10: The Medical Profession Flashcards
(31 cards)
What is a profession?
An occupation that can make distinctive claims about its work practices an status
What is a professional?
A member of a profession
Member of a community and sense of professional identity
What is professionalisation?
The social and historical process that results in an occupation becoming a profession
What are the 3 steps to professionalisation of medicine?
- Asserting exclusive claim over body of knowledge
- Establish control over market, exclude competitors
- Establish control over professional work practice
Describe the historical professionalisation of medicine
- Doctors only used to care for the wealthy
- GMC in 1858 by the medical act - power over registration and med schools
- Traditional model of self regulation
How did the GMC control the registration of doctors in the past?
Assumed any individual admitted to the profession was of good character and competence
Describe traditional self regulation
Doctrine of clinical autonomy. Only doctors had enough expertise to monitor and control the work of other doctors
What is professional socialisation?
The process through which new entrants acquire their professional identity, through interaction with others
- Gain technical competence
- Norms and values
What is formal curriculum?
- Acquisition of technical knowledge and expertise
- Tested through examination
- Lay person to professional through medical education
What is informal curriculum?
- Acquisition of attitudes and beliefs
- Performance noted, not formally examined
What are the arguments for self regulation?
- Unusual degree of skill in professional work, non-pros not equipped to evaluate
- Responsible enough to work without supervision
- Trusted to take action on rare occasions when an individual is incompetent or unethical
What are criticisms of the rules on professional propriety?
- Doctors discouraged from raising concerns about each other
- Etiquette - no close monitoring of each other
- Informal control - quiet chats. Social norms powerful corrective influence
What are the criticisms of self regulation?
- Self serving
- Favours agents over principles
- Monopoly rent
- Promotes self deceiving vision of objectivity and reliability of knowledge of members
What were the bad apple enquiries?
A series of medical scandals that undermined the ability of self regulation.
Resistance of external scrutiny resulted in a lack of external monitoring, and the NHS failed to detect unacceptable or incompetent professional behaviour and take action
Difficult to act
Patients and whistleblower not believed or discrefitied
What was the historical approach of the GMC to problems with professionalism?
- Refined its remit to serious professional misconduct
- Admin systems were unclear who was in charge and on what authority
- Insufficiently responsive
What publications were significant in reforming the GMC and regulation?
- Tomorrow’s Doctor’s (1193)
- Medical (professional performance) act
- White paper 2007 - wide ranging reforms
When did self regulation end?
Describe
1997
GMC had jurisdiction to consider whether a doctor’s standard of professional performance is seriously deficient
How is the GMC currently made up?
- Mix of lay and professional members, independently appointed
- Overseen by the Professional Standards Authority for Health and Social Care
What are some reasons for FTP?
- Misconduct
- poor performance
- Criminal activity
- Physical or mental illness
- Ruling by regulatory body in UK or overseas
What happens if there are concerns about a doctor’s fitness to practice?
- Referred to GMC Medical Practitioners Tribunal Service
- Can put in conditions on registration, suspend, remove from register
- Can be overruled by the Professional Standards Authority for Health and Social Care
How are doctors licensed?
Need licensed revalidated every 5 years
Evidence to show they are FTP
Who sets standards for each speciality for licensing?
Medical colleges
What is the role of a responsible officer?
- Assessments of evidence in appraisal
- Healthcare organisations have a duty to appoint an RO
- Doctor responsible for local performance and conduct issues within the GMC
- Duty to share info with other organisations on performance to protect patients
What are the aims of revalidation?
- Assure patients
- Maintain and improve practice
- Provide support to keep practice up to date
- Identify concerns early
- Encourage patient feedback
- Act as a driver for improving clinical governance and standards of care.
