9. Seek support early

Seek the right support early

Given the extent of WHS breaches in the health system, it is not surprising that doctors require support like employees, contractors and visiting workers in other industries.

Here are some practical steps if you experience medical workplace abuse or a work-related mental health concern:

1. Seek confidential personal and professional support and advice from independent trusted health professionals first

2. Follow the internal incident reporting processes in your workplace effectively and anonymously after seeking advice from like-minded colleagues

3. If required, obtain personal legal advice, first from your medical defence organisation, the AMA or a private lawyer specialising in WHS

4. Enlist whistle blower protections if reporting an unlawful matter to an employer

5. Access up to date information about WHS issues on the websites of appropriate national or state authorities (regulators/police), including when it advisable/necessary to report bullying, sexual harassment, discrimination, racism, verbal/physical violence, mental injury externally

6. If you are receiving treatment for a work- related injury, consider making a workers’ compensation claim (physical or psychological injury) but be mindful of the potential risks (e.g. your injury will no longer be confidential in your workplace)

There are a myriad of people and services (listed below) who can effectively assist doctors who require highly confidential preventive support, early intervention, or crisis response — without embarrassment, career damage, or risking a mandatory report to the Medical Board.

The key is early access to the appropriate avenue for you in your time of need. However, finding a trusted independent health professional can be challenging if you are feeling vulnerable and stressed. This is why it is critical that every doctor develops a trusted relationship with their own GP for their routine preventive and other health care.

1. Seek confidential personal and professional support and advice from trusted health professionals first

This is the first step because your trusted professional will not only support and advise you but will help you access the right help at the right time in the future.

This may include:

· Your trusted independent GP or psychologist.

· Your employer or college wellness program or a confidential Employee Assistance Program (EAP).

· Doctors’ Health Alliance — Doctors’ Health Line 24/7: 1800 006 888 (free services for doctors and medical students across Australia). NSW & ACT: 02 9437 6552 | NT & SA: 08 8366 0250 | QLD: 07 3833 4352 | TAS & ACT: 1300 374 377 | VIC: 1300 330 543 | WA: 08 9321 3098 | New Zealand: 0800 471 2654

· Drs4Drs — connect to a counsellor: 1300 374 377

· Hand-n-Hand Peer Support: https://www.handnhand.org.au/ (not an emergency service)

Concerns around confidentiality and mandatory reporting to the Medical Board are often misplaced – your privacy is protected under Privacy Laws, and mandatory reporting usually applies only when there is a risk of serious patient harm. In this situation, professionals are not required to make a mandatory report if doctors seek help and take time off work if compromised or impaired. For these reasons, every doctor benefits from developing a trusted relationship with a GP and should feel safe reaching out for their help.

For more information on mandatory reporting please see topic 10 ‘popular articles.

Anonymous help lines for debriefing (particularly if you fear a professional may make a mandatory report to the Medical Board about an issue such as ongoing alcohol or other drug abuse):

· Lifeline (24/7): 13 11 14

· National Alcohol and Other Drug Hotline: 1800 250 015

· SMART Recovery Australia: https://smartrecoveryaustralia.com.au/

· Australian Drug Foundation (service finder): https://adf.org.au/help-support/search/

· Drug and Alcohol Counselling Online (24/7): https://counsellingonline.org.au/

· Family Drug Support (for families): 1300 368 186

Online information about mental health:

· The Essential Network (TEN) App — Black Dog Institute: https://www.blackdoginstitute.org.au/the-essential-network/

· Hand-n-Hand peer support: https://www.handnhand.org.au/

· myCompass (online CBT) — Black Dog Institute: https://www.mycompass.org.au/

· Beyond Blue (workplace): https://www.beyondblue.org.au/get-support/before-blue/employee

2. Follow the internal incident reporting processes in your workplace effectively and anonymously after seeking advice from like-minded colleagues

Check your employer’s intranet/website for the correct incident reporting procedure for your workplace. There should be an option to make an anonymous report if you wish to protect your identity. Always have documented evidence of your concern and try to enlist the support of others who have experienced a similar issue to build strong evidence of the incident (see below).

