Just thought some may be interested in the new GMC Good Medical Practice guidelines for doctors. The aim of this publication is to outline the duties of a doctor registered with the General Medical Council:
"Patients must be able to trust doctors with their lives and health. To justify that trust you (doctors) must show respect for human life and make sure your practice meets the standards expected of you in four domains.
Knowledge, skills and performance
* Make the care of your patient your first concern.
* Provide a good standard of practice and care.
* Keep your professional knowledge and skills up to date.
* Recognise and work within the limits of your competence.
Safety and quality
* Take prompt action if you think that patient safety, dignity or comfort is being compromised.
* Protect and promote the health of patients and the public.
Communication, partnership and teamwork
* Treat patients as individuals and respect their dignity.
* Treat patients politely and considerately.
* Respect patients’ right to confidentiality.
* Work in partnership with patients.
* Listen to, and respond to, their concerns and preferences.
* Give patients the information they want or need in a way they can understand.
* Respect patients’ right to reach decisions with you about their treatment
and care.
* Support patients in caring for themselves to improve and maintain their health.
* Work with colleagues in the ways that best serve patients’ interests.
Maintaining trust
* Be honest and open and act with integrity.
* Never discriminate unfairly against patients or colleagues.
* Never abuse your patients’ trust in you or the public’s trust in the profession.
You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions."
Well I suppose in theory if they don't listen to and respond to our concerns and preferences, we could wave the document in front of them and say we will complain to the GMC. In theory! L
It only says they have to "Listen to, and respond to, their concerns and preferences". It doesn't mean they have to agree with us or do what we would prefer, only that they should listen and respond. That response could very well be a firm "No"
The investigations or treatment you provide or arrange must be based on the assessment you and your patient make of their needs and priorities, and on your clinical judgement about the likely effectiveness of the treatment options. You must not refuse or delay treatment because you believe that a patient’s actions or lifestyle have contributed to their condition.
para 32
You must give patients* the information they want or need to know in a way they can understand. You should make sure that arrangements are made, wherever possible, to meet patients’ language and communication needs.
para 16
In providing clinical care you must:
a prescribe drugs or treatment, including repeat prescriptions, only when you have adequate knowledge of the patient’s health and are satisfied that the drugs or treatment serve the patient’s needs
b provide effective treatments based on the best available evidence
c take all possible steps to alleviate pain and distress whether or not a cure may be possible
para 51
You must support patients in caring for themselves to empower them to improve and maintain their health
must means an overriding duty
I take this to mean that the doctor has to discuss your treatment with you. The clincher is that the clinical judgement lies with the doctor. However, para 16 says that the treatment must be based on the best available evidence. the RCP/BTA statement is not the best available evidence.
In my view, if a patient discusses his/her thyroid treatment and the doctor says "you don't have hypo, your in range, I'm not prescribing T3/NDT, I'm lowering your dose" etc., s/he has to give the patient the evidence to support that view (para 32). Then, as part of the discussion they have to have (para 57), the patient gives the doctor some supporting evidence for what they want the doctor has to act on that evidence (para 16b). they also have to take this scenario as spontaneous Continuing Professional Development.
There is a lot of evidence to support TUK endorsed treatment but it is not yet collated for easy use by patients to give to doctors to implement para 16b.
it is best to attempt agreement with the doctor but as we know some doctors are better than others. if the doctor doesn't comply with Good Medical Practice and harm to patients health occurs as a reult of that failure to comply with GMP, then patients should complain to the Clinical Commissioning Group or the GMC.
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