Suspension of doctors
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《英国医生杂志》
EDITOR—With reference to Empey's editorial on the suspension of doctors,1 suspensions that are badly performed cause human, psychological costs that cannot be measured easily and that can be widely different and sometimes devastating for doctors, their health, their families, and their subsequent lifestyles and working style.
This happens mainly when the authority is doing nothing positive while the doctor's skills and confidence are allowed to decline.
Italy has a blame culture; most failures in standards of care are caused by weaknesses in systems rather than individuals. Also Italy doesn't have a team practices' system, so no procedure is managed in the practice itself. Everything is decided by the local medical council, which could be "cleverly" reflexive or follow the suspension culture, often resulting in reactive and apparently arbitrary decisions being made.
Quick and objective investigations of allegations, adherence to reasonable time scales, and full consideration of alternatives to exclusion are needed. Often doctors lack knowledge, competencies, and experience to help them act with empathy, which is fundamental for real improvements in practice.
Francesco Carelli, national representative
EURACT Council, Italian College of General Practitioners, 20123 Milan, Italy carfra@tin.it
Competing interests: None declared.
References
Empey D. Suspension of doctors. BMJ 2004;328: 181-2. (24 January.)
This happens mainly when the authority is doing nothing positive while the doctor's skills and confidence are allowed to decline.
Italy has a blame culture; most failures in standards of care are caused by weaknesses in systems rather than individuals. Also Italy doesn't have a team practices' system, so no procedure is managed in the practice itself. Everything is decided by the local medical council, which could be "cleverly" reflexive or follow the suspension culture, often resulting in reactive and apparently arbitrary decisions being made.
Quick and objective investigations of allegations, adherence to reasonable time scales, and full consideration of alternatives to exclusion are needed. Often doctors lack knowledge, competencies, and experience to help them act with empathy, which is fundamental for real improvements in practice.
Francesco Carelli, national representative
EURACT Council, Italian College of General Practitioners, 20123 Milan, Italy carfra@tin.it
Competing interests: None declared.
References
Empey D. Suspension of doctors. BMJ 2004;328: 181-2. (24 January.)