New study reveals factors influencing health impairment among Australian doctors

Public health researchers are calling for greater support for doctors experiencing their own health challenges after examining more than 112,000 records.

The 10-year study, which analysed data from the Australian Health Practitioner Regulation Agency (Ahpra) between 2012 and 2022, examined records of 112,677 doctors registered to practice in Australia (excluding New South Wales).

Of these, 1.1 per cent of registered doctors received at least one health impairment notification during this period, a total of 1,732 records.

Health impairment notifications are reports made to Ahpra when there are concerns that a doctor's physical or mental health, cognitive capacity, or substance abuse may be impacting their ability to practice safely.

Lead researcher Professor Marie Bismark, from the University of Melbourne's Faculty of Medicine, Dentistry and Health Sciences, said the findings highlight the need for targeted support and early intervention.

“Our research shows that the risk of health impairment notifications increases with age and varies significantly across medical specialties. This information is vital for developing tailored approaches to support doctors' wellbeing throughout their careers.”

“The data showed that male doctors, those in rural and remote areas, and certain specialties were more likely to receive impairment notifications."

Martin Fletcher, one of the co-authors of the study and former CEO of Ahpra, emphasised the importance of these findings for policy development.

"Understanding what contributes to health impairment in doctors is essential to shaping evidence‑based, compassionate regulation that protects patients while genuinely supporting practitioner wellbeing,” he said.

Key findings include:

• Doctors aged 70 or older were nearly three times more likely to receive notifications than those aged 30-39.
• Psychiatrists, general practitioners, and non-specialists had higher rates of notifications compared to other specialties.
• Anesthetists had higher rates of substance abuse notifications than other specialties.
• Doctors trained in non-comparable overseas jurisdictions were less likely to receive health impairment notifications than Australian-trained doctors.
• Doctors in rural and remote areas were more likely to have health impairment notifications than those in metropolitan areas.
• Male doctors were 1.45 times more likely to receive health impairment notifications than female doctors.
• Substance abuse was the most common reason for health impairment notifications, accounting for 38 per cent of all cases. Mental health concerns were the second most frequent, at over 33 per cent.

Ahpra Acting Executive Director of Health Regulation, Monica Lambley, encouraged practitioners to prioritise their own health and wellbeing, and help their colleagues do the same.

“Too often, practitioners struggle in silence when they are dealing with health challenges,” she said.

“Seeking help when they need it, and actively engaging with recommended treatments, is the best thing that a practitioner can do to get the support they need to continue to practice safely, and ensure their patients receive safe care.”

In recent years, Ahpra has sought to better identify, and respond to, practitioner distress in the regulatory process. That has included providing more support for practitioners with health impairments while still requiring mandatory notifications when there is a risk of harm.

"It's crucial to recognise that reporting a health concern doesn't necessarily mean the end of a doctor's career,” Professor Bismark said.

“The focus is on protecting the public from harm, and supporting doctors to return to safe practice wherever possible. Our study found that only 21.5 per cent of notifications resulted in practice restrictions – such as conditions - or rarely  , removal from practice.”

Professor Bismark said doctors from non-comparable jurisdictions (countries outside of Australia, New Zealand, Ireland, the United Kingdom, Canada and the United States) often faced challenges working in Australia and received higher rates of notifications about conduct and competence, but not for health impairment.

“This raises questions about potential biases and missed opportunities to identify health impairments among this group of doctors,” Professor Bismark said.

The researchers said that while 1.1 per cent of doctors received notifications, this figure likely underestimates the true prevalence of health impairment in the medical workforce.

This research project supports the University of Melbourne’s Impact Accelerator in Health Futures. Learn more about Impact Accelerators: Advancing Research 2030: Excellence for Impact.