Judge Sandy Horneman-Wren explores the complex world of disciplinary proceedings for health practitioners in Queensland in his presentation, Doctors in the Dock. 

Hedley Thomas, award-winning investigative journalist and critically acclaimed podcaster and MLSQ director Dr Mellissa N. will explore the complexities of accountability and transparency at the dynamic intersection of Media, Medicine, and the Law, and how curiosity, courage and leadership can drive meaningful cultural and systemic change.

I'm not a bad person.... am I? Navigating equity in a rapidly changing social landscape

A/Prof Rhea Liang

A/Prof Rhea Liang is a general and breast surgeon on the Gold Coast, medical educator, Clinical Sub Dean at Bond University, and systems change leader. She researches, advocates and consults in diversity and equity issues. She serves on the British Journal of Surgery editorial board and the American College of Surgeons International Relations Committee. She is the past Chair of the RACS Operate With Respect Education committee, current Chair of the Commonwealth A Better Culture Curriculum Design group, and in 2023 became the first Australian woman awarded RCSEng(Hon) for contributions to surgical education and diversity over the past two decades. 

The Scenario continued...

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

The anaesthetic registrar, when questioned about the clinical incident, indicated that she had possibly made an error of judgment due to fatigue.  She had worked lots of on-call, filled in for illness and stayed behind to help when needed, which was often.  She felt that this rotation and the fatigue had ruined her life.  The anaesthetic head of department was aware of the hours she was working, and refused to grant much of her claimed overtime, indicating it wasn’t in the budget and we all “just had to do what we had to do for the patients 

The ED resident who managed the patient, subjected to the investigation and questions about his management, became increasingly despondent and went on sick leave.  He subsequently brought legal action against the hospital for psychosocial injury, alleging that he had spoken to the emergency director about difficulties managing the endless flow of sick and injured patients, and feeling unsupported and unable to provide the care he felt they deserved.  As a result, he has developed insomnia, anxiety and has been diagnosed with PTSD.  He is unsure if he will return to the hospital or even the profession.

The director of surgery, considering the allegations, has come under scrutiny.  As part of this, it is revealed that he was employed at a time of crisis in an area of need, both clinically and politically.  His appointment was signed off by the DMS, medical credentialling committee and regional office.

An investigation by the media has uncovered multiple complaints by patients, which leads to the discovery that the surgical department in the hospital has encountered a substantially higher morbidity and mortality rate than others within the state.  The media are quick to blame the director of surgery, however this data is readily available and known to the hospital executive.  The DMS indicates that the hospital executive were made aware, but they were not concerned, indicating it was because of poor funding from the government, and what can we do?  The DMS does not pursue it.

Under intense media interest and community and political pressure, an inquiry lays bare the cultural problems within the hospital.  The DMS and GM are particularly under the spotlight.  They respond that they have been working under unreasonable constraints and resource issues imposed on them from above and have been doing the best they can in the circumstances.

In response to sustained and intense pressure, the DMS retires, the director of surgery is suspended by Ahpra, the registrar’s have long been rotated to other jobs, and the government decides to substantially increase resources in the area.  They commit to building a nice, shiny new hospital and hope it will attract a new cohort of doctors.  Every other regional health service complains that they are just as deserving, but the media have moved on to the latest tragedy within the Kardashian household.

A new breed of clinical leaders is emerging to guide the hospital into a new era, but they are now desperate to know – Why would anyone want to be a clinical leader?

This panel discussion will deep dive into who wants to take the lead. The panel members are: 

• Prof Michael Cleary
• Dr Hash Abdeen
• Ms Sonya Black
• Dr Jillian Farmer 

The Scenario continued...
Unfortunately, while performing surgery, the patient deteriorated and died on the table.  This led to a Coroners notification, investigation and plenty of media attention.  All staff were interviewed by police, hospital and external investigators.

