The risks of practising uninsured

tightrope danger

A doctor has received disciplinary action for practising without appropriate professional indemnity insurance, in a case which one stakeholder said highlights an issue relevant to all health practitioners

The Medical Board of Australia has announced that the GP, Dr Yusuf Bhamjee, was reprimanded by a tribunal for practising without the cover.

On 19 March 2018, during a telephone call with an officer from the Australian Health Practitioner Regulation Agency, the Western Australian GP said that he did not, at that time, have professional indemnity insurance (PII) arrangements in place and had been unable to obtain them.

He was advised that he was not permitted to practise as a medical practitioner in the absence of appropriate PII arrangements.

After the conversation Dr Bhamjee immediately ceased practising as a medical practitioner.

On or about 15 March 2016, Dr Bhamjee submitted an application for specialist registration (general practice) and was asked whether he committed to having appropriate PII arrangements in place for all practice undertaken during the registration period, to which he marked, “yes”.

Registration was granted effective 7 September 2017, and the doctor began his employment at a medical practice on 6 November 2017.

However, during the period 6 November 2017 to 19 March 2018, he did not have PII arrangements in place – yet continued to practise as a medical practitioner.

Around 3 April 2019, Dr Bhamjee provided AHPRA with a Certificate of Currency from MDA National (a PII provider) which indicated that they had granted appropriate PII cover for the period 19 March to 30 June 2018 and provided retroactive PII cover for the uninsured period.

The Medical Board referred the matter to the State Administrative Tribunal of Western Australia.

Dr Bhamjee admitted to behaving in a way constituting professional misconduct.

As well as receiving a reprimanded by the tribunal, Dr Bhamjee was fined $2,000 and had conditions imposed on his registration requiring him to successfully complete a program of education in relation to ethical practice and professional obligations as a medical practitioner. He was also ordered to pay the Board’s costs of $1,500.

The case serves as a warning to health practitioners including pharmacists as well as GPs that they must have appropriate professional indemnity insurance in place in order to practise, says Gary West, professional officer at Pharmaceutical Defence Limited (PDL).

Without commenting specifically on Dr Bhamjee’s case, Mr West told the AJP that three main considerations exist: risk, requirement and reassurance.

“With risk, obviously there’s a potential burden or risk for the patient or their family, if the practitioner did not have PII, or they have insufficient assets to cover a claim,” he said.

“The risk for practitioners is to either their ability to practise, or to their business, as well as the financial implications if a claim had to be paid without assistance from a policy.

“Then there are potential penalties such as damage or risk to reputation, which could impact on the ability to practise, and any fines or costs involved.

“PII is a requirement. If your name is on the register, PII is mandatory,” Mr West said.

“If you do happen to practise without any PII, it could be illegal – your annual renewal requires that you acknowledge that you have PII – there’s an expectation by the public, the regulator and the profession that you have it.”

Mr West said that even if a pharmacist is travelling internationally or is between jobs, allowing their insurance to lapse could still expose them to significant risk or penalties.

“Most professional indemnity policies are claims made policies,” he explained. “That means you must have a policy in place at the point when you are first made aware of an incident.”

A pharmacist may have made a dispensing error or other misstep while insured – but because the policy applies to the point at which the pharmacist discovers the error or a claim is made, a lapsed policy would leave the practitioner exposed.

Likewise, a pharmacist insured by one provider at the time of an incident, who then changed policies, would find the new provider would be the one to manage the claim process, even though they were not involved at the time of the incident.

“You must have a policy in place at the time when you’re first made aware of an incident or claim, even if the incident was some time ago and you’ve since left that place of employment, or you’re on leave or travelling,” Mr West said.

“I could decide I might do something else with my life that’s non-pharmacy, but if my name still appeared on the register and there was a claim made against me now from a previous incident, I would be at risk of these impacts.”

PDL is aware of the AHPRA audit process identifying lapses of PII, he warned.

“The final point is reassurance – for patients and the public, for pharmacists and their families.

“The reassurance of something like a PDL policy, which provides 24/7 cover for individuals, irrespective of their current employment or if they’re in between jobs or holidaying, is peace of mind.”

He highlighted that PDL provides representation of pharmacists by pharmacists, as well as educational support via its Practice Alerts and newsletters.

PDL members can call 1300 854 838 Australia-wide for confidential advice and support.

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