Follow the workplace policy for incident reporting in the correct order. For example, do not go straight to the Chair/CEO or an external body unless the matter is criminal — in which case it may be more appropriate to notify police immediately.

Sometimes, you may be expected to speak to a supervisor or manager before lodging a written report. People you may need to contact (as appropriate): a Health and Safety Representative; practice manager; HR. Keep these employer and after-hours emergency contacts in your phone.

If you fear career damage, consider:

A. Document discreetly: Keep factual records of significant incidents or repetitive minor incidents in a secure place (including dates and times, witnesses, and impacts). Repetitive patterns often emerge, there is often email, recorded message or CCTV evidence – compile this over time.

B. Maintain professionalism: assume your communications may be scrutinised if a complaint is made.

C. Find allies: collective support from peers/senior colleagues deters perpetrators and protects you.

D. Re-read the rules: your employer’s WHS policies and the Medical Board’s Code of Conduct; see Topic 6 for definitions (bullying, discrimination, etc.). Know your protections: WHS literacy is career armour.

E. Act collectively: ideally, escalate as a like-minded group via internal reporting; confidential systems should protect whistleblowers and prohibit retaliation.

F. Expect pushback, misinformation and lies: stay calm, stick to facts, refuse to be scapegoated, especially during prolonged investigations when it is challenging for management to establish the truth.

G. Hold leadership accountable: request formal WHS interventions and system changes when risks are evident. Psychosocial hazards (discrimination, racism, sex discrimination and harassment, bullying, violence) and reprisals against whistle blowers are unlawful; penalties for boards and senior management include fines, reputational damage, and sometimes imprisonment (see topic 3).

3. If required, obtain personal legal advice, first from your medical defence organisation or the AMA before engaging a private lawyer specialising in WHS

Seek early expert confidential advice: contact your MDO, AMA and/or ASMOF before speaking up.

NB. Mandatory reporting criteria: seek advice from your MDO before any Ahpra notification of a colleague at risk of harming patients (see topic 10).

AMA — legal assistance and advice on routine matters affecting doctors: https://www.ama.com.au/act/membership-benefits

ASMOF — representation before industrial tribunals and in employer negotiations: https://www.asmof.org.au

Use free legal guidance and educate yourself: There is extensive legal guidance on the websites of the Australian Human Rights Commission, State/Territory Anti-Discrimination bodies, Fair Work Commission, or your state WHS regulator.

These associations can advise when to seek private legal counsel.

Government law and justice (state/territory):

(NSW) Law Access; Law and Justice

(VIC) Law and Justice

(ACT) Justice and Community Safety

(QLD) Law and Safety

(NT) Law and Safety

(TAS) Law and Public Safety

(WA) Community Safety

(SA) Crime, Justice and the Law

Legal Aid:

Private legal professionals can be expensive and combative. Nevertheless, expert legal advice can also help break through the complexity of legal issues and help you find solutions sooner.

4. Enlist whistle blower protections if reporting an unlawful matter to an employer

If your employer is a registered entity, you can make a protected (and if needed, anonymous) whistleblowing disclosure to the most senior person or governing body. Whistle blowers are legally protected when reporting suspected unlawful conduct (e.g., fraud, corruption, HR abuses, drug-related offences). Retaliation — identity disclosure, dismissal, discrimination, harassment, intimidation, reputational harm — is a criminal offence and a civil breach.

Resources (Fair Work Commission):

Whistle blower Disclosures Fact Sheet: https://www.fwc.gov.au/documents/organisations/resources/fs003-whistleblower-disclosures-fact-sheet.pdf

Whistle blower Protections Overview: https://www.fwc.gov.au/registered-organisations/whistleblowing/whistleblower-protections

Additional Whistleblowing Resources: https://www.fwc.gov.au/registered-organisations/whistleblowing/whistleblowing-resources

Know what constitutes a reportable harmful behaviour (see Topic 6):

https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health/psychosocial-hazards/harmful-behaviours

Bullying: https://www.safeworkaustralia.gov.au/safety-topic/hazards/bullying

Sexual and gender-based harassment: https://www.safeworkaustralia.gov.au/safety-topic/hazards/sexual-and-gender-based-harassment

Discrimination (Fair Work Commission): https://www.fwc.gov.au/issues-we-help/discrimination

Racism: https://www.safeworkaustralia.gov.au/safety-topic/hazards/racism

Workplace violence and aggression: https://www.safeworkaustralia.gov.au/safety-topic/hazards/workplace-violence-and-aggression

Australian Human Rights Commission (AHRC): handles complaints under federal discrimination laws (sex, disability, race, age), plus irrelevant criminal record and religious belief discrimination in employment.

