• Contents page •
• RCGP • PMETB • Government • GMC •
• Up • Curriculum group • 12 Facts about GP • Position on Training • Future of Vocational Education • Good Medical Practice • Valuing General Practice • What Sort of Doctor • The Future GP • EU Title III/IV •
•  •

What Sort of Doctor?

Areas of Performance

1. Professional Values

  1. The doctor tries to render a personal service which is comprehensive and continuing.
  2. In his practice arrangements he balances his own convenience against that of his patients, takes into account his responsibility to the wider practice community, and is mindful of the interests of society at large.
  3. He accepts the obligation to maintain his own mental and physical health.
  4. He puts a high value on communication skills.
  5. He subjects his work to critical self-scrutiny and peer review, and accepts a commitment to improve his skills and widen his range of services in response to newly disclosed needs.
  6. He recognizes that researching his discipline and teaching others are part of his professional obligations.
  7. He sees that part of his professional role is to bring about a measure of independence: he encourages self help and keeps in bounds his own need to be needed.
  8. His clinical decisions reflect the true long-term interests of his patients.
  9. He is careful to preserve confidentiality.

2. Accessibility

  1. He can be seen quickly for urgent matters, and normally within two days for non-urgent matters.
  2. He is prepared to visit patients in their homes.
  3. He is available for advice on the telephone at known times.
  4. His staff are helpful to patients and see themselves as facilitating the doctor-patient contact.
  5. He provides adequate out-of-hours cover.
  6. His patients are aware of the procedure by which the doctor or his deputy can be contacted at any time of the day or night.

3. Clinical Competence

  1. The doctor is shrewd, observant, and skilled at eliciting relevant information.
  2. He works swiftly but surely, without undue sense of rush.
  3. In general, his history-taking and physical examinations are economical, and his notes pithy and informative; but when occasion demands, he is capable of more exhaustive procedures.
  4. His personal style of consulting is consistent but is responsive to individual patients' needs and demonstrates a logical problem-defining process.
  5. He links physical, social and emotional factors when formulating his assessment of the patient and when planning further management.
  6. He makes appropriate use of other members of the practice's health care team, and of colleagues and agencies outside.
  7. He prescribes effectively, with caution and mindful of costs.
  8. He carefully follows up his patients and actively seeks to learn the consequences of his action or inaction.
  9. The clinical records he keeps help him to monitor patients' progress and to plan anticipatory care and other preventive measures.
  10. He employs opportunistic health education and constantly reinforces advice on lifestyles; and by giving relevant information freely to patients tries to encourage them to share responsibility for their own health care.

4. Ability to communicate

  1. The doctor is receptive, and conveys a sense of attentiveness, of professional concern for the patient's unfolding problem, and of personal commitment to the patient.
  2. He shares information and decision-making with the patient as much as possible; the patient feels supported and encouraged by the doctor and better informed than before, and so feels more capable of handling future episodes of a similar illness.
  3. Notices and educational displays in the waiting room are clear, and as far as possible positive and optimistic.
  4. The staff handle enquiries sensitively.
  5. Entries in the clinical records are legible, ordered, pertinent, accurate and retrievable.
  6. They are capable of being used for teaching, research and audit.
  7. Letters to consultants are informative and explicit about the reason for referral and the doctor's expectations.
  8. The ancillary staff and other members of the practice's health care team have frequent opportunity to meet the doctors informally to discuss aspects of practice policy or matters of mutual clinical interest.
  9. Times are set aside for more formal meetings when longer-term issues can be discussed.
  10. The doctor is sensitive to the views of staff and anxious to involve them in policy-making as far as possible.

Criteria for Assessment

1. Professional Values

Perception of Role

The doctor sees himself as providing a service to his practice population, sharing with others responsibility for promoting, preserving and restoring the health of individual patients The doctor regards medical practice solely as a way of earning a living or of encountering interesting clinical promoting, preserving and restoring the health of individual material.

Responsibilities

He balances his own convenience against that of his patients, and keeps the interests of the wider community in mind He invariably puts his own convenience above the needs of patients, and has no concern for his wider responsibility to society.

Personal Care

He believes in the importance of continuity of care, gives a personal service, and tries to make it as comprehensive as possible He does not think continuity of care matters, delegates excessively, and his clinical interests are dominated by one or two hobby horses.

Development

The practice has continually evolved over the years in response to newly disclosed health care needs, and is  continuing to do so. The nature of his practice is static. He is not in touch with fresh developments within his own profession. He regards the development of his practice as finished.

