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Issue 17 - April 2018
Welcome to the first Chiropractic Board of Australia newsletter for 2018. You’ll notice a new look to our newsletter and we hope the new format is easier to read during your busy day.
We’ll be keeping you up to date with changes to standards and guidelines, public consultations, regulation and registration matters, Board projects and events. As always, the Board welcomes your feedback.
We recently released a public consultation paper seeking feedback on the draft revised registration standard and guideline for continuing professional development (CPD). We encourage you to have your say ‒ find out more in this newsletter.
Workplace-based learning: from theory to practice is the topic of the 2018 Chiropractic Board of Australia Forum. The two-day forum, on 28 and 29 July, will explore existing research on workplace-based learning and related concepts with a focus on application of this work in the context of solo and small health-professional practice. You can read more about the forum below.
One way the Board keeps the public safe is by looking at the data collected by the National Registration and Accreditation Scheme (the National Scheme) about registered chiropractors. An interesting study on the types and trends of complaints received about chiropractors, osteopaths and physiotherapists has recently been published and further details can be found in this newsletter.
We have had some significant changes to the Board over the last three months. In December 2017 Health Ministers appointed Dr Arcady Turczynowicz as the new practitioner member from South Australia and the Board looks forward to working with our newest member.
The February 2018 Board meeting was the last meeting for outgoing Executive Officer Paul Fisher, who has held the role since 2011. On behalf of the Board, I thank Paul for the enormous amount of work he has carried out on our behalf over the years. In early March, the Board welcomed our very talented new Executive Officer Clarissa Martin and we look forward to working with her.
Dr Wayne Minter AM Chiropractor Chair, Chiropractic Board of Australia
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The role of the Board is to keep the public safe. One way it does this is by looking at the data collected by the National Scheme about registered chiropractors.
The Board strongly supports evidence-based regulation and regularly looks at trends found in National Scheme data when making decisions about registration and notifications (complaints).
Newly published research from The University of Melbourne Medical School is a welcome addition to the Board’s conversation on the types and trends of complaints received about chiropractors.
Published in Chiropractic and Manual Therapies, the retrospective cohort study looked at all formal complaints about registered chiropractors, osteopaths and physiotherapists in Australia lodged with health regulators from 2011-2016.
For chiropractors it found that while the majority of chiropractors had no complaints made about them to the regulator, 1.3 per cent attracted more than one and accounted for almost 36 per cent of their professions’ total.
Chiropractic Board of Australia Chair Wayne Minter AM maintains that evidence is important to all parts of health practitioner regulation. He would like to remind registered chiropractors that they must use acceptable evidence about chiropractic practice to inform their care of patients.
‘The public is entitled to receive safe, ethical, evidence-based and competent care from chiropractors. Though gathering data on the complaints received about chiropractors and using that information to help protect the public is not new for the Board, each piece of additional research helps paint the picture for practitioners and the public of what is and is not acceptable conduct, performance and behaviour,’ Dr Minter said.
The Board looks at complaints data closely and reminds chiropractors of the important obligations they have through codes and guidelines, including its Code of conduct. Where there is evidence that the practice of a chiropractor or a group of chiropractors may be unsafe or creates a significant risk of harm to the public, the Board will act.
The Board recognises the importance of clearly communicating its expectations to chiropractors. In addition to its regular communiqués and newsletters the Board hosted forums in six locations around Australia last year. We would like to thank the more than 400 chiropractors who attended the forums. Our aim was to provide important information to you about regulatory matters and to give you an opportunity to engage with the Board.
The forums allowed the Board to inform attendees about advertising, self-assessment of formal learning activities and continuing professional development. Those of you who attended were enthusiastic participants in the discussions about these important issues. There were a number of questions raised that the Board was able to address and we are committed to continuing to provide you with support and information to help you comply with your professional obligations.
The Board’s first priority when setting policies and standards and making regulatory decisions is to consider public safety. In addition to presentations from practitioner members the Board’s community members presented information to forum participants about the public’s expectations of chiropractors. They noted that complaints about boundary issues are high in comparison to other professions and that 26 per cent of complaints are about the clinical care provided by chiropractors. The strong message from the community members was that you as chiropractors should consider patient safety first and that keeping up to date and providing evidence-based care is essential. It is crucial to ensure that you communicate effectively with patients and keep good records about the care you provide.
The Board has published the forum presentations on its website for practitioners who were unable to attend or who wish to review the information. These include recordings of the presenters and transcripts. We strongly encourage you to access these presentations and to contact us with any questions or comments.