The surgical consultant says he wasn’t properly informed of the patient.  The registrar indicated that he isn’t really supervised, and just told to “get on with it”.  Rumours around the hospital are that this registrar is a bit gung-ho and overconfident.

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

The anaesthetic registrar, when questioned about the clinical incident, indicated that she had possibly made an error of judgment due to fatigue.  She had worked lots of on-call, filled in for illness and stayed behind to help when needed, which was often.  She felt that this rotation and the fatigue had ruined her life.  The anaesthetic head of department was aware of the hours she was working, and refused to grant much of her claimed overtime, indicating it wasn’t in the budget and we all “just had to do what we had to do for the patients 

The ED resident who managed the patient, subjected to the investigation and questions about his management, became increasingly despondent and went on sick leave.  He subsequently brought legal action against the hospital for psychosocial injury, alleging that he had spoken to the emergency director about difficulties managing the endless flow of sick and injured patients, and feeling unsupported and unable to provide the care he felt they deserved.  As a result, he has developed insomnia, anxiety and has been diagnosed with PTSD.  He is unsure if he will return to the hospital or even the profession.

The director of surgery, considering the allegations, has come under scrutiny.  As part of this, it is revealed that he was employed at a time of crisis in an area of need, both clinically and politically.  His appointment was signed off by the DMS, medical credentialling committee and regional office.

An investigation by the media has uncovered multiple complaints by patients, which leads to the discovery that the surgical department in the hospital has encountered a substantially higher morbidity and mortality rate than others within the state.  The media are quick to blame the director of surgery, however this data is readily available and known to the hospital executive.  The DMS indicates that the hospital executive were made aware, but they were not concerned, indicating it was because of poor funding from the government, and what can we do?  The DMS does not pursue it.

Under intense media interest and community and political pressure, an inquiry lays bare the cultural problems within the hospital.  The DMS and GM are particularly under the spotlight.  They respond that they have been working under unreasonable constraints and resource issues imposed on them from above and have been doing the best they can in the circumstances.

Dr Jillann Farmer in this episode will cover

• Roles and responsibilities of clinical leaders
• Managing clinical risk
• Maintaining standards

The Scenario
The setting is a large regional hospital in a relatively disadvantaged town.  There is difficulty attracting staff, and most positions are filled by locums, newly arrived IMG’s and rotating registrars.

A patient presents on a Friday evening, another victim of drug related gang violence.  He had been pinned to a wall by a car and sustained multiple injuries. He was resuscitated by the ED and then whisked off to theatre by the enthusiastic surgical registrar, who happened to be walking past the ED on his way home.

Unfortunately, while performing surgery, the patient deteriorated and died on the table.  This led to a Coroners notification, investigation and plenty of media attention.  All staff were interviewed by police, hospital and external investigators.

The surgical consultant says he wasn’t properly informed of the patient.  The registrar indicated that he isn’t really supervised, and just told to “get on with it”.  Rumours around the hospital are that this registrar is a bit gung-ho and overconfident.

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

The anaesthetic registrar, when questioned about the clinical incident, indicated that she had possibly made an error of judgment due to fatigue.  She had worked lots of on-call, filled in for illness and stayed behind to help when needed, which was often.  She felt that this rotation and the fatigue had ruined her life.  The anaesthetic head of department was aware of the hours she was working, and refused to grant much of her claimed overtime, indicating it wasn’t in the budget and we all “just had to do what we had to do for the patients 

The ED resident who managed the patient, subjected to the investigation and questions about his management, became increasingly despondent and went on sick leave.  He subsequently brought legal action against the hospital for psychosocial injury, alleging that he had spoken to the emergency director about difficulties managing the endless flow of sick and injured patients, and feeling unsupported and unable to provide the care he felt they deserved.  As a result, he has developed insomnia, anxiety and has been diagnosed with PTSD.  He is unsure if he will return to the hospital or even the profession.

The director of surgery, considering the allegations, has come under scrutiny.  As part of this, it is revealed that he was employed at a time of crisis in an area of need, both clinically and politically.  His appointment was signed off by the DMS, medical credentialling committee and regional office.

