This month we have a special spotlight in our newsletter on osteopathy, paediatric1 care and advertising.
The Osteopathy Board of Australia (the Board) has decided to share this information with you to make sure it is clear what you should consider as an osteopath when providing services to children and when you are advertising these services.
We are sharing useful information with you that explains the National Law2 and the Board’s expectations of how you should meet your obligations as a registered osteopath. We would ask you to take the time to read all the information we have provided and then review your advertising.
We remind you that you can only treat children and babies if you have the training, education and competence to do so.
The Board and the Australian Health Practitioner Regulation Agency (AHPRA) continue to receive high numbers of complaints about osteopaths, including advertising treatments for paediatric conditions and/or making beneficial claims of treatments for children and babies. There have been over 300 complaints received this financial year about osteopath advertising. The majority raise valid concerns. With this in mind we ask all osteopaths to review their advertising and check it is both correct and compliant.
Late last year the Board published a second bulletin on advertising. Please read it again. We will continue to provide educative information to you about what is and is not acceptable when advertising your services to potentially vulnerable groups. This newsletter looks at how the advertising guidelines relate to advertising osteopathy care for children and babies. The information shared reflects the common mistakes made by osteopaths and how you can make changes if you are in breach of the advertising requirements.
This is an important conversation to have with the profession. As health professionals, osteopaths have an obligation to make sure patients are receiving the right care, at the right time and from the right professional.
Please err on the side of caution, and if in doubt then leave it out of your advertising.
Dr Nikole Grbin
Chair, Osteopathy Board of Australia
1In this newsletter references to ‘children’ and ‘paediatric’ are terms used interchangeably by the Board to refer to anyone aged under 18.
2Health Practitioner Regulation National Law, as in force in each state and territory (the National Law).
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The role of the Board is to protect the public consistent with the National Law.
The Board has recently published its Position statement on paediatric care. This is a must-read document for every osteopath in Australia. The position statement is available on the Board’s website.
In regulating the osteopathy profession, the Board is responsible for registering practitioners and setting the professional standards they must meet to make sure the public has access to safe and competent services from osteopaths.
This position statement has been published to make it clear for practitioners and the wider public, including patients and those who have concerns about osteopathy treatment for children. The Board has circulated the statement widely to the Board’s stakeholders.
Osteopaths need to deliver effective health care within an ethical framework. Like all health practitioners, they must take particular care when managing the care of children and young people.
While individual osteopaths have their own beliefs and values, the Code of conduct for osteopaths makes it clear that those values must be secondary to the wellbeing of their patients and the promotion of health in their patients and the community.
In maintaining good practice, practitioners should consider the balance of benefit and harm in all clinical decisions. If the care needs of a patient are beyond the training, education and competence of a practitioner the Board expects them to appropriately refer that patient to another healthcare provider.
You have a responsibility to recognise and work within the limits of your competence and scope of practice. This applies to all osteopaths whether newly graduated or those who have been practising for many years.
The Board's Code of conduct for osteopaths states:
‘Practitioners have a responsibility to recognise and work within the limits of their competence and scope of practice. Scopes of practice vary according to different roles; for example, practitioners, researchers and managers will all have quite different competence and scopes of practice.’ See section 1.2, Professional values and qualities.
Good practice involves:
The Board considers a registered osteopath’s scope of practice as ‘the professional role and services that an individual health practitioner is educated and competent to perform’. This means that you can work in areas of practice in which you are educated, trained, experienced and competent. This also means you cannot work in areas of practice where you are not.
If you wish to change or develop your scope of practice, you must complete further education and training to ensure your competence. The Board cannot recommend post-graduate or continuing education courses, it is up you to assess where you need to update your learning and then complete this learning before changing or extending your scope of practice.
Osteopaths should not claim to provide care for babies and children unless they have the appropriate education, training and competence to do so.
When practitioners do not have the clinical skills and knowledge to appropriately assess and manage a paediatric patient, the Board expects them to refer the patient to another healthcare practitioner who has the appropriate skills, or to co-manage the patient with them. This should happen immediately when there are serious conditions that need urgent referral.
