The problem with the GGT levels of doctors is identifying the norm, the
mean, the median and the spread.
It is not a bell shaped curve. I suspect that there are two peaks, one at
the lower end for the young, principled, mentally well or religious and the
other the rest of us!
-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Julian Bradley
Sent: 26 April 2010 13:20
To: [log in to unmask]
Subject: Re: 2 assertions on appraisal and (re)validation
At 07:42 26/04/2010, you wrote:
>for me the major critiscm is that Appraisal now and proposed doesnt look
di=
>rectly at what one does with ones pts=2C surely what maintaining standards
=
>is what its all about. i suspect that this is because doing so is
difficult=
> logistically and expensive=2C whereas time on CPD=2C counting numbers of
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>complaints=2C and a piss-poor audit are easy and cheap.
The lack of meaningful evidence so far into the process is pretty
scandalous.
In general practice:
With QOF scores and other markers of practice performance there is
some evidence (admittedly marginal) about how patients are treated.
Counting numbers of complaints by itself is meaningless, but some
awareness of the complaints any of us generate is relevant.
However in a time of financial constraint I continue to believe the
most "economical, efficient and effective" further _screening_
procedures for doctors with serious performance problems would
probably be a machine marked MCQ(1) and a GGT blood test.
Evaluation of doctors where there is concern (the majority of whom
will be fine) is bound to be expensive and time consuming.
(1) Not designed to "spread" candidates, avoiding ambiguous and silly
questions, but specifically designed to look at and reinforce
knowledge that should be universal, so probably with a pass mark
around 90-95% and a failure rate at first use of no more than 3-5%,
lower after that.
Developmental appraisal (which we may or may not be able to afford)
is not generally related meaningfully to the detection and assessment
of poor performance and the confusion of the two is seriously unhelpful.
All that said there are too many vested interests driving the present
system, so any meaningful change is unlikely.
Julian
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