The Registrar is on site in Wellington, New Zealand, covering key highlights and insights from CLEAR’s 8th International Congress on Professional and Occupational Regulation.
The closing keynote of CLEAR’s International Congress brought a powerful and deeply human perspective to one of the most pressing challenges facing regulators today.
Marie Bismark, Senior Fellow at the University of Melbourne, invited attendees to look beyond individual practitioner performance and confront the systemic constraints that shape the conditions for safe practice.
Her message was anchored in lived experience. As she recounted serving as the sole psychiatrist for a population of 60,000 people, she described the “constant anxiety” because the standard of care she was trained to provide was impossible to deliver.
That tension, Bismark noted, is now increasingly visible in regulatory work. Practitioners routinely report that they are doing the absolute best they can with too few staff, outdated equipment, or overwhelming caseloads. Many cases that reach regulators reflect not only an individual’s actions but the structural deficits around them.
Yet regulators must balance fairness to practitioners with their obligation to protect the public.
Bismark outlined several questions regulators should explore when resource limitations are a factor:
- Were practitioners triaging appropriately?
- Did they communicate delays, establish safety-net plans, or escalate risks to leadership?
- Did organizational culture allow them to raise concerns without fear of punishment?
She highlighted real-world cases where failure to address systemic deficiencies led to severe disciplinary outcomes, even when practitioners were not directly responsible for clinical errors. These decisions underscore a shifting expectation that professional obligations extend to identifying and challenging unsafe environments.
Bismark also urged regulators to recognize the toll these environments take on practitioner health. Burnout, moral injury, and impaired wellbeing can themselves become risks to public safety. Modern regulators, she argued, must consider not just investigation pathways, but also health pathways and supportive approaches that avoid unnecessary stigma.
Her closing message was a call to connection. To remain close to the communities most affected by constrained systems. “Ultimately,” she reflected, “they’re the ones with the greatest investment in ensuring practitioners have what they need to do their jobs well.”
8th International Congress on Professional and Occupational Regulation
Council on Licensure, Enforcement and Regulation (CLEAR)
Congress Presenters: Marie Bismark, Senior Fellow, University of Melbourne
