Individual health practitioners should "toughen up" over being publicly named when their practice fell below acceptable standards, journalist Donna Chisholm says.
She told 200 people attending the recent Health and Disability Commissioner medico-legal conference in Wellington "the message is toughen up, people. If you stuff up, step up".
People within the medical profession seeking care for themselves knew who to avoid and who was the best in the business, but patients were kept in the dark when choosing health providers.
Her comments came during a panel discussion on the public's right to know versus practitioner privacy.
Introducing the topic, deputy health and disability commissioner Rae Lamb said under the office's two-year-old naming policy it had become common practice to name district health boards in breach of the code of patient rights and increasingly to name other organisations, but rarely were individual providers named.
Barrister Gaeline Phipps said it was "somewhat arrogant" to think that the media were going to do a better job of informing people than specialist agencies such as the commission.
She referred to sensational, exaggerated and incomplete coverage of health-care stories and some health practitioners being deemed guilty on the basis of rumours.
Agencies trusted with enhancing patient safety had to be allowed to get on with their work in a way which did not wreak unnecessary harm.
Consumer advocate Barbara Robson cautioned against overstating the negative effect of being named, relating her experience as a district health board member when her board was about to be named by the HDC over the death of an elderly patient.
She had told fellow board members "we have to live with this day of shame".
"We don't fudge it. We go out and make a sincere response to the community and outline the improvements that have been made to the system."
This would make it clear that the board had listened to the commissioner, acknowledged the devastating outcome "and we get on with fixing it up".
Good health reporters would not confine their coverage to the "shock, horror and outrage" but recognise the effort being made and that all care at the hospital was not undermined.
She also urged those present to ensure that the mechanisms around fitness to practise and competence were used on those practitioners who were "bad apples".
She praised the medical council for its "What to do when you have concerns about a colleague" draft document which recently went out for comment.
University of Otago Dunedin School of Medicine dean and chairman of the New Zealand Medical Council Dr John Adams said the decisions about naming were easy where there were severe and obvious issues of negligence or complaints were vexatious or unfounded.
It was the grey area in the middle which was more difficult.
If the situation was a "one-off" event for the practitioner concerned, Dr Adams asked what effect publicity would have on the treatment of other people in the care of that doctor.
Would they get suspicious, and would that compromise their treatment and their relationship with that doctor, he asked.
Further, could it compromise the trust other patients had in their doctors.
If doctors worried they could be named and started to practise defensively they could become worried about contributing to learning from their mistakes.
Dr Adams said he considered the existing legislation, organisations and processes which dealt with issues involving practitioners' performance were working.
Maybe the system was not perfect, "but I think we're doing pretty well".
Ms Chisholm said patients would not necessarily leave a practice because of a minor misdemeanour, but knowing about it could mean they could be more articulate and challenging about that aspect of the doctor's care.
The medical council recently rejected criticism that it had been too slow to respond to concerns about South Auckland GP Dr Rantilal Ranchhod, saying that the concerns raised did not reflect the facts of the case.
