Patient safety

It is amazing to me how persons, myself included, entrust our mortal health and well being to persons styled as medical practitioners or doctors without any investigation as to whether they are actually qualified or whether they have picked up a book, journal or magazine related to the field of medicine since the day they walked out of medical school.

Even if such an investigation could take place, most persons would either lack the wherewithal to initiate it or for that matter may not even know where to begin. In times like these some form of oversight, whether governmental or otherwise, needs to be instituted to protect the members of the public from themselves and from the unscrupulous.

The new dispensation in relation to the medical profession is governed by the Medical Profession Act, 2010. This legislation amongst other things provides for the creation of a new governing body, registration of medical practitioners, disciplinary procedures and general standards relating to the operation of the medical profession in Barbados.

As with most pieces of legislation, there’s the initial uproar, the following debate with oftentimes unrelated speeches in Parliament, publication in the Gazette which the average person neither reads nor knows about and then the statute fades into oblivion without any further enlightenment on the part of those whom it is intended to protect.

So what does the Medical Profession Act mean for you, John Q. Public? First, it attempts to define something which no one gives thought to when they are actually sick and in need of medical attention, namely what is a doctor or medical practitioner. Essentially, under Section 9 of the act, a person can practise medicine by holding a medical degree from a tertiary institution recognised by the Medical Council, has completed the minimum internship period at a hospital or medical institution, can read, write, speak and understand English, is a fit and proper person and is registered pursuant to the provisions of the act.

The first three we generally take for granted, the fourth, one assumes, means that the individual has shown that he has no skeletons in his closet which would impair his ability to practise medicine or undermine the confidence of the public in the profession, convictions for sexual offences being a prime example.

Any member of the public can verify the professional particulars of any practising doctor by reference to the Medical Register which must be kept for inspection at the office of the council and provides information as to the description of the practitioner’s qualifications, his home, work address, national registration number and so on.

Unlike the Legal Profession Code of Ethics, Cap. 370A, which is extremely specific, Sections 22 and 23 of the act attempt to codify in broad brush strokes the professional duties or responsibilities of any registered medical practitioner.

These responsibilities include:

(1) providing only such services as are medically necessary;

(2) prescribing only such medication as is necessary;

(3) possession of proper equipment so as to not place the health and safety of patients at risk;

(4) ensuring that employees are properly trained;

(5) not engaging in behaviour which is contrary to generally recognised medical ethics such as:

(a) engaging in sexual or improper conduct with a patient;

(b) betrayal of a professional confidence;

(c) abandoning a patient in danger without cause and without allowing that person time to retain another practitioner;

(d) issuing a certificate knowing that the information is false or misleading (for example certifying that an employee is entitled to sick leave knowing full well that he is not);

(e) excessive drinking or taking of drugs;

(f) holding himself out as a specialist without having been registered as such by the council; and

(g) failing to provide a medical report within three months of a request.

On this last point I would be remiss in my duty to my own profession if I failed to point out that the lawyer cannot make any progress on your personal injury claim and the insurance company will certainly not be settling such claim unless and until the doctor provides his medical report.

The act also outlines the recourse where a medical practitioner has run afoul of any of its provisions but that aspect will have to be dealt with in next week’s instalment.

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