One lady owner
I see that medical council is starting consultation over a peer-review system for doctors. I like Ron Paterson’s comment on the idea.
““It is the body that is saying to the New Zealand public ‘yes, this doctor has a warrant of fitness’, and I think at the moment we have a tougher warrant of fitness system for our cars than we do for our doctors.””
This is true. On the other hand, if you were marketing me on TradeMe, I would be a “1981 model in poor condition with high mileage; one lady owner.”
But seriously, a peer review system for doctors is a good idea, if it is done well. Everyone wants to feel assured that their doctor is both competent and up-to-date. Having said that, it needs to be pointed out that doctors already have a perfectly good system of maintaining expertise known as Maintenance of Professional Standards (MoPS). Currently this system is occasionally audited but not really enforced. All that needs to be done is to insist upon completed documentation each year on application for the Annual Practicing certificate. Most providers of continuing medical education material will give a certificate documenting completion. It would be a simple matter to document your attendance at conferences and peer-review forums.
Britain is currently going down the route of true competency reviews. Doctors will continually have to document that they do a sufficient numbers of a certain procedure to prove they are competent in that procedure. This sounds good in theory. There is no doubt that a doctor who does 30 whatsit operations a year will be better than a doctor who does 5. But will a doctor who does 10/year (the minimum to stay competent) be any better than the doctor who did 8 last year and now has to stop? This system is virtually guaranteed to remove the last vestiges of hospital services from rural areas.
The kind of peer review now being contemplated by the medical council is actually a minor form of the competency review currently done on poorly performing doctors. I know colleagues who have been subject to these reviews and they tell me that they are intrusive, time-consuming and not terribly useful. Judging from the medical council’s financial figures, they are also quite expensive. I fail to see how these reviews will give better results than a beefed up Annual Practicing Certificate requirement.
Unless by “better results” you mean a sudden profusion of bureaucrats and busybodies.
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Jan 27 09 2:49 pm
..one lady owner”
I’ve had a couple of those. First time you floor them there’s a shower of noxious gases and black smoke from the rear, the tail pipe has holes and rust, the steering pulls one way and the alignment is out of whack.
JC
What a co-incidence. Sounds just like me.
Jan 27 09 4:01 pm
Ron Patterson is an OK type of guy. I worked with him for awhile and I must admit I do respect him.
One of the issues I had was Doctors filling out medical certifcates for staff to have time off for ‘illness’or a benefit, that were at best questionable and at worst absolute bullshit. (And yes Milsy I am saying that staff lie about being sick to take time off work)
Ron suggested that perhaps some of the time Doctors were being threatened or just plain ‘beaten down’ by patients for sickness certs and a way to protect them (Drs) was some sort of system that allowed other Drs to peer review parts of a Doctors responsibilty and confirm or reject the need for a certificate. This could be a win win for all concerned.
Im not sure as it seems like another layer of beaurocracy however I do believe that this is a legit problem.
Jan 27 09 4:07 pm
i’m not sure that there is any evidence that the current MOPS system isn’t working. or that this new system will be any better.
this will be expensive and, if the current medical council have anything to do with it, excessively politically correct. compulsory cultural competence assessments anybody?
Oooo, yes! Pick me! Pick me!
Jan 27 09 10:51 pm
lucy:
Medical certificates are not a huge problem. You can usually negotiate a reasonable compromise with a patient. The real problem is sickness benefits. Beneficiaries become quickly disgruntled when you query the reasons and soon withdraw their patronage and the patronage of their entire family and relatives and/or whanau (often quite a large number of patients). The only real solution for this would be to make independent review compulsory (using doctors paid directly by WINZ)
Jan 28 09 7:03 am
I wonder if it’s possible to build a good medical operation simulator, flight simulators have done wonders for pilots.
I suspect it would be considerably more complex, as an operation simulator has to interact with the simulation (a flight simulator just displays “scenery”)
Jan 28 09 7:30 am
Ahh, Here we are: http://www.sciencedaily.com/releases/2005/06/050627062144.htm
Jan 28 09 10:27 am
“I suspect it would be considerably more complex, as an operation simulator has to interact with the simulation (a flight simulator just displays “scenery”)”
Reminds me of the story about the cardiologist calling into the garage to pick up his car after repairs.
The mechanic says “Hey Doc, I’ve taken off the head, replaced the valves, cleaned the fuel lines and tuned her up.. how come I get paid forty grand a year for that and you get four hundred?”
The Doc smiled and said “Try doing that whilst the motor’s running”.
JC
Jan 29 09 6:46 pm
Hate to disagree Macdoctor but when you work in HR as I used to suspect medical certificates are a huge problem.
They are usually a similar type of person that obtains a sickness benefit. They always suffer from stress or a bad back ( a lot are on ACC) and their jobs have to be covered sometimes for up to a year or in one case four years before we could medically retire them. This is not fair to their colleagues who sometimes have to put up with a stream of temps and always end up shouldering additional work.
With enough experience you can tell some who is genuinely having health problems and you got out of your way to help them but the others…. it is frustrating.
In a large organisation (5000 plus staff)it can be 2.5% (125) of the work force (I researched the issue) that is one hell of a lot of unplanned leave to cover.
Unfortunately, if a patient tells you they are still sick, you are obliged to believe them. Every doctor has too much experience of patients, who you are convinced are malingerers, but turn out to have rare and distressingly severe diseases.
Jan 30 09 7:46 am
Point taken. Its good to see both sides of the argument and I would hazzard a guess that the frustration is about equal on both sides.
Your guess is right.