An investigation by the media has uncovered multiple complaints by patients, which leads to the discovery that the surgical department in the hospital has encountered a substantially higher morbidity and mortality rate than others within the state.  The media are quick to blame the director of surgery, however this data is readily available and known to the hospital executive.  The DMS indicates that the hospital executive were made aware, but they were not concerned, indicating it was because of poor funding from the government, and what can we do?  The DMS does not pursue it.

Mr Ryan Nattrass in this episode will cover

• Liability of medical leaders in the event of clinical problems
• Bacchus Marsh

The Scope of Credentialing 
This session is chaired by MLSQ committee member Dr Jenny Schafer.

The Scenario

The setting is a large regional hospital in a relatively disadvantaged town.  There is difficulty attracting staff, and most positions are filled by locums, newly arrived IMG’s and rotating registrars.

A patient presents on a Friday evening, another victim of drug related gang violence.  He had been pinned to a wall by a car and sustained multiple injuries. He was resuscitated by the ED and then whisked off to theatre by the enthusiastic surgical registrar, who happened to be walking past the ED on his way home.

Unfortunately, while performing surgery, the patient deteriorated and died on the table.  This led to a Coroners notification, investigation and plenty of media attention.  All staff were interviewed by police, hospital and external investigators.

The surgical consultant says he wasn’t properly informed of the patient.  The registrar indicated that he isn’t really supervised, and just told to “get on with it”.  Rumours around the hospital are that this registrar is a bit gung-ho and overconfident.

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

The anaesthetic registrar, when questioned about the clinical incident, indicated that she had possibly made an error of judgment due to fatigue.  She had worked lots of on-call, filled in for illness and stayed behind to help when needed, which was often.  She felt that this rotation and the fatigue had ruined her life.  The anaesthetic head of department was aware of the hours she was working, and refused to grant much of her claimed overtime, indicating it wasn’t in the budget and we all “just had to do what we had to do for the patients 

The ED resident who managed the patient, subjected to the investigation and questions about his management, became increasingly despondent and went on sick leave.  He subsequently brought legal action against the hospital for psychosocial injury, alleging that he had spoken to the emergency director about difficulties managing the endless flow of sick and injured patients, and feeling unsupported and unable to provide the care he felt they deserved.  As a result, he has developed insomnia, anxiety and has been diagnosed with PTSD.  He is unsure if he will return to the hospital or even the profession.

The director of surgery, considering the allegations, has come under scrutiny.  As part of this, it is revealed that he was employed at a time of crisis in an area of need, both clinically and politically.  His appointment was signed off by the DMS, medical credentialling committee and regional office.

Dr Bavahuna Manoharan in this episode will cover

• Liability of administration in credentialling
• Scope of practice – how do you determine and supervise it?

Psychosocial hazards in healthcare 
This session is chaired by MLSQ committee member Dr Catherine Yelland

The Scenario

The setting is a large regional hospital in a relatively disadvantaged town.  There is difficulty attracting staff, and most positions are filled by locums, newly arrived IMG’s and rotating registrars.

A patient presents on a Friday evening, another victim of drug related gang violence.  He had been pinned to a wall by a car and sustained multiple injuries. He was resuscitated by the ED and then whisked off to theatre by the enthusiastic surgical registrar, who happened to be walking past the ED on his way home.

Unfortunately, while performing surgery, the patient deteriorated and died on the table.  This led to a Coroners notification, investigation and plenty of media attention.  All staff were interviewed by police, hospital and external investigators.

The surgical consultant says he wasn’t properly informed of the patient.  The registrar indicated that he isn’t really supervised, and just told to “get on with it”.  Rumours around the hospital are that this registrar is a bit gung-ho and overconfident.

