Patients want doctors who are competent, respectful, honest and able to communicate with them. This is patient-centred professionalism. In the United Kingdom, it is being embedded into practice by the General Medical Council (GMC) through medical regulation in a partnership between the public and doctors. The foundation is a national code of professional standards – Good Medical Practice – that has been tied to medical licensure to secure doctors’ continuing compliance whilst they are in active practice. The revalidation of a doctor’s license to practise is the means of achieving such compliance. Revalidation requires that specialists and general practitioners must be able to demonstrate – on a regular basis – that they are keeping themselves up to date and remain fit to practise in their chosen field. It begins in April 2005. For revalidation, doctors’ performance, conduct and health will be assessed against the headings of Good Medical Practice. Doctors will collect a folder of illustrative evidence that will form the basis of an annual appraisal carried out at the workplace by an appropriately trained colleague. The results of these annual appraisals will be submitted to the GMC for a revalidation decision every 5 years. Where doctors’ performance or conduct gives cause for concern, they may have to undergo a further searching assessment under the GMC’s Fitness to Practise Procedures. Under these procedures the GMC can order a doctor to retrain or, if circumstances warrant it, to stop practising.
In my Gordon Arthur Ransome Oration and other papers, I have described the nature and development of patient-centred professionalism, the key features of which are summarised in Figure 1.
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