Professional Growth

He maintains and improves his skills, and continually  widens his horizons. He maintains his clinical curiosity and at the same time feels involved with his patients' problems,  He allows intellectual atrophy to set in and practises in a  narrow, disjointed, mechanistic way. He relates only superficially to his patients.

Self-Awareness

He subjects his work to critical self-scrutiny and review by colleagues. He enjoys being a general practitioner and he accepts the obligation to maintain his own physical and mental health. He is complacent about the quality of his work and sees no point in reviewing it. He never reflects on what he is trying to achieve. He has become cynical or defeated, or drives, himself excessively.

Personal Behaviour

He is of good repute and known for his integrity. He displays dignity in his personal behaviour and honourable dealing with his partners. He has good relationships with colleagues and staff. In his personal and private life he is not a good model. He is not well regarded by his peers.

Teaching and Research

He is interested in teaching and research and sees these activities as part and parcel of professional life. He is antipathetic towards anything to do with the
academic aspects of general practice and has no thought for those who will follow him in his profession.

Communication

He places high value on communication, and recognizes the importance of achieving a shared view of problems with patients. Patients are open with him, trusting his and his staffs discretion. He does not see communication as a two-way process, and does not know or care whether he is getting through to patients. He is careless about confidentiality.

Patients' Autonomy

He encourages patients' self-help, and keeps in bounds his need to be needed. His clinical decisions reflect the true long-term interests of his patients. He allows the development of unwholesome dependence on himself or on psychotropic drugs.

Professionalism

He is a thorough professional: a thinking, questioning doctor He equates being a doctor with being a provider; he behaves as a grocer, or a bartender.

2. Accessibility

Consulting Arrangements

The doctor can be seen very quickly by patients for urgent matters during normal working hours. Patients with non urgent matters are normally seen by their doctor within two days. The doctor cannot usually be seen quickly for urgent for urgent matters during normal working hours. Patients with non urgent matters usually have to wait several days for an appointment to see their own doctor.

Home visits

The doctor is prepared to visit patients in their homes: clear  arrangements exist for requests. The doctor is very reluctant to do home visits; arrangements  for requests are confusing, and difficult for patients.

Patient queries

The doctor deals with patients' queries himself, or gives clear guidelines to his staff on how to deal with them.  The doctor avoids dealing with queries himself, nor does give clear guidelines to his staff on how to deal with them.

Contactability

The doctor can be very readily contacted by his staff for advice. The doctor is very difficult to contact for advice.

Out-of -hours cover

The doctor provides adequate out-of-hours cover; the arrangements are clearly known and acceptable to his patients. He personally takes a share in the rota duty. The doctor provides inadequate out-of-hours cover. The arrangements are poorly understood by his patients. He does not share in the rota duty.

Access to staff

Access to ancillary and attached staff is easy and the arrangements are made clear to patients. Access to staff is difficult; arrangements are poorly understood by patients.

Facilitation

The ancillary staff facilitate doctor-patient contacts in the most helpful way. The ancillary staff are over-protective of the doctor and make it very difficult for patients to have access to him.

Punctuality

The doctor does not keep patients and staff waiting unnecessarily. The doctor is regularly late with appointments.

3. Clinical Competence

History Taking

The doctor consistently gives evidence of his ability to take a relevant history. He appears to be listening to what his patient says and is able to respond to the verbal and non- verbal cues which he is given. He constructs his questions logically and puts them clearly. He uses the medical record both to verify and to amplify the history. The doctor persistently fails to elicit a relevant history. He gives evidence of not hearing what his patient is saying, or of actively preventing the patient from communicating. He does not follow up verbal and non-verbal clues, or he actively pursues irrelevant aspects of the patient's history. He fails to verify points in the history by reference to the medical record, or fails to use the medical record itself as a source of further information about past events

Source: The RCGP - History of the College, What Sort of Doctor

 

• Contents page •
• Up • Curriculum group • 12 Facts about GP • Position on Training • Future of Vocational Education • Good Medical Practice • Valuing General Practice • What Sort of Doctor • The Future GP • EU Title III/IV •
•  •
Top of page
Get Adobe Acrobat Reader

Copyright statement
Copyright for all the information published on this web remains with the original authors.
Where known, sources are acknowledged.
There is no claim of ownership of any of the material on this web by the web author.
If your copyright has been infringed please inform me and I will
acknowledge you or remove the material.