporting law in practice.
  
  
  
  Interviewees perceived the introduction of a mandatory reporting law as a response to failures of the profession to adequately protect the public from impaired practitioners. Mandatory reporting of impaired practitioners was reported to have several benefits: it provides treating practitioners with a 'lever' to influence behaviour, offers protections to those who make reports and underscores the duty to protect the public from harm. However, many viewed it as a blunt instrument that did not sufficiently take account of the realities of clinical practice. In deciding whether or not to make a report, interviewees reported exercising clinical discretion, and being influenced by three competing considerations: protection of the public, confidentiality of patient information and loyalty to their profession.
  
  
  
  Competing ethical considerations limit the willingness of Australian health practitioners to report impaired practitioner-patients under a mandatory reporting law. Improved understanding and implementation of the law may bolster the public protection offered by mandatory reports, reduce the need to breach practitioner-patient confidentiality and help align the law with the loyalty that practitioners feel to support, rather than punish, their impaired colleagues.
authors.affiliation: Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne. Melbourne, Victoria, Australia.
authors.forename: Marie M
authors.initials: MM
authors.lastname: Bismark
authors.affiliation: School of Law, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: Ben
authors.initials: B
authors.lastname: Mathews
authors.affiliation: Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne. Melbourne, Victoria, Australia.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Morris
authors.affiliation: Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne. Melbourne, Victoria, Australia.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Thomas
authors.affiliation: Center for Health Policy/Center for Primary Care and Outcomes Research Stanford Medical School & Stanford Law School, Stanford University, Stanford, California, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Studdert
mesh_terms: D001291:Attitude of Health Personnel; D001315:Australia; D000066491:Clinical Decision-Making / Q000941:ethics*; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D019221:Mandatory Reporting / Q000941:ethics*; D061214:Patient Safety / Q000331:legislation & jurisprudence*; D010815:Physician Impairment / Q000331:legislation & jurisprudence* / Q000523:psychology; D036301:Qualitative Research; D035642:Whistleblowing / Q000941:ethics / Q000331:legislation & jurisprudence*
keywords: MEDICAL ETHICS; MEDICAL LAW; MENTAL HEALTH