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Parent Category: OCNZ

Published: 14 January 2010

Post Graduate Education 

• Australian & NZ Association of Clinical Anatomists (ANZACA)
• AUT 
• Chiropractic & Osteopathic College of Australasia (COCA)
• International Association for the Study of Pain (IASP)
• NZ Pain Society
• University of Otago
• Physiotherapy Accupuncture Association of New Zealand (PAANZ)

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Parent Category: OCNZ

Published: 27 September 2009

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Parent Category: OCNZ

Published: 03 November 2009

A Guide for Practitioners

What to do if you believe a registered practitioner poses a risk of harm to the public:

Incompetent Practitioners

Under the HPCA Act if you believe that another health practitioner may pose a risk of harm to the public through incompetence, you may give the Registrar written notice of the reasons on which the belief is based (HPCA Act section 34(1)).

The notice must provide sufficient information for the complaint to be investigated. This includes:

• the reason(s) for the belief; and
• the times, dates, place(s) and people involved in important events.

We prefer not to receive anonymous complaints, as there is no way to accurately assess both sides of the situation.

When a health practitioner is dismissed for posing a risk of harm to the public or when a practitioner resigns for reasons relating to competence, his/her employer must immediately before the resignation or dismissal, give the Registrar written notice of the reasons for the resignation or dismissal (section 34(3)). No action can be taken against the person giving such a notice unless the person acts in bad faith (section 34(4)).

 What the Registrar Does

After receiving such a notice, the Registrar must notify:

• the practitioner’s employer
• ACC
• Health and Disability Commissioner
• Director-General of Health

These people also need to be informed if the Council considers that there is no longer a risk of harm to the public (section 35(1)) and the practitioner concerned, must be given a copy of both notices.

What the Council Does

Promptly after receiving such a notice the Council will make inquiries into the matter and if it considers that the notice is neither frivolous nor vexatious (s36(3)) may review the competence of the practitioner, providing that the practitioner is registered and holds a current practising certificate. If the practitioner is not registered and/or does not hold a current practising certificate, the matter is investigated by the Ministry of Health.

How to minimise the likelihood of complaints

You should:

• communicate clearly with every patient, making sure that you understand what they are telling you; and
• explain to them what you are going to do and why; and
• ensure that you have their consent to do what you say you are going to do.

If a patient says that they don’t want a particular treatment then you can’t do it, even if you think that not doing it will be detrimental to their health or wellbeing. In such a situation it might be helpful to try and explain what you want to do and why in a different way, or offer an alternative treatment.

Always offer a gown or towel for patients to cover themselves if they wish.

Keep clear notes of each consultation that are sufficiently detailed for:

1. another person to be able to carry on with treatment if you are unable to do so for any reason
2. you to be able to recall exactly what happened should a complaint be made against you.

See “Complaints and Discipline under the HPCA Act 2003” for information about what happens when a complaint is made.

 What to do if you know of someone who is claiming to be an osteopath, but is not registered and/or does not hold a current practicing certificate:

Notify the Registrar of the Council, or the Ministry of Health.

You will need to provide sufficient information to enable an investigation to take place. Information could include:

• an advertisement in the Yellow Pages under “Osteopath”;
• a business card or an advertisement in a newspaper that suggests or states that the person is an osteopath or is practising osteopathy.
• a sign outside the person’s business that suggests that they practice osteopathy
• an advertisement on the Internet that suggests that the person practices osteopathy.

If such a complaint is made to the Registrar, she may send a warning to the person involved if it the first time that it has come to the Council’s attention, or forward it to the Ministry of Health for investigation. The Ministry of Health will investigate and may prosecute if they think that the breach is serious.

Note: It is not illegal to be unregistered and do what an osteopath does, except for HVLA (restricted activity) as long as the practitioner makes it clear to each patient that he/she is not an osteopath and does not hold him/herself out to be an osteopath.

Unregistered practitioners are not eligible to be registered with ACC.

To confirm if a practitioner is currently registered to work as an osteopath in New Zealand, you can search the register here or contact the Registrar directly.

Click here to view Ahpra's ‘Let’s talk about it’ videos launched to support patients and practitioners when a concern is raised.

Complaints and Discipline under the HPCA Act 2003

If the Council considers that it has information which raises one or more questions about the appropriateness of the conduct or the safety of the practice of an osteopath, it may refer the question(s) to a professional committee (PCC), s68(3).	The Council receives a complaint about an osteopath. Does the complaint allege that the practice or conduct of an osteopath has affected a particular health consumer, s64(1)?	When a notice of conviction is given to the Council, in accordance with s67, the Council must refer the notice to a PCC, s68(2)

The council must promptly forward to the Health and Disability Commissioner any complaint alleging that the practice or conduct of an osteopath has affected a health consumer s64(1).

If the Health and Disability Commissioner refers a complaint to the Council, the Council must promptly assess the complaint and consider the action(s) that should be taken, s65(1). The Act does not specifically state what actions may be taken, However, it does state that the Council may decide to refer the complaint to a PCC, s65(2). Some suggested options for the council at this point are set out below.

