No More. It Ends Here.
- All Medical records convictions in practices passing accreditation to be quashed. Any conviction with medical records as a component of the judgment to be quashed. Compensation to be paid by AHPRA / Medical Board Aust. (MBA).
GUVNOT.COM/1/6
AHPRA / the medical boards have undertaken to convict many doctors of having unsuitable records. It is common punishment to undergo education and/or mentoring. These have significant costs to the doctors involved – both in terms of time and money.
I think at the most basic level, if a practice has passed accreditation, which includes a medical record component, this means that the medical records of the practitioners in the practice fall within the broad range of accepted medical records for the practitioners.
In short, if the practice has passed accreditation, the practice medical records are “normal”. Any doctor with a conviction encompassing medical records deficiencies, should be compensated for what AHPRA / the Boards have done to them. If AHPRA/ the Boards are relying on medical records deficiencies as part of a conviction, it implies that any conviction obtained is poorly justifiable.
Any convictions need to be reversed. Compensation needs to be paid. Any medical records assessors working for AHPRA / the Boards, need to have their role investigated.
Records
The advent of AI notes shows often that even what were previously sparse medical records , actually relate to extensive medical consultations. AI is however much better at recording the minutiae of a consultation and presenting it in a verbose AHPRA sanctioned format. Real practitioners who need to earn a living usually chose to spend the time “consulting” a patient rather than spend the time recording it. And it goes without saying , if you spend a lot of time recording, you are not spending a lot of time consulting. Whether the verbosity of AI is an asset to real practitioners versus lawyers is another issue that needs to be discussed – another time.
It is of interest to consider how many medical records convictions are occurring. A colleague was required to produce a report on a medical education punishment. The lady at AVANT was very forthright and helpful telling the practitioner that AHPRA looked on her report summaries very favourably. She mentioned she was doing up to 20 per week.
Extrapolating this to 2 medical indemnity organisations, and possibly other states, it is likely that there are at least 2000 to 3000 educations or punishments being inflicted on doctors annually. This equates to a 10-year risk of 20,000 to 30,000 punishments being inflicted, and if full-time versus part-time practice is allowed for, gives the average full-time medical practitioner a 50% chance of receiving a medical education punishment every 10 years.
I repeat, medical records convictions are likely to give the average full-time medical practitioner a 50% chance of receiving a medical education punishment every 10 years.
WTF ??? WTF???
They are used by the Daleks at AHPRA to create an atmosphere of fear. Obey! Obey! Obey! Obey! or else.
AHPRA / the Medical Boards are to compensate doctors for all convictions involving medical records in accredited practices.
So: All Medical Records judgments against doctors working in Accredited Practices to be quashed.
As a corollary, any doctor convicted of an offence without a patient complaint as witness to the offence, to be given leave to apply to have the offence quashed - at AHPRA expense.
Expenses and compensation to be paid.
THE AHPRA POINT OF VIEW: on this issue
The proposition that medical records convictions should be automatically quashed where a practice has passed accreditation misunderstands both the purpose of accreditation and the role of regulatory enforcement. Accreditation assesses systems and minimum organisational standards at a point in time; it does not certify the adequacy of every individual clinical record created by every practitioner across all encounters. Passing accreditation does not immunise individual clinicians from scrutiny. The regulator’s task is to assess actual records against evolving professional standards, not to defer to generalised organisational badges of compliance.
Documentation standards exist precisely because medical records are the primary evidence by which care can be reconstructed when harm is alleged or risk is identified. Where records are deficient, the regulator cannot reliably assess whether care was safe, appropriate, or justified. In such circumstances, remedial education and mentoring are proportionate responses to identifiable deficits. These interventions are corrective, not punitive, and are designed to elevate practitioners to contemporary standards of accountability.
The suggestion that outcomes should override documentation quality reflects a dangerous conflation of result with process. Good outcomes can occur despite unsafe practice; poor outcomes can occur despite appropriate care. Regulatory systems cannot rely on outcome narratives alone. They require contemporaneous records to evaluate decision-making and to identify patterns of undocumented risk. Where practitioners choose to prioritise speed over documentation, that is a professional choice with regulatory consequences.
AHPRA’s position is that the only reliable basis for judging clinical adequacy is the assessment of records by regulatory staff operating within the Scheme. Patient perceptions of having experienced a “good outcome” are not an adequate evidentiary standard for determining whether care met contemporary professional expectations. While many regulatory staff do not practise clinically, their specialised experience in assessing large volumes of deficient practice, confers the necessary competence to determine adequacy of care within a modern regulatory framework.
Claims that record-related findings are used as a “fallback” ground for sanction ignore the evidentiary burden faced by regulators. Records are the most objective artefact available in assessing care. If records do not demonstrate adequate assessment, consent, reasoning, or follow-up, the regulator is entitled to infer that these elements may not have occurred to an acceptable standard. The burden rests with the practitioner to evidence safe practice through their records.
Proposals for compensation by AHPRA for record-based findings invert the accountability relationship between regulator and regulated. AHPRA is charged with protecting the public, not underwriting the costs of bringing practitioners into compliance. If record-keeping requirements are experienced as onerous, this reflects the reality that contemporary medical practice demands a level of evidentiary rigour that earlier eras did not require. Regulation evolves because risk evolves. Practitioners are expected to evolve with it.
Erasmus (the old dog): Call It As I See It
Legalistic view:
When accreditation is treated as evidence of “adequacy” yet individual practitioners are sanctioned for
record-keeping within accredited systems, internal inconsistency arises. Without clear harmonisation between
accreditation benchmarks and regulatory thresholds, enforcement risks appearing arbitrary.
Human interest view:
Doctors subjected to repeated record-based sanctions often describe practising in a constant state of fear,
where documentation becomes a defensive ritual rather than a clinical tool. Over time, this erodes confidence
and drives experienced clinicians away from frontline care.
Patient view:
Patients expect their doctor to be present and engaged, not practising under the shadow of disciplinary
checklists. When fear of paperwork becomes central to care, the relationship that sustains healing weakens.
Legal fairness view:
Where the same conduct passes accreditation yet fails regulatory scrutiny, practitioners are left without clear
guidance as to the operative standard. This uncertainty undermines procedural fairness and predictability of
enforcement.
Clinical realism view:
No written record can fully capture the complexity of a consultation. Treating documentation as a proxy for
care quality risks mistaking administrative completeness for clinical competence.
Governance view:
High-volume reliance on record-based findings may indicate systemic pressure to identify sanctionable grounds
even in the absence of demonstrable patient harm, weakening confidence in the integrity of regulatory intent.
