The Medical Council is seeking feedback on its review of Good Medical Practice from patients, the public, stakeholders and doctors. Good Medical Practice is the Council's main document setting out standards for doctors practising in New Zealand.
Council chairperson Dr John Adams says, "Everyone in New Zealand whether it's our children, parents, partners or friends has a keen interest in health and how they're treated by their doctor."
We expect our doctors to be clinically competent and up to date with their knowledge, but to also be professional in their conduct and decision making.</a>
"We all have an opinion on what we think makes a good consultation, whether it's being treated with respect; being listened to and heard; whether our doctor is sensitive and acknowledges our cultural needs; and whether the doctor is empathic and compassionate when hard decisions need to be made and bad news broken."
"The aim of our review is to ensure that Good Medical Practice outlines the duties of a good doctor in a simple and clear manner.
"Good Medical Practice is intended to help doctors to monitor their own conduct and the conduct of their colleagues. It is also intended to serve as a source of education and reflection for medical students. We are also aware that is often referred to by patients who are uncertain about the quality of care they have received."
Dr Adams says that more emphasis has been placed on explaining the key principles and standards in the foreword to Good Medical Practice.
"We believe that this section is perhaps the most overlooked part of the document, as it outlines the key duties and competences that should underpin all good professional practice. We also plan to include additional principles in this section, which state that doctors must:
- Be aware of cultural diversity, and function effectively and respectfully when working with and treating people of different cultural backgrounds.
- Maintain the trust of colleagues; and treat them politely and considerately.
- Demonstrate a commitment to autonomous maintenance and improvement in their clinical standards.
- Work cooperatively with, and be honest and open in their dealings with, managers, employers, the Medical Council and other authorities."
Dr Adams also said that the Council is seeking feedback on several other key changes, including:
- The addition of a specific reference to Te Tiriti o Waitangi (Treaty of Waitangi) and a requirement that doctors '...apply the principles of partnership, participation and protection in the delivery of health care' (paragraph 17).
- A supplementary text-box which provides specific advice on the subject of end-of-life care (following paragraph 23).
- The inclusion of new duties to provide information to the patient in the event of an adverse outcome. These new duties require a doctor to discuss how the harm or distress caused can be alleviated, how the cause of the harm will be investigated and (if possible) what can be done to prevent the adverse event from happening again (paragraph 22).
- The inclusion of new duties on the protection and welfare of vulnerable patients, and the reporting of abuse (paragraph 26).
- Include more comprehensive and explicit advice on the subject of informed consent (paragraphs 32-34, and the supplementary advice that follows).
- The inclusion of new guidance outlining doctors' responsibility for ensuring consistency and continuity of patient care. This is not intended to impose a duty on doctors to assume responsibility for every patient themselves, but does require them to ensure that someone is personally accountable for each patient's care (paragraphs 48-50).
Dr Adams says, "We've got no fixed views on what is right or wrong in what we've proposed. The paper is the result of some preliminary consultation and considered discussion between Council staff and Council members. We now want to put our ideas out for robust debate, and encourage the profession and the public to make comment."
The consultation document on Good medical practice is available: ttp://www.mcnz.org.nz/news-and-publications/consultations/good-medical-practice/
Feedback should be emailed to email@example.com or posted to:
Senior Policy Adviser and Researcher
Medical Council of New Zealand
PO Box 11-649
by 12 October 2012
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