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Mandatory notifications: A pharmacy council shares what this pharmacist did when faced with a medical practitioner attempting to self-prescribe diazepam

The Pharmacy Council of NSW has shared a case of a pharmacist in a difficult situation, with a medical practitioner attempting to self-prescribe diazepam.

The medical practitioner had used a family member’s name on the prescription, reports the council.

As the pharmacist asked questions about the prescription and the patient’s history, the medical practitioner’s behaviour alerted suspicion, prompting the pharmacist to check the Ahpra register.

They subsequently discovered there were conditions on this medical practitioner’s registration which did not allow them to prescribe this medication.

Following this, a mandatory notification was made.

“The pharmacist was initially reluctant to make the notification due to a perception that they would become further involved in the matter,” said the Pharmacy Council of NSW.

“However, discussion with another colleague helped to dispel that concern.

“Most of the time a mandatory notification does not require the practitioner making the notification to provide any further correspondence to the regulatory authority, but for more serious matters, further information may be sought.”

In this case, the medical practitioner had breached conditions on their registration.

They had a history of drug-seeking behaviour and had obtained previous supplies of diazepam in this manner.

“Had this pharmacist chosen not to make the notification, it is likely that the medical practitioner’s behaviour would have continued unabated,” said the Council.

“The medical practitioner was a risk to himself and would also pose a risk to public if practising whilst intoxicated.

“By making the notification, the medical practitioner was able to be directed to an appropriate pathway to resolve their issues.”

Remediation is reportedly the more common outcome for these matters, with the aim to bring the health practitioner back to a level where they are safe to practice.

Under the Health Practitioner Regulation National Law (NSW), health practitioners (including pharmacists) must tell Ahpra if they have formed a reasonable belief that a practitioner has behaved in a way that constitutes notifiable conduct.

Notifiable conduct by a registered health practitioner is:

  • practising while intoxicated by alcohol or drugs
  • sexual misconduct in the practice of the profession
  • placing the public at substantial risk of harm because of an impairment (health issue), or
  • placing the public at risk because of a significant departure from accepted professional standards.

Only treating practitioners in Western Australia providing a health service to a practitioner-patient or student are exempt from the requirements to make a mandatory notification.

However, these practitioners still have a professional and ethical obligation to protect and promote public health and safety and so may consider whether to make a voluntary notification, said Ahpra.

There are consequences if you fail to make a mandatory notification when you have to. Although this is not a criminal offence under the National Law, the Pharmacy Board of Australia may take regulatory action such as, for example, imposing a caution, explains Ahpra.

But the Council said that health practitioners are traditionally reluctant to make mandatory notifications for various reasons.

“These include a fear of becoming a part of a drawn out legal process or a perception that they are ‘dobbing in’ their peers or fellow health practitioners.

“It can be a challenging dilemma. However, health practitioners are often well placed to identify other colleagues who pose a risk to patients.”

If you are a registered health practitioner and you are not sure whether you should raise a concern, contact Ahpra to discuss your obligations in a confidential way or discuss them with your professional indemnity insurer, a trusted colleague or a legal adviser.

PDL provides Australia-wide, 24/7 professional incident and claims support and advice service to protect members and minimise patient harm on 1300 854 838.

Readers can call 1300 244 910 for anonymous and confidential support from a pharmacist colleague over the phone through the Pharmacists’ Support Service (PSS), available 8am to 11pm EST 365 days of the year.

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