A culture of fear and censorship in the Australian medical profession
On a Friday in August 2021, Dr Sally Price received a phone call from the Australian Health Practitioner Regulation Agency (AHPRA). There had been an anonymous complaint against her, and AHPRA was to follow up with an investigation.
“So of course, I was checking my email all afternoon,” says Dr Price, who describes the ensuing investigation as, “destructive” and “very stressful.”
At the time, Dr Price was a practicing GP in Perth, with additional qualifications in nutritional medicine and Ayurveda. In over 30 years of practice, Dr Price had never received a complaint before, and she was mystified as to which of her patients could possibly have complained to AHPRA.
When the email from AHPRA finally arrived in her inbox, Dr Price was surprised to find that the complaint was not from a patient, but from a social media follower who, to the best of her knowledge, she has never met or had any contact with.
The complaint centred around five Facebook story posts, four of which were reposted content from a non-partisan, pro-choice activist group called Reignite Democracy Australia (RDA). Two of the posts referenced efforts of politicians (in Australia and Italy) to resist vaccination mandates. Another story was a repost offering insight into the physiological effects of the fear response.
The complainant characterised the reposts as “anti-vaccination,” though none of the posts gave advice on vaccination or stated any opinion on the Covid vaccines. This was all that was required for AHPRA to launch an official investigation into Dr Price’s conduct.
AHPRA’s position statement on the Covid vaccination rollout (March 2021) set the bar for such vague complaints to trigger investigations, when they specifically barred doctors from expressing messages that could be construed as anti-vaccination on their social media:
”There is no place for anti-vaccination messages in professional health practice, and any promotion of anti-vaccination claims including on social media, and advertising may be subject to regulatory action.”
Dr Price was given two weeks to respond, during which time she engaged with her indemnity organisation in a highly stressful back-and-forth, knowing that her reputation, and maybe even her licence were on the line. Dr Price was strongly advised to offer to undergo ‘re-education’ at her own cost, so as to avoid more serious consequences, such as suspension, or having conditions imposed.
AHPRA agreed that Dr Price should undergo 10 hours of re-education and submit a letter of reflection detailing what she had learned from the process. “What you have to do is pull your forelock and tell AHPRA that you’ve been a very naughty girl,” says Dr Price.
As part of her re-education, Dr Price was required to study the Australian Medical Association’s (AMA) Code of Ethics (2017). Ironically, this firmly established in Dr Price’s mind that the AMA’s Code of tehics and AHPRA’s position statement on the Covid vaccination rollout were at odds with each other. “As I studied the AMA Code of Ethics, I was struck by how AHPRA’s position statement overrode our professional ethics, and that had me more deeply concerned,” says Dr Price. “It highlighted to me that none of this was ok.”
The AMA’s Code of Ethics states that doctors must, “consider first the well-being of the patient,” (Article 2.1.1) and that they must provide full informed consent before undertaking any tests, treatments or procedures (Article 2.1.4). Dr Price says that AHPRA’s position statement and hawkish regulatory behaviour put the public health agenda before the patient and made it “impossible” for doctors to provide valid informed consent to patients.
AHPRA’s unilateral decision that all doctors must fall in line with the vaccination rollout was also in conflict with the AMA Code’s provision that doctors may conscientiously object to providing certain treatments or procedures (Article 2.1.13), and that they may publicly state opinions contrary to the status quo (Article 4.3.3). Further, the Code requires that doctors “practise effective stewardship, the avoidance or elimination of wasteful expenditure in health care…” (Article 4.4.1), and that they use their “knowledge and skills to assist those responsible for allocating health care resources, advocating for their transparent and equitable allocation.” (Article 4.4.3) These articles imply a responsibility for doctors to speak out and take action when they believe that public health policy could be improved upon.
Feeling conflicted about how to practice good medicine under these conditions, Dr Price decided to take some leave to reflect and regroup. She lodged a complaint with Ahpra and the Ombudsman, requesting either a waiver to excuse her from the requirements of AHPRA’s position statement, or that AHPRA explain how she might be able to practice under their conditions whilst also keeping to the AMA’s Code of Ethics. No waiver or explanation was provided, and so Dr Price determined that continuing to practice as a GP was untenable. Her registration has since lapsed.
Dr Price says that, as it stands, the system has strayed from its primary purpose of letting doctors be doctors, and putting patients first. She speaks to a culture of fear within the medical profession. “The thing to understand is that doctors feel like someone is always behind them waiting to stab them in the back or put a bag over their head. That’s how it feels being under AHPRA,” she says.
The censorial nature of AHPRA’s regulatory practices was brought into the national spotlight several weeks ago by former AMA president Dr Kerryn Phelps, who recently revealed that she is Covid vaccine injured. In a submission to the federal government’s Long Covid Inquiry (Submission #510), Phelps wrote, in reference to the aforementioned AHPRA position statement,
“Regulators of the medical profession have censored public discussion about adverse events following immunisation, with threats to doctors not to make any public statements about anything that ‘might undermine the government’s vaccine rollout’ or risk suspension or loss of their registration.”
This is a view also held by cardiologist and Australian Medical Professionals’ Society (AMPS) founder, Dr Chris Neil, who warned in a recent article for Spectator Australia, that many medical professionals believe that not only is the AHPRA position statement unlawful, but that “it is at the root of a dangerous shift in Australian Medicine.” Neil points to the changes to the National Law for Health Practitioner Regulation introduced last October in the Queensland Parliament.
The changes, which the AMA strongly opposed, will further compel doctors to fall in line with public policy decided by bureaucrats , and will create a culture of ‘guilty until proven innocent’ by way of publicly naming and shaming medical professionals who are under investigation. AMPS has gone on the defensive with a Stop Medical Censorship national tour, on which medical, legal and other professionals gather to speak to audiences about the implications of censorship in medicine.
Dr Price says she feels damaged by the experience of being investigated by AHPRA, and she may not return to the profession. “I’m not sure that I want to come back. If medicine were to return to its ethical code, I will reconsider.”