>Should I be judged by the circumstances in an isolated community - or
>the GPs practising in isolated situations have their surgical and
>obstetric skills judged by the GP or specialist levels of tertiary care?
>
>I'm not disagreeing with the principle - just looking at the
>practicalities of establishing "minimum standards" when the job is not
>uniform.
>
>BTW , supposing everyone can agree what "minimum standards" in any
>particular situation were, how would you handle mobility? And what do
>you do with GPs who fall below them? Legal implications? Especially if
>there is an assumption that x% ought to fail...
There is a need for research.
NCAA are starting to have a sense of the characteristics of doctors who are
not practicing to current acceptable standards.
While their assessments are very broadly based, and there is much to
commend them, I'm not aware of any response from NCAA or the NHS to the two
key questions.
1) Transparency about where the acceptable / unacceptable threshold is set
2) How to deal with the consequence of the results if applied consistently
and comprehensively
FWIW it doesn't seem to me mobility should be a big issue. The probity
factor should ensure that doctors don't accept, or give colleagues, jobs
they aren't trained to do.
The common core skills of general practice apply everywhere. The
additional competencies needed to work in a remote community may be
definable, but are clearly not core.
Julian
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