If you are an osteopath and wish to advertise that you treat children, the following information can help you meet your obligations under the National Law.
Under the National Law, there is a different test for what you claim in advertising and what services you can offer in practice. A higher standard of evidence is needed to support claims made in advertising regulated health services. This is because in advertising, a statement may be easily misinterpreted or taken out of context and then become misleading.
There is helpful advice available that you can refer to when developing or reviewing your advertising, particularly when it relates to children and babies. This includes:
While this guidance applies to any marketing and advertising of osteopathy services, the Board is particularly concerned about advertising of services relating to pregnancy, childbirth, and parents/carers with newborns, neo-nates and children of all ages. The Board is concerned about advertising across all services being provided to this broad group of patients.
To make sure you comply with the advertising requirements, you should review your advertising now using these points as a checklist, as well as referring to the Guidelines for advertising regulated health services and the information that has been published on a dedicated Advertising resources section on the AHPRA website.
Osteopaths cannot use the term ‘specialist’ when referring to their practice or registration in their advertising or any other materials. Even if you have the appropriate training and experience, you cannot give the impression or advertise that you specialise or are a specialist in paediatrics and treating neonates, infants and young children.
If you treat children, you should exercise caution when you advertise to ensure that you do not convey the impression that you are a specialist health practitioner.
Specialist registration applies to only to a small number of health professionals, and is a protected title under the National Law. Osteopaths can only apply for general registration.
The use of words and phrases such as ‘specialises in’ may be misleading or deceptive as patients can interpret the advertisements as implying that the osteopath is more skilled or has greater experience than is the case; or is more qualified or more competent than a holder of the same registration category.
Words such as ‘experienced in’ or ‘working primarily in’ are less likely to be misunderstood.
For further information, see the Guidelines for advertising of regulated health services on the Board’s website under Codes and guidelines.
Testimonials of any form, such as visual or text, are probibited. If your patients are happy with your services, please do not use their experience or image in your advertising. If there is a complaint about your advertising, the use of testimonials about clinical care is a clear breach of advertising rules under the National Law and will result in action by AHPRA and the Board.
The Board has published a report of its work in the regulation of the osteopathy profession under the National Scheme during 2015/16.
The report provides a profession-specific view of the Board’s work to manage risk to the public. It is a profile of regulation at work for the osteopathy profession in Australia for the 12 months to 30 June 2016.
Insights into the profession include:
The data in this report is drawn from the 2015/16 annual report published by AHPRA and the National Boards, reporting on the National Scheme. For more information, download a PDF copy of the Osteopathy Board's 2015/16 profession summary from the AHPRA website.
A New South Wales chiropractor has been convicted of false advertising after he claimed to be able to prevent, treat and cure cancer in his advertising.
Dr Hance Limboro was sentenced after he pleaded guilty to 13 charges and was convicted and fined $29,500 by the court and ordered to pay AHPRA’s legal costs. He was fined for using testimonials in his advertising, which is not allowed when advertising regulated health services.
Under the National Law, Dr Limboro was convicted of unlawfully advertising a regulated health service and using testimonials. Read the full news item.
In conjunction with the National Boards, AHPRA is responsible for the national registration process for 14 health professions. A subset of data from this annual registration process, together with data from a workforce survey that is voluntarily completed at the time of registration, forms the National Health Workforce Dataset (NHWDS).
The NHWDS includes demographic and professional practice information for registered health professionals and is de-identified before it can be made publically available.
The NHWDS Allied Health 2015 data has recently been released as a series of fact sheets on each allied health profession − the NHWDS Allied Health Fact Sheets 2015 – by the Commonwealth Department of Health.
The data included are generated through Workforce Surveys, which are provided by AHPRA on behalf of the Department of Health to all health professionals as part of their yearly re-registration. Each survey is slightly different and is tailored to obtain data specific to that profession.