Out of proportion


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Male pharmacists are disproportionately over-represented as respondents at serious misconduct hearings, research reveals

Australian research, analysing seven years of health practitioner disciplinary tribunal hearings, has found that males were over-represented as respondents across all of the five largest healthcare professions.

 The research, by University of Technology Sydney law professor Jenni Millbank, also found that doctors faced less severe outcomes than the other professions included in the study (pharmacists, nurses & midwives, dentists and physiotherapists) and that failures in clinical care were the least likely type of matter to lead to restrictive action.

While male pharmacists made up just under 40% of the pharmacy workforce, they were respondents in nearly 80% of serious misconduct hearings, Professor Millibank found.

And this finding of male over-representation was matched in the other professions.

“Female dentists appear in the misconduct cases at less than one-quarter of their representation in the profession, whereas female doctors and pharmacists appear at around one-third their populations. In contrast, male nurses appear at fourfold their proportion of the professional population,” she said.

Around a third (32,3%) of the cases of illegal or unethical prescription or provision of drugs related to pharmacists. Just over half of these cases had a doctor as the respondent.

The proportion of males to females in this particular type of case was “roughly similar to their appearance in the dataset as a whole,” Professor Millbank said, with female respondents accounting for 27.8% of those involved in these charges.

Men comprised 80.4% of respondents in the 166 sexual misconduct hearings. This rose to 96.7% of the subset of cases involving inappropriate sexual conduct.

Of the sexual misconduct hearings (regardless of gender) 42% involved doctors, while psychologists were disproportionately likely to be involved in these hearings.

Pharmacists, however, were “sharply underrepresented” in these cases, the data showed.  

There were four pharmacists among the 38 cases relating to impairment. Nineteen of these cases involved nurses, and this was the case type with the highest proportion of female respondents (44%).     

“Taking an overview of all outcomes, it appears that doctors are less likely than the other professions to be removed from practice by tribunals,” Professor Millbank said. “This discrepancy is noticeably more pronounced when deregistration is the outcome, with both nurses and psychologists being deregistered at considerably higher rates than doctors.”

The study was the first to compare outcomes for the five most populous professions by reference to the type of misconduct proved, she said.

“Comparing outcomes for professions across the main types of misconduct allows one to consider whether, in effect,different professions are receiving different outcomes for the same malfeasance, and the answer is ‘yes’.”

Professor Millbank reviewed all publicly available Australian tribunal-level decisions concerning complaints of serious misconduct and/or impairment brought against the five most populous regulated health professions (nurses and midwives, doctors, psychologists, pharmacists, and dentists) from 1 July 2010 to 30 June 2017.

The study was published in the Australian Health Review.

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