Causes & risk factors factsheet: https://humanrights.gov.au/sites/default/files/factsheet_-_causes_and_risk_factors_of_sex_discrimination_sexual_harassment_and_other_unlawful_behaviours_0_0_0.pdf

How to make a complaint: https://humanrights.gov.au/complaints#main-content

State/Territory contacts:

Anti-discrimination bodies: https://www.fairwork.gov.au/website-information/related-sites#anti-discrimination

WHS regulators and related government sites: https://www.fairwork.gov.au/tools-and-resources/other-workplace-relations-help/related-government-sites#workplace-health-and-safety

Bullying — additional mechanisms:

Safe Work Australia guide: https://www.safeworkaustralia.gov.au/system/files/documents/1702/guide-preventing-responding-workplace-bullying.pdf

Fair Work Commission — stop-bullying (eligibility + lodge): https://www.fwc.gov.au/issues-we-help/bullying/what-do-if-youre-bullied-work

Workplace Advice Service (free legal advice if eligible) and translated information: https://www.fwc.gov.au/about-us/information-your-language

Fair Work Ombudsman — help if stop-bullying orders not complied with: https://www.fairwork.gov.au/about-us/contact-us

Sexual harassment — support and reporting:

1800RESPECT (24/7): 1800 737 732

Respect@Work Information Service (AHRC): Phone 1300 656 419 | Email respect@humanrights.gov.au

Seeking support — counselling & services (factsheet): https://humanrights.gov.au/sites/default/files/factsheet_-_seeking_support_-_counselling_and_support_services_0_0_0.pdf

Fair Work — sexual harassment at work: https://www.fairwork.gov.au/employment-conditions/bullying-sexual-harassment-and-discrimination-at-work/sexual-harassment-in-the-workplace

Discrimination — additional supports:

AHRC support services list: https://humanrights.gov.au/our-work/sex-discrimination/list-support-services

FWC discrimination hub: https://www.fwc.gov.au/issues-we-help/discrimination

Protection from discrimination at work: see your State/Territory Equal Opportunity/Anti-Discrimination agency (NSW, VIC, ACT, QLD, NT, TAS, WA, SA — links via the anti-discrimination page above)

Mental injury — national resources:

National Mental Health Commission: https://www.mentalhealthcommission.gov.au/

Find support: https://www.mentalhealthcommission.gov.au/find-support

Safe Work Australia — mental health at work: https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/mental-health

6. If you are receiving treatment for a work- related injury, consider making a worker’s compensation claim (physical or psychological injury) but be mindful of the risks of doing so (e.g. your injury will no longer be confidential in your workplace)

Doctors rarely make worker’s compensation claims because of the fear of career damage and the bureaucratic processed involved. Unfortunately, these fears are usually entirely justified - unless injuries are severe.

Nevertheless, part of the reason the health system fails to address work health and safety in medical practitioners is because it has little evidence of work-related injury and claims. For example, senior management and boards of hospitals are often oblivious to the extent of mental injury in doctors as these statistics are simply not reported to them – unlike the high levels of claims by nurses and other health professionals.

Here is a brief overview of worker's compensation:

https://www.healthdirect.gov.au/workers-compensation

For more information on psychological injury claims:

Safe Work Australia — psychological injuries: https://www.safeworkaustralia.gov.au/workers-compensation/workers-compensation-psychological-injuries

Tip: build a trusted relationship with a professional such as a GP or psychologist – they will be a critical back up for you in times of crisis, save important telephone numbers in your phone at your fingertips when you need future support, keep a simple incident log overtime on your smart phone to monitor patterns of repetitive negative behaviours, and enlist the support of like-minded colleagues where possible.

9. Seek support early

Seek the right support early

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