Good Medical Practice

Question 1

Knowledge skills and performance domain key points (4)

Answer 1

1) patient 1st concern
2) good standard of care
3) knowledge up to date
4) limits of competence

Question 2

Safety and equality domain (2)

Answer 2

1) prompt action if safety, dignity or comfort compromised

2) protect and promote health

Question 3

Communication partnership and teamwork (3)

Answer 3

1) treat as individuals (dignity politeness and right to confidentiality)
2) work in partnership with patient (ICE, information given, shared decisions and support to reach that decision)
3) work with colleagues in patients best interests

Question 4

Maintaining trust (3)

Answer 4

1) honest & open & integrity
2) never discriminate unfairly
3) never abuse patients or public’s trust

Question 5

If a patient requests a second opinion?

Answer 5

You MUST respect their right to one

Question 6

Can you treat yourself or someone with whom you have a close personal relationship?

Answer 6

You MUST AVOID doing this (wherever possible)

Question 7

Times to make sure you have consent?

Answer 7

Ex, Ix, Tx, teaching, research

Question 8

When should you make records/notes?

Answer 8

At the same time as the events/ASAP after

Question 9

What should records include? (5)

Answer 9

1) clinical findings
2) decisions/actions agreed (who made them)
3) info given to patient
4) Ix, Tx given
5) who is making notes and when

Question 10

Ways to keep patients safe (5)

Answer 10

1) contribute to confidential enquiries
2) adverse event recognition
3) adverse incidents (medical devices)
4) ADRs
4) responding to organisations monitoring public health

Whilst respecting patient’s confidentiality

Question 11

What if a patient is not receiving basic to cover their needs?

Answer 11

Immediately tell someone who is in a position to act straight away

(You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised)

Question 12

If patients are at risk because of inadequate premises/equipment/resources/policies/systems?

Answer 12

Put matter right if possible

Raise concerns

Record steps taken

(You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised)

Question 13

Concerns that a colleague may not be fit to practise and may be a risk to patients?

Answer 13

Ask for advice from a colleague
/defence body
/GMC

If still concerned, report this
And record steps taken

(You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised)

Question 14

What should you do if an emergency arises in a clinical setting or the community?

Answer 14

You must offer help
Take account of your own safety
Your competence
And the availability of other options for care

Question 15

What if you have a condition you could pass to patients? Or your judgement or performance could be hindered by a condition or it’s Tx?

Answer 15

You must consult a suitably qualified colleague

You must follow their advice about any changes to your practice they consider necessary

(You must not rely on your own assessment of the risk to patients)

Question 16

What if you need to leave work early?

Answer 16

Patient safety may be affected if there is not enough medical cover.

So you must take up any post you have formally accepted, and work your contractual notice period before leaving a job

unless the employer has reasonable time to make other arrangements.

Question 17

Writing references?

Answer 17

You must be honest and objective when writing references, and when appraising or assessing the performance of colleagues

including locums and students

References must include all information relevant to your colleagues’ competence, performance and conduct

Question 18

What if colleagues have problems with their health?

Answer 18

You must support them

But patient safety always 1st

Question 19

What information must you share with patients?

Answer 19

1) their condition, it’s likely progression & Tx options (incl risks and uncertainties)
2) your role and responsibilities within team
3) who is responsible for what, and how information will be shared around
4) + additional info needed if in research/teaching

Question 20

Does confidentiality count after someone’s died?

Answer 20

Yes!

Question 21

What if you have a conscientious objection to a procedure?

Answer 21

You must explain to patients

must tell them about their right to see another doctor

make sure they have enough information to exercise that right

In providing this information you must not imply or express disapproval of the patient’s lifestyle, choices or beliefs

If it is not practical for a patient to arrange to see another doctor, you must make sure that arrangements are made for another suitably qualified colleague to take over your role

Question 22

What to do/say if something goes wrong?

Answer 22

You must be open and honest with patients

1) put matters right (if possible)
2) offer apology
3) explain fully and promptly what has happened and the likely short-term and long-term effects

Question 23

What if a patients condition puts you at risk?

Answer 23

You must not deny Tx

If a patient poses a risk to your health or safety, you should take all available steps to minimise the risk

Before providing Tx or alternative arrangements

Question 24

What if a colleague is refusing to Tx a patient due to their personal views?

Answer 24

You must not unfairly discriminate against patients or colleagues by allowing your personal views to affect your

1) professional relationships
2) Tx provided or arranged

You should challenge colleagues if their behaviour does not comply with this guidance

Follow the guidance (Domain 2: Safety and quality) if the behaviour amounts to abuse or denial of a patient’s or colleague’s rights

Question 25

How to respond to complaints?

Answer 25

You must respond promptly, fully and honestly to complaints and apologise when appropriate

You must not allow a patient’s complaint to adversely affect the care or treatment you provide or arrange

Question 26

When is it appropriate to end a professional relationship with a patient?

Answer 26

ONLY when the breakdown of trust between you and the patient means you cannot provide good clinical care

Question 27

Do you have to give someone you have been - professionally - in contact with you name and GMC number (if asked)?

Answer 27

Yes!

Question 28

Must always be honest about…? (4)

Answer 28

1) experience
2) qualifications
3) current role
4) research guidelines

Question 29

How to ensure honesty whilst writing reports?

Answer 29

Make sure document is not false or misleading

Must not deliberately leave out relevant information

Question 30

When must you always let the GMC know about legal/disciplinary procedures? (3)

Answer 30

If anywhere in the world:

1) you have accepted a police caution, or been criticised by an official inquiry
2) you have been charged with or been found guilty of a criminal offence
3) another professional body has made a finding against your registration as a result of fitness to practise procedures

Question 31

What if you are suspended by an organisation from a medical post, or have restrictions placed on your practice?

Answer 31

You must, without delay, inform any other organisations you carry out medical work for

and any patients you see independently

Question 32

What if you are faced with a financial conflict of interest?

Answer 32

You must be open about the conflict

declaring your interest formally

and you should be prepared to exclude yourself from decision making

Question 33

What if patients give you gifts?

Answer 33

You must not ask for or accept

(– from patients, colleagues or others –)

any inducement, gift or hospitality

that may affect or be seen to affect the way

you prescribe for, treat or refer patients or commission services for patients

You must not offer these inducements/gifts

Question 34

What does “colleague” mean?

Answer 34

anyone a doctor works with, whether or not they are also doctors