Professional boundaries and notifications

Good Medical Practice: Professional Standards & Boundaries

The Medical Board of Australia's Good Medical Practice: A code of conduct for doctors in Australia defines the ethical and professional standards expected of all registered doctors in Australia. Compliance with the code is admissible in disciplinary proceedings under the National Law as evidence of whether a practitioner has maintained professional standards.

Treating Self and Immediate Family Members

Section 4.15 of Good Medical Practice explicitly dictates that medical practitioners should avoid providing medical care to anyone with whom they have a close personal relationship, including family members, domestic partners, close friends, or themselves:

• Loss of Objectivity: Personal intimacy impairs diagnostic objectivity, compromises history taking and physical examination, and inhibits the exploration of sensitive issues (such as mental health, substance misuse, or sexual health).
• Close relationships: The code says to avoid treating people close to you because objectivity, privacy and consent can be compromised. It specifically prohibits prescribing Schedule 8, psychotropic medicines or drugs of dependence, and elective surgery, for close relations. This is not a blanket prohibition of every Schedule 4 prescription in every circumstance.
• Unavoidable care: Provide necessary emergency help, document appropriately and arrange independent ongoing care as soon as practical. Personal familiarity must not replace a proper assessment.

Professional Boundaries and Sexual Misconduct

Maintaining strict professional boundaries is a cornerstone of the medical relationship. Good Medical Practice establishes zero tolerance for boundary violations:

• Prohibition of Sexual Relationships: Sexual or inappropriate romantic relationships between a medical practitioner and a current patient are strictly forbidden under any circumstances. A patient's consent or initiation of a relationship provides no defense.
• Former Patients: Entering a romantic or sexual relationship with a former patient may also constitute professional misconduct, particularly where the previous clinical relationship involved unequal power, vulnerability, or psychiatric psychotherapy.
• Carers and Family Members: Sexual or predatory behavior toward individuals close to the patient (such as a parent of a pediatric patient or an elderly patient's spouse) is equally classified as professional misconduct.

Conflicts of Interest and Financial Dealings

• Doctors must not exploit patients' trust for financial or commercial gain.
• Clinicians must not accept financial kickbacks, inducements, or lavish hospitality from pharmaceutical, device, or diagnostic companies.
• If a practitioner holds a financial interest in an external service (such as a private radiology centre, pathology lab, or pharmacy), they must fully disclose this interest to the patient and offer alternative referral choices without bias.

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Mandatory Notifications under the National Law

Section 140 of the Health Practitioner Regulation National Law establishes a statutory obligation for registered health practitioners and employers to notify AHPRA if they form a "reasonable belief" that another registered practitioner has engaged in "notifiable conduct".

The Four Grounds of Notifiable Conduct

A mandatory notification must be submitted when a practitioner has:

1. Intoxication: Practised the practitioner's profession while intoxicated by alcohol or drugs.
2. Sexual Misconduct: Engaged in sexual misconduct in connection with the practice of the practitioner's profession.
3. Substantial Impairment: Placed the public at risk of substantial harm in the practitioner's practice because the practitioner has an impairment (defined as a physical or mental health condition, disability, or disorder that detrimentally affects their capacity to practise).
4. Significant Departure from Accepted Standards: Practised the profession in a way that constitutes a significant departure from accepted professional standards, placing the public at risk of harm.

The "Reasonable Belief" Standard

A "reasonable belief" requires a state of mind based on reasonable grounds. It requires more than mere rumor, workplace gossip, or uncorroborated suspicion, but does not require conclusive legal proof or an exhaustive forensic investigation before notifying. If a doctor directly witnesses a colleague practising while intoxicated or engaging in sexual misconduct, a reasonable belief is established.

Treating practitioners and notifications

The guidelines introduced in March 2020 use a high threshold for treating practitioners: for impairment, intoxication or a significant departure from accepted standards, the practitioner-patient must be placing the public at substantial risk of harm. “Imminent” is not an additional statutory requirement. Treatment engagement, leave, restrictions and other safeguards are relevant to whether that risk exists. Diagnosis alone is not notifiable conduct.

Sexual misconduct has a different threshold: reasonable belief that the practitioner-patient has engaged, is engaging or is at risk of engaging in sexual misconduct in connection with practice. It is not confined to future substantial risk. In Western Australia, treating practitioners are exempt while providing a health service to the practitioner-patient; workplace colleague obligations remain separate.

Seek confidential regulatory/legal advice when uncertain, but address immediate patient safety without delay. Share only the information necessary for a lawful notification and continue caring for the practitioner-patient.

Primary references (checked 7 October 2026): Medical Board code; Ahpra notifications.