The Board has published a consultation paper on the review of the Continuing professional development registration standard and guidelines.
The revised registration standard sets out the Board’s proposed minimum requirements for continuing professional development (CPD) for chiropractors.
The public consultation will close on 4 May 2018.
Together with five other National Boards, the Board has reviewed the current registration standard and guidelines in keeping with good regulatory practice. The six Boards involved in reviewing core registration standards undertook research and benchmarking to inform the development of the standards. A summary of the research is available to download:
The Board welcomes your feedback on the revised CPD registration standard and guidelines. To view the consultation paper and make a submission before 4 May 2018, please see the Current Consultations page on the Board’s website.
The Board will be hosting a stakeholder forum in Melbourne on Saturday 28 and Sunday 29 July 2018.
The forum will explore existing research on workplace-based learning and related concepts with a focus on application of this work in the context of solo and small health-professional practice.
Saturday’s program will focus largely on the individual. It will include exploration of theories of workplace-based learning in the health professions while also delving into notions of expectations and beliefs about health professionals, and practicalities of evidence-based practice.
Sunday’s program has more of a peer and community focus, and will probe theories such as communities of practice before exploring models of peer feedback in the workplace.
Chiropractors will have an opportunity to attend so keep a look out for more information about this on the Board’s website soon. The Board will also record the forum for those unable to attend in person.
The Board has published a consultation paper on the draft guideline for informing a National Board about where you practise
Public consultation has started and will close on 25 May 2018.
In September 2017, the Queensland Parliament passed the Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2017. The Bill contained a set of amendments to the Health Practitioner Regulation National Law (the National Law), as in force in each state and territory except Western Australia. Corresponding legislation has also been passed in Western Australia. These amendments include changes to the information a registered health practitioner is required to provide about their practice arrangements when requested by the National Board (referred to as ‘practice information’).
The draft guideline has been developed to help chiropractors and other registered health practitioners to provide practice information in a way that meets their obligations under the National Law.
The consultation paper is available under Current consultations, and the Board invites feedback from practitioners, stakeholders and the community.
In late 2017, the Board expressed its gratitude for the efforts of outgoing member Dr Phillip Donato OAM, who has made a significant contribution to the Board’s work. As the inaugural Chair of the National Board, Phillip’s contribution has been seminal in the Board’s achievements since the start of the National Scheme.
Outgoing Board member and former Chair Phillip Donato OAM takes with him the sense of a job well done and pride in his fellow Board members.
Phillip’s interest in health practitioner regulation was initially sparked by his involvement in professional associations and other chiropractic bodies, including roles on ethics committees.
‘It became clear to me that I had a more natural affinity with matters of public safety and professional standards.’
In 1992, Phillip joined the Chiropractic Board of South Australia (CBSA) and was its Chair from 1995 to 2009. During that time the CBSA serviced three other health professional boards and three national accreditation councils, all under the same roof.
‘This also helped to spark an interest in accreditation, whereupon I became the inaugural Chair of the Council on Chiropractic Education Australasia.’
Before his appointment to Chair of the Chiropractic Board of Australia in 2009, Phillip spent a year coordinating the Regulatory Reference Working Group and various other transition groups.
‘The task by all concerned to develop, transition, and implement the new National Law and accreditation/registration system was a colossal undertaking.’
One of Phillip’s first priorities as the National Board Chair was to ensure a smooth transition from state-based regulation to a national scheme model. This work meant ensuring consistency with standards across the country; developing new standards; facilitating cultural change within the profession; and ensuring effective and efficient board and regulatory processes.
‘The Board’s first year where we had to get all our standards, processes and procedures in place and be ready for the start of the National Scheme was very intense and involved many hours.
‘As Chair, being ready to transition into the new system was a proud moment. The Board members were equal to the tasks to get ready for the start of the scheme. They were energetic, committed and we all worked well together.’
Phillip believes community and stakeholder expectations will continue to increase, and future challenges for the Board could include the questions surrounding what effective and best practice in regulation will be, ensuring optimal and timely complaint management, the attainment and use of data to drive effective decision-making, developing proactive prevention strategies in relation to practice behaviours, and finally, the global environment and its challenges.
‘The issue of ongoing competency by the profession will be around for a while. As a result, matters pertaining to program accreditation, curriculum and evidence-based education and practice will continue to grow.’
Phillip said the National Scheme must continue to serve the public interest to ensure its ongoing success.
‘The scheme must be impartial and objective in all decision-making and needs to ensure that it is achieving its aims.’
