Underperforming doctors: a postal survey of the Northern Deanery
BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7146.1705 (Published 06 June 1998) Cite this as: BMJ 1998;316:1705
This article has a correction. Please see:
- George Taylor, deputy director general practice (g.b.taylor{at}ncl.ac.uk)
- Postgraduate Institute for Medicine and Dentistry, University of Newcastle, Newcastle upon Tyne NE2 4AB
- Accepted 22 May 1998
Abstract
Objectives: To discover the perceived size of pool of doctors considered to be underperforming in general practice in the Northern Deanery and to discover whether these perceptions are based on formal assessments.
Design: Postal questionnaire.
Setting: Area covered by the Northern Deanery.
Subjects: Seven health authority directors of primary care, seven secretaries of local medical committees, and 14 chief officers of community health councils.
Results: The response rate was 100% for directors of primary care and secretaries of local medical committees and, after one reminder, 92% for chief officers of community health councils. Numbers of doctors perceived to be underperforming ranged from none to over 15 in different health authority areas. Main areas for concern were communication skills, clinical skills, and management skills. Patients' representatives were concerned about lack of power of patients and health authorities and doctors' lack of accountability. Health authorities were concerned about lack of power, identification of underperforming doctors, and doctors' professional loyalty. Local medical committees were concerned about the problem of identifying underperformance. A number of methods were used for identification, and there was no common method applied.
Conclusions: The number of doctors thought to be underperforming was small. Work still needs to be done on developing tools that can be used in everyday practice to enable doctors to confirm for themselves, their colleagues, and their patients that they are providing an adequate level of care.
Key messages
To quantify the problem of underperforming general practitioners in the Northern Deanery, a postal survey was carried out among representatives of healthcare commissioners, doctors, and patients
A small but not insignificant number of doctors were identified as providing a poor level of performance
Main areas for concern were communication skills, clinical skills, and management skills.
Various methods were used for identifying underperforming doctors, but there was no common method applied
Perceived problems with the present system of dealing with underperforming doctors included identification, lack of power of patients and health authorities, and doctors' professional loyalty and lack of accountability
Footnotes
- Accepted 22 May 1998