The lapsed registration, the medical scheme claims and the CPD audit
Kobus V. has been registered as a clinical psychologist for fourteen years and practises alone in Bloemfontein. His annual registration fee, due by 31 March, was not paid. After two reminders the Registrar suspended his registration in May, and the register reflects that suspension. Kobus nevertheless continued: he saw 23 patients between May and June, submitted 23 claims to a medical scheme under his practice number, and signed two medico-legal reports for the Road Accident Fund. In July he was selected for a random continuing professional development audit. He uploaded a portfolio for the cycle ending 31 March showing 22 points, none of them in ethics, human rights or medical law. Three of the entries are "clinical meetings" to which he awarded himself 2 points each, with no attendance certificates. He tells the auditor that "everyone rounds up" and that the CPD system is administrative.
1. What is Kobus's legal and regulatory position after the suspension, and what follows from the 23 consultations, the scheme claims and the two reports?
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Status. Registration is the statutory authority to practise. Once the Registrar suspends for non-payment, he is not a registered practitioner and nothing he does in a professional capacity is lawfully done. The suspension is not a billing problem with a grace period.
The consultations. Seeing 23 patients while unregistered is practising without registration. It is an offence under the Health Professions Act and independently constitutes professional misconduct. He also cannot rely on his indemnity cover for acts performed while unregistered - most policies exclude them.
The medical scheme claims. The scheme's rules entitle it to pay only for services lawfully rendered by a registered provider. Claims submitted under a practice number while suspended are recoverable, will be reversed, and are likely to be reported to the Council for Medical Schemes and to the HPCSA. At the far end this is characterised as fraud, not an administrative irregularity, and the amounts are small enough to be easily proven.
The RAF reports. Reports signed by an unregistered practitioner carry no weight; the Fund may reject them and may query every report he has signed. He has also misrepresented his status to a statutory body.
Aggravation. He received two reminders and knew of the suspension before he continued. Continuing after notice removes the mitigation of ignorance.
The overriding duty. He may not simply abandon his patients. He must stop practising, tell them promptly, hand over records to practitioners they nominate, and make arrangements for anyone in acute difficulty. Abandonment in the name of compliance is a separate complaint waiting to happen.
2. How does he get restored to the register, and how should the CPD shortfall and the unsupported entries be handled?
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Restoration. He applies to the Registrar on the prescribed form, pays the outstanding annual fees plus the restoration penalty the Council levies, and satisfies the Registrar that he is fit to be restored. Only when the register reflects restoration may he see patients again. Restoration is a Registrar/Board administrative process - it does not extinguish the conduct complaint that will follow.
CPD. The Council's CPD system requires a set number of points per twelve-month cycle for psychologists with a mandatory ethics component - check the current Board guidelines for the exact figures and dates, because they are revised. Two separate problems arise here. First, the shortfall itself: a random audit that discloses non-compliance normally produces a request to remedy within a stated period, and referral to the Board if not remedied, with possible conditions, a caution, a fine, or suspension until compliant. Second, the three self-awarded entries without certificates: a portfolio must be evidenced by provider accreditation numbers, dates and certificates. Self-allocating points is not a shortcut, it is a record that is false, and a false portfolio is treated as an integrity matter, not a paperwork matter.
What he should do. Remove the unsupported entries rather than defend them. Tell the auditor plainly that they cannot be substantiated. Then build the missing points properly - accredited ethics activities, peer review, supervision, conference attendance - and keep the certificates. Do not backdate, do not invent providers, and do not ask colleagues to issue retrospective certificates.
Framing. His "everyone rounds up" comment, on the record, will be quoted. Candour at the audit stage is worth more than any explanation offered later.
3. Design the compliant CPD and practice-administration routine he should have had. What evidence would satisfy an auditor?
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A cycle calendar. Fix 1 April to 31 March in the diary with three review dates (August, December, March), so the shortfall is discovered in December, not July.
Point allocation. Plan backwards from the required annual total, ring-fencing the mandatory ethics allocation first, then distributing the remainder across accredited workshops, conferences, peer review groups, supervision received or given, structured reading with assessment, e-learning with a certificate, and examining or publication activity where the guidelines recognise it. Carry-over between cycles is limited by the guidelines - do not assume unused points survive.
Evidence file. For every entry: date, title, provider name and accreditation number, points awarded, and the certificate or attendance record. A single indexed folder, scanned the week of the activity, is the whole system.
Category discipline. Ethics, human rights and medical law points are a distinct category, not a synonym for "a workshop that mentioned consent". Confirm the category on the certificate.
Administration. Diarise the annual fee date separately from CPD; set an automatic payment or a calendar alert; keep proof of payment; check the register entry after payment each year to confirm nothing has lapsed. The suspension in this case would have been prevented by one recurring reminder.
Practice-side controls. A written billing checklist confirming registration status before each claim cycle, a named locum or colleague for absences, and an indemnity policy reviewed annually with the insurer told about any change in scope or status.
The test an auditor applies is simple: could a stranger reconstruct what you did, when, and for how many points from your file alone? If not, the portfolio fails regardless of how much you actually learned.