In the wake of hospital inquiries: impact on staff and safety
Authors: James A Dunbar, Prasuna Reddy, Bill Beresford, Wayne P Ramsey and Reginald S A Lord
Published online: 15 October 2007
In reply: Dr Arnold raises the difficulties involved in bringing poorly performing colleagues to notice and proposes that reporting doctors to a medical board is the best option.
There are difficulties in relying solely on medical boards. First, doctors have a very high threshold for referral to a medical board, so poor performance may not be reported. Even serious cases of poor performance can go unreported for many years.1 Second, there are many cases of remediable poor performance2 that require a different approach. In the United Kingdom, local procedures are managed by medical directors as part of their contract. The Good Medical Practice guidelines issued by the General Medical Council make it clear that all doctors have a responsibility to report poorly performing colleagues.3 If the medical director then fails to act, the hospital’s insurance could be invalidated and the medical director would appear before the General Medical Council.
A number of Australian jurisdictions, including the Australian Capital Territory, New South Wales and Queensland,4,5 have made substantial progress in developing local procedures that offer the best opportunity for remediation of doctors where possible, and for discipline by the medical board where not. With these procedures, we can assure patients of safety while maintaining as many doctors as possible in the workforce.
References
- Dunbar JA, Reddy P, Beresford B, et al. In the wake of hospital inquiries: impact on staff and safety. Med J Aust 2007; 186: 80-83. 0_CBBFGBDB
- Leape LL, Fromson JA. Problem doctors: is there a system-level solution? Ann Intern Med 2006; 144: 107-115. 0_i1091826
- General Medical Council. Good medical practice. London: GMC, 2006. http://gmc-uk.org/guidance/good_medical_practice/index.asp (accessed Aug 2007).
- Queensland Health. Safe doctors: fair system. http:// www.health.qld.gov.au/patientsafety/webpages/safedocs.asp (accessed Aug 2007).
- Duckett SJ. A new approach to clinical governance in Queensland. Aust Health Rev 2007; 31 Suppl 1: S16-S19. 0_i1091833