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

The anaesthetic registrar, when questioned about the clinical incident, indicated that she had possibly made an error of judgment due to fatigue.  She had worked lots of on-call, filled in for illness and stayed behind to help when needed, which was often.  She felt that this rotation and the fatigue had ruined her life.  The anaesthetic head of department was aware of the hours she was working, and refused to grant much of her claimed overtime, indicating it wasn’t in the budget and we all “just had to do what we had to do for the patients 

The ED resident who managed the patient, subjected to the investigation and questions about his management, became increasingly despondent and went on sick leave.  He subsequently brought legal action against the hospital for psychosocial injury, alleging that he had spoken to the emergency director about difficulties managing the endless flow of sick and injured patients, and feeling unsupported and unable to provide the care he felt they deserved.  As a result, he has developed insomnia, anxiety and has been diagnosed with PTSD.  He is unsure if he will return to the hospital or even the profession.

Dr Clare Wood in this episode will cover

• Psychosocial hazards in the clinical workplace
• Burnout – the cost, who is responsible and how do prevent it?
• Liability of leaders in managing the welfare of their team

Balancing fatigue, workload and risk
This session is chaired by MLSQ committee member Dr Catherine Yelland

The Scenario

The setting is a large regional hospital in a relatively disadvantaged town.  There is difficulty attracting staff, and most positions are filled by locums, newly arrived IMG’s and rotating registrars.

A patient presents on a Friday evening, another victim of drug related gang violence.  He had been pinned to a wall by a car and sustained multiple injuries. He was resuscitated by the ED and then whisked off to theatre by the enthusiastic surgical registrar, who happened to be walking past the ED on his way home.

Unfortunately, while performing surgery, the patient deteriorated and died on the table.  This led to a Coroners notification, investigation and plenty of media attention.  All staff were interviewed by police, hospital and external investigators.

The surgical consultant says he wasn’t properly informed of the patient.  The registrar indicated that he isn’t really supervised, and just told to “get on with it”.  Rumours around the hospital are that this registrar is a bit gung-ho and overconfident.

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

The anaesthetic registrar, when questioned about the clinical incident, indicated that she had possibly made an error of judgment due to fatigue.  She had worked lots of on-call, filled in for illness and stayed behind to help when needed, which was often.  She felt that this rotation and the fatigue had ruined her life.  The anaesthetic head of department was aware of the hours she was working, and refused to grant much of her claimed overtime, indicating it wasn’t in the budget and we all “just had to do what we had to do for the patients 

Mrs Sonya Black in this episode will cover

• Fatigue and staffing – who is responsible? What can you do, what should you do?
• Overtime (Frankston, NSW)

Inappropriate workplace behaviour or resilience building?
This session is chaired by MLSQ committee member Dr Catherine Yelland

The Scenario

The setting is a large regional hospital in a relatively disadvantaged town.  There is difficulty attracting staff, and most positions are filled by locums, newly arrived IMG’s and rotating registrars.

A patient presents on a Friday evening, another victim of drug related gang violence.  He had been pinned to a wall by a car and sustained multiple injuries. He was resuscitated by the ED and then whisked off to theatre by the enthusiastic surgical registrar, who happened to be walking past the ED on his way home.

Unfortunately, while performing surgery, the patient deteriorated and died on the table.  This led to a Coroners notification, investigation and plenty of media attention.  All staff were interviewed by police, hospital and external investigators.

The surgical consultant says he wasn’t properly informed of the patient.  The registrar indicated that he isn’t really supervised, and just told to “get on with it”.  Rumours around the hospital are that this registrar is a bit gung-ho and overconfident.

During the investigation, the surgical resident revealed that she had been exposed to racial and sexual harassment and bullied and belittled by the surgical consultant.  She had made the surgical registrar aware of this, but nothing had been done.  She had mentioned it to the DMS, who chalked it up to a “personality clash” and told her she needed to harden up.  The consultant denies all allegations and angrily indicates he intends to sue for defamation.

Mrs Sonya Black in this episode will cover

• Ethical and legal responsibilities and consequences of clinical leaders
• Vexatious complaints