This article identifies the role played by a series of medical scandals in the UK, occurring from the mid-1990s onwards, in ending a collegial model of self-regulation of the medical profession that ...had endured for 150 years. The state’s original motive in endorsing professional self-regulation was to resolve the principal–agent problem inherent in the doctor–patient relationship. The profession, in return for its self-regulating privileges, undertook to act as a reliable guarantor for the competence and conduct of each of its members. Though sufficient to ensure that most doctors were “good”, the collegial model adopted by the profession left it fatally vulnerable to the problem of “bad apples”: those unwilling, incapable or indifferent to delivering on their professional commitments and who betrayed the trust of both patients and peers. Weak administrative systems in the NHS failed to compensate for the defects of the collegium in controlling these individuals. The scandals both provoked and legitimised erosion of the profession’s self-regulatory power. Though its vulnerability to bad apples had been present since the founding of the 19th century profession, it was the convergence of social and political conditions at a particular historical moment that transformed the scandals into an unstoppable imperative for reform. Huge public anger, the voice permitted to a coalition of critics, shifts in social attitudes, the opportunity presented for imposing standards for accountability, and the increasing ascendancy of pro-interventionist managerialist and political agendas from the early 1990s onwards were all implicated in the response made to scandals and the shape the reforms took. Scandals need to be understood not as simple determinants of change, but as one performative element in a constellation of socially contingent forces and contexts. The new rebalancing of the “countervailing powers” has dislodged the profession as the senior partner in the regulation of doctors, but may introduce new risks.
► The era of collegial self-regulation for the UK medical profession has ended after 150 years. ► The role of scandal in provoking and legitimising reform is important but under-examined. ► We show that the profession harboured a structural susceptibility to transgression by individuals since its foundation. ► A contingent set of social and political forces and contexts both created the opportunity for reform and shaped the outcomes of reform.
BackgroundBurn is major Public health problem in Bangladesh. Interplast Australia and New Zealand , Australian & New Zealand Burn Association (ANZBA) and CIPRB come forward to help Bangladeshi ...physician to improve their burn management skill. ANZBA initiated EMSB training program for Bangladeshi physician in 2008. The study was designed to determine the effectiveness of EMSB programme in Bangladesh.MethodsA cross sectional survey was conducted among a randomly selected EMSB trained doctors. In-depth interviews (IDIs) and Focus Group Discussion (FGD) were conducted with faculties and organisers of the EMSB program.ResultsIn a total of 24 providers courses during the 2008 and 2012, 529 doctors participated and among them 417 completed the course successfully. 43 faculty members also developed to run the course. Trained 87.5% doctors are using EMSB skills in burn management. About 38% doctor felt that the course helped them to improve their confidence. Majority of doctors stated EMSB is essential for the Bangladeshi doctors to learn better management of burn. From qualitative study it was found that the courses maintaining same quality and standard as running anywhere in the world. However, it has recommended to train nurses and more doctors from periphery of the country.ConclusionsEMSB created a large doctors community who are effectively managing burn patients. It also create demand for learning burn management skill. EMSB training is required for medical doctors and nurses at the grass root level which could avert a number of deaths and also reduce the severity of the burn injuries.
100 YEARS AGO/50 YEARS AGO
American journal of public health (1971),
04/2016, Volume:
106, Issue:
4
Journal Article
Peer reviewed
From AJPH, April 1916 50YEARS AGO Recent Federal Legislation: Its Meaning for Public Health One does not hear that old myth so much anymore, about the good medical care in this country being ...available to the very rich and the very poor.
Full text
Available for:
CEKLJ, FSPLJ, ODKLJ, UL, VSZLJ
Drawing on the evidence base of core clinical skills and competencies required by newly qualified nurses, this comprehensive text provides useful learning outcomes, activities to encourage reflection ...and tips to expand readers' knowledge and practice.
Within the medical community there is persistent debate as to whether the information available through social media is trustworthy and valid, and whether physicians are ready to adopt these ...technologies and ultimately embrace them as a format for professional development and lifelong learning.
To identify how physicians are using social media to share and exchange medical information with other physicians, and to identify the factors that influence physicians' use of social media as a component of their lifelong learning and continuing professional development.
We developed a survey instrument based on the Technology Acceptance Model, hypothesizing that technology usage is best predicted by a physician's attitudes toward the technology, perceptions about the technology's usefulness and ease of use, and individual factors such as personal innovativeness. The survey was distributed via email to a random sample of 1695 practicing oncologists and primary care physicians in the United States in March 2011. Responses from 485 physicians were analyzed (response rate 28.61%).
Overall, 117 of 485 (24.1%) of respondents used social media daily or many times daily to scan or explore medical information, whereas 69 of 485 (14.2%) contributed new information via social media on a daily basis. On a weekly basis or more, 296 of 485 (61.0%) scanned and 223 of 485 (46.0%) contributed. In terms of attitudes toward the use of social media, 279 of 485 respondents (57.5%) perceived social media to be beneficial, engaging, and a good way to get current, high-quality information. In terms of usefulness, 281 of 485 (57.9%) of respondents stated that social media enabled them to care for patients more effectively, and 291 of 485 (60.0%) stated it improved the quality of patient care they delivered. The main factors influencing a physician's usage of social media to share medical knowledge with other physicians were perceived ease of use and usefulness. Respondents who had positive attitudes toward the use of social media were more likely to use social media and to share medical information with other physicians through social media. Neither age nor gender had a significant impact on adoption or usage of social media.
Based on the results of this study, the use of social media applications may be seen as an efficient and effective method for physicians to keep up-to-date and to share newly acquired medical knowledge with other physicians within the medical community and to improve the quality of patient care. Future studies are needed to examine the impact of the meaningful use of social media on physicians' knowledge, attitudes, skills, and behaviors in practice.
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