In total, Phillip was a member of the National Board regulating chiropractors for eight years – five as its Chair. During his time as Chair, Phillip also chaired the cross-professional Notifications Taskforce and spearheaded the International Chiropractic Regulatory Collaboration (ICRC).
This immersion in health practitioner regulation has seen him devote 25 years to public safety, including 15 years in accreditation (nationally and internationally).
Since his retirement from the Board, Phillip has been able to concentrate more on his practice. It’s also freed him up to devote more time to the local community service organisations he is involved with. Phillip is Chair of a frontline agency for the homeless as well as the Lions Medical Research Foundation.
Socially, he is now enjoying going to the movies a bit more often and attending the occasional live concert.
‘Thank you, it has indeed been an honour to serve the public and professional communities in the public interest, and it’s been humbling to work with such great and wonderful people. I wish the Chair and current Board members all the very best in their regulatory endeavours.’
AHPRA has successfully prosecuted Mr George Zaphir, from Queensland, for unlawful use of the protected title ‘chiropractor’ and for holding out as a registered health practitioner, including chiropractor, medical practitioner and acupuncturist.
Two of the six charges related to unlawful use of the protected title chiropractor. The additional four charges related to holding out as a registered health practitioner (acupuncturist and chiropractor) and holding out as authorised or qualified to practise as a medical practitioner and as a chiropractor. The charges related to statements made by Mr Zaphir to several people in March 2016, including comments that he was a doctor of integrated medicine and had an 85 per cent success rate in treating cancer. Pretending to be a registered health practitioner (holding out) is an offence under the National Law.
Mr Zaphir was previously registered as a chiropractor from May 1982 to November 2010, when he failed to renew his registration. He has never held registration as a medical practitioner. In August 2016, the Office of the Health Ombudsman issued an Interim Prohibition Order on Mr Zaphir, prohibiting him from providing any health service in a clinical or non-clinical capacity.
Mr Zaphir pleaded guilty to all six charges. At Caboolture Magistrates Court on 30 January 2018, Magistrate Kinsella recorded a conviction in respect of all charges, fined him $12,000 and ordered that he pay AHPRA’s costs of $3,537.17.
In his sentencing remarks, Magistrate Kinsella commented that the key objectives and purpose of the National Law are to protect the public to ensure that only those qualified and registered to provide health services do so. Magistrate Kinsella said that the breach by Mr Zaphir was a serious breach of the National Law and was conduct akin to showing contempt for the National Law.
Chiropractic Board of Australia Chair Wayne Minter AM welcomed the court’s decision.
‘To pretend to be a registered health practitioner and make baseless claims to vulnerable people is very serious conduct which may put people at risk,’ Dr Minter said. ‘Together with AHPRA, the Board will continue to seek the strongest possible penalties under the National Law against anyone who falsely claims to be a registered chiropractor.’
Anyone with concerns about the registration status of a person working as a registered health practitioner can check the national register of practitioners or contact AHPRA on 1300 419 495.
The Medical Board of Australia, supported by the Australian Health Practitioner Regulation Agency (AHPRA), has implemented the final recommendation of the Chaperone Review and added to the information published on the national register of practitioners.
In August 2016, the Medical Board of Australia and AHPRA commissioned an independent review of the use of chaperone conditions as a regulatory tool to manage allegations of sexual misconduct.
In March 2017, AHPRA and the Medical Board committed to making wide-ranging reforms to their management of sexual misconduct cases, as recommended by independent reviewer Professor Ron Paterson in the Chaperone Review Report.
Reforms included:
AHPRA and the Medical Board have now implemented all Professor Paterson’s recommendations by including links from individual medical practitioner listings on the national online register of practitioners to published disciplinary (tribunal and court) decisions.
The national register of practitioners contains accurate, up-to-date information about the registration status of all 678,938 registered health practitioners in Australia. It is an important way the National Scheme helps keep the public safe.
The public register will now display links to externally published court and tribunal decisions about individual registered medical practitioners who have been involved in disciplinary action with the Medical Board of Australia or AHPRA, when the decisions are public but not when suppression orders are in place.
There are now live links on the register to disciplinary decisions involving medical practitioners that have been made since February 2017 to the end of March 2018. Over the next year, links to relevant court and tribunal decisions about medical practitioners dating back to the start of the National Scheme in 2010 will be added. New decisions will be added as they are received.
This change will not affect the vast majority of doctors who routinely provide high quality, safe care to their patients. But it will give the community easier access to information that is already public, so they can make an informed decision about their medical care.