 

Review the osteopath's competence under Part 3 of the Act.	Refer the complaint to a PCC, s65(2)	Address concerns about the osteopath's fitness to practise under Part 3 of the Act.	Take no further action.

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Parent Category: OCNZ

Published: 27 September 2009

Click here to download the code of ethics in pdf format

Section 118 of the Health Practitioners Competence Assurance Act 2003 requires the Osteopathic Council to set standards of clinical competence, cultural competence, and ethical conduct to be observed by the profession. This page addresses the latter.

This Code of Ethics has a number of goals. It is intended to provide a common standard for all osteopaths to follow. It also is intended to provide a benchmark for the public on the standard of practice they can expect from an osteopath.

This Code will also be used by the Osteopathic Council’s Professional Conduct committee, along with other relevant legislation such as the Code of Health and Disability Services Consumers Rights, as a tool for adjudicating on complaints and competence issues.

The osteopath must:

1. Make the care of the patient their main concern. The quality of the relationship between the osteopath and their patient is a major determinant of successful treatment. Osteopaths as health professionals must set boundaries for their practice that ensure patients feel informed, acknowledged, respected, valued and safe.
   
   
2. Ensure Informed Consent is always used. Please click here to view Council's Guidelines for Informed Consent. Ensure patients are fully informed of their rights. The treatment of a patient is only permitted with his or her informed consent. Care should be taken in explaining the diagnosis and treatment proposed in language that the patient can easily understand. Informed consent applies to every part of an osteopath’s interaction with a patient including case history taking, physical examination, decisions arising from a diagnosis, advice regarding possible adverse reactions to treatment, lifestyle changes proposed, referrals prescribed and further treatment.
   
   When a patient is under the age of 16 years, particular care must be taken to ensure that the patient’s parent or guardian fully understands the nature of the diagnosis and treatment proposed, and consents to the treatment being administered.  In rare circumstances a patient under the age of 16 may be able to give informed consent, however if doubt exists then consent must be obtained from the patient’s parent or guardian.
   
   Ensure that information on patient’s rights (ie. the Code of Health and Disability Services Consumers’ Rights) is readily displayed and available in clinics.
3. Assist the patient’s understanding of the nature, purposes, benefits and limitations of osteopathy. Provide patients with information on osteopathy.
   
   
4. Understand the concept of duty of care and associated responsibilities. In order to ensure clear boundaries are established around their practise, osteopaths must conduct themselves in an honourable and professional manner when dealing with their patients, the public and with other members of the profession. Objectivity must be maintained and personal beliefs not be allowed to influence professional opinions.
   
   Accurately record client information and interventions to facilitate the care, treatment and support of the patient.
   
   
5. Not overstate or exaggerate the seriousness of a patient’s condition and only perform or participate in procedures that are within his or her competence and can be clinically justified.
   
   
6. Disclose any significant proprietary interest they have in any care options recommended.
   
   
7. Always respect their patient’s rights, dignity, autonomy and requirements for continuity of care. This also includes respecting a patient’s right to refuse treatment.
   
   
8. Respect the confidentiality of the information received in the course of the professional consultation, only disclosing information when the patient consents or the law requires. All such disclosures should be in writing only and a patient file copy made.
   
   All information concerning patients (patient records, case history notes, appointment records, etc.) must be kept confidential by all those involved in the osteopathic clinic. Patient information may only be provided if the patient consents to the release of the information or the law allows it, or the law requires it. If the latter, advice should be sought before this decision is made.
   
   
9. Act with propriety in, and not breach, the trust arising from the professional relationship with patients. Ensure that the relationship with patients remains professional. In particular, the language used in questioning, explaining the condition diagnosed, advising the patient or explaining the treatment proposed must be as clear as possible.
   
   
10. Not exploit patients in any way. In particular, there must be no sexual relationship, nor inappropriate sexual behaviour, with a patient during the professional relationship. Inappropriate sexual behaviour includes, but is not limited to, the use of language (whether spoken or written) of a sexual nature, the use of visual material of a sexual nature, or physical behaviour of a sexual nature.
    
    
11. Respect every patient’s right to be treated by an osteopath whose professional ability is in no way impaired by any mental condition, physical condition, alcohol or illicit drugs that could undermine the practitioner’s fitness and competence to practice safely with the public.
    
    
12. Operate osteopathic practices in a professional manner. Ensure clinics are operated in a professional manner, particularly in terms of cleanliness, hygiene and privacy of consultation areas. Make provision for the continuing care of patients during his or her absence from practice where possible.
    
    
13. Not undertake research or other studies involving people without the research or study protocol being approved by a properly constituted ethics committee for that purpose and without the full knowledge and consent of those involved in the research.
    
    
14. Be aware of and use appropriate avenues under current legislation (eg. the Health Practitioners Competence Assurance Act 2003) or professional protocols / rules for raising concerns about a colleague’s professional ability.
    
    
15. Accurately inform interested parties, including patients, health practitioners and the Osteopathic Council, about their qualifications and competence and the work they are undertaking to maintain competence.