A call for doctors' professional organisations to "step up" their monitoring of doctors' performances to retain public confidence has been made by New Zealand Medical Council chairman Dr John Adams.
In a speech to the New Zealand Medical Association's annual South General Practice conference and medical exhibition in Dunedin, Dr Adams spoke of the pressure throughout the developed world for regulation of doctors to be taken "substantially out of the hands" of doctors' bodies.
In the United Kingdom there was a move to a system of recertifying doctors, called revalidation. It had been delayed by the recession, but was expected to be introduced next year. It was comprehensive, very bureaucratic and expensive.
While the New Zealand public continued to have high trust in doctors, it was clear the profession had to increasingly demonstrate its internal processes deserved that trust.
He suggested the right balance needed to be struck between external regulation and the profession's internal accountability procedures. If the profession did not listen to society enough, there was a danger it could become isolated and paternalistic.
In New Zealand there were moves to bolster compulsory professional development with some form of regular practice review and clinical audit, but this was proving "easier said than done" with some doctors' colleges, and the council was working to define what this meant. The council believed working with colleges to set up regular practice reviews on a voluntary basis was one way doctors could meet obligations under their moral contract.
In response to a question, he said helping struggling doctors was not the council's business, but that of the professional colleges. Once a matter got to the council, it had a quasi-judicial function and needed to decide whether to investigate further.
Colleges needed to take some responsibility for getting doctors to "come up to speed" by quality assurance through regular review.
Asked why the medical council had a staff of 50 and a budget of $12 million, Dr Adams said that was what it cost to regulate. To a further question on whether the council was "bureaucratically weighed down", he said it would cost a "lot more" to introduce a system such as was proposed in the United Kingdom if professional colleges did not step up.
