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Competency 4 – Maintaining relationship with patients:Understand the risk associated with medical practice

Objective: to ensure the appreciation of the professional position of the OH advisor, employer and employees

UNDERSTAND THE RISK ASSOCIATED WITH MEDICAL PRACTICE, HOW TO MINIMISE RISK AND THE NEED FOR EARLY TREATMENT WHEN INCIDENTS OCCUR.

The GMC lays out guidance for doctors with respect to managing their own health and wellbeing. It defines the importance of managing one’s own health to enable doctors to provide safe and effective care for their patients.

The GMC Good Medical practice outlines the following:

Doctors must:

  • Protect those you manage from risks to their health
  • Protect patients from risks arising from your own or your colleagues’ health
  • Respond constructively to signs that colleagues have health problems; in particular you
  • Should be alive to mental health problems, depression, and alcohol and drug dependence
  • Help and support colleagues who have health problems.

Medical practice, like any other job has associated hazards and risks. It is important for all doctors to be aware and provide appropriate care for themselves and others that they work with, alongside the patients that they treat.

Doctors are at risk of general workplace hazards such as:

  • mental health problems e.g. depression, burn out, stress
  • physical health problems e.g. musculoskeletal problems, cardiovascular problems
  • accidents and injuries e.g. slips and trips

Stress, depression and burnout can occur in any work environment. Health care workers have a high incidence of mental health problems. Doctors in particular have a high incidence of alcohol abuse and suicide. (Firth Cozens J)

Specific hazards relating to the workplace include:

  • blood borne viruses
  • radiation
  • community acquired infections
  • hospital acquired infections

The GMC has set out general guidance in respect to personal health for doctors in Good Medical Practice. This includes the following:

  • You should be registered with a general practitioner outside your family to ensure that you have access to independent and objective medical care. You should not treat yourself.
  • You should protect your patients, your colleagues and yourself by being immunised against common serious communicable diseases where vaccines are available.
  • If you know that you have, or think that you might have, a serious condition that you could pass on to patients, or if your judgment or performance could be affected by a condition or its treatment, you must consult a suitably qualified colleague. You must ask for and follow their advice about investigations, treatment and changes to your practice that they consider necessary. You must not rely on your own assessment of the risk you pose to patients.

In addition to the above the Faculty of Occupational Medicine’s Good Occupational Medical Practice  states:

  • If you know that you have, or think that you might have, a serious condition that you could pass on to patients, of if your judgement or performance could be affected by a condition or its treatment, you must consult a suitably qualified colleague.  You must ask and follow their advice about investigations, treaement and changes to your practice that they consider necessary.  You must not rely on your own assessment of the risk you pose to patients.

It is the duty of all doctors to minimise the risk of harm to themselves, colleagues and patients by acting in a timely fashion to possible hazards and risk. Following an incident that might expose a doctor or a member of their team to a hazard the doctor should respond quickly to allow for treatment where necessary.

There is guidance published around managing specific workplace hazards such as blood borne viruses. These can be accessed via the HSE or GMC websites.            

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