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HaDSoc > 10: The Medical Profession > Flashcards

10: The Medical Profession Flashcards

1
Q

What is a profession?

A

An occupation that can make distinctive claims about its work practices an status

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2
Q

What is a professional?

A

A member of a profession

Member of a community and sense of professional identity

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3
Q

What is professionalisation?

A

The social and historical process that results in an occupation becoming a profession

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4
Q

What are the 3 steps to professionalisation of medicine?

A
  • Asserting exclusive claim over body of knowledge
  • Establish control over market, exclude competitors
  • Establish control over professional work practice
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5
Q

Describe the historical professionalisation of medicine

A
  • 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
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6
Q

How did the GMC control the registration of doctors in the past?

A

Assumed any individual admitted to the profession was of good character and competence

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7
Q

Describe traditional self regulation

A

Doctrine of clinical autonomy. Only doctors had enough expertise to monitor and control the work of other doctors

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8
Q

What is professional socialisation?

A

The process through which new entrants acquire their professional identity, through interaction with others

  • Gain technical competence
  • Norms and values
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9
Q

What is formal curriculum?

A
  • Acquisition of technical knowledge and expertise
  • Tested through examination
  • Lay person to professional through medical education
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10
Q

What is informal curriculum?

A
  • Acquisition of attitudes and beliefs

- Performance noted, not formally examined

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11
Q

What are the arguments for self regulation?

A
  • 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
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12
Q

What are criticisms of the rules on professional propriety?

A
  • Doctors discouraged from raising concerns about each other
  • Etiquette - no close monitoring of each other
  • Informal control - quiet chats. Social norms powerful corrective influence
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13
Q

What are the criticisms of self regulation?

A
  • Self serving
  • Favours agents over principles
  • Monopoly rent
  • Promotes self deceiving vision of objectivity and reliability of knowledge of members
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14
Q

What were the bad apple enquiries?

A

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

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15
Q

What was the historical approach of the GMC to problems with professionalism?

A
  • Refined its remit to serious professional misconduct
  • Admin systems were unclear who was in charge and on what authority
  • Insufficiently responsive
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16
Q

What publications were significant in reforming the GMC and regulation?

A
  • Tomorrow’s Doctor’s (1193)
  • Medical (professional performance) act
  • White paper 2007 - wide ranging reforms
17
Q

When did self regulation end?

Describe

A

1997

GMC had jurisdiction to consider whether a doctor’s standard of professional performance is seriously deficient

18
Q

How is the GMC currently made up?

A
  • Mix of lay and professional members, independently appointed
  • Overseen by the Professional Standards Authority for Health and Social Care
19
Q

What are some reasons for FTP?

A
  • Misconduct
  • poor performance
  • Criminal activity
  • Physical or mental illness
  • Ruling by regulatory body in UK or overseas
20
Q

What happens if there are concerns about a doctor’s fitness to practice?

A
  • 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
21
Q

How are doctors licensed?

A

Need licensed revalidated every 5 years

Evidence to show they are FTP

22
Q

Who sets standards for each speciality for licensing?

A

Medical colleges

23
Q

What is the role of a responsible officer?

A
  • 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
24
Q

What are the aims of revalidation?

A
  • 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.
25
Q

What is appraisal

A

Annual, local evaluation of doctors which considers the whole of their practice

26
Q

What evidence is required for appraisal?

A
  • Continuing professional development
  • Quality improvement activity
  • Feedback from colleagues and patients
  • Significant events- feedback and reflect on harm to patients etc
  • Review of complaints and compliments
27
Q

What are the 3 key steps of appraisal?

A
  • Annual with GMP at core
  • Portfolio of supporting evidence as basis for discussion
  • Positive recommendation from a responsible officer
28
Q

Describe appraisal of junior doctors

A
  • Revalidation
  • RO recommendation
  • Annual review of competence progression, using record of in training assessment
  • Based on values of GMP
29
Q

Describe the rise of managerialism

A 
Appointing consultants
Allocating clinical excellence awards
Job descriptions
Insist on implementation of govt policy
Ensure compliance with guidelines and clinical governance
30
Q

What is clinical autonomy?

A

The freedom to make decisions based on professional judgement and specialist knowledge

31
Q

Why is self regulation positive ?

A
  • Commitment to a common set of values, behaviours and relationships
  • Puts patients first
  • Protects patients from risk of harm by a colleagues conducts, performance or health

HaDSoc (10 decks)

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