Role of the doctor consensus statement released
News Item
posted by Research Admin on 6 November 2011
Location
National
Friday, 4 November 2011, 4:51 pm
Press Release: New Zealand Medical Association
A consensus statement on the role of the doctor in New Zealand, published in the most recent issue of the New Zealand Medical Journal, highlights the key skills and personal attributes required by doctors to ensure patient care is not compromised in a health sector undergoing significant change. New Zealand Medical Association (NZMA) Chair Dr Paul Ockelford says that there have been huge changes in health care delivery in the last 20 or so years and it is essential that the doctor’s role reflects these changes. Dr Ockelford says that a core part of the statement is also the doctor’s responsibility to work as leaders towards improving public health.
The consensus statement also recognises that patients now take a more active role in decision-making regarding their health care, partly as a result of having greater access to health information.
To read the full press release, go to: http://www.nzma.org.nz/news/2011/11/04/consensus-statement-on-the-role-of-the-doctor-released
For information on how to access the full text, go to: http://journal.nzma.org.nz/journal/124-1345/4947/
by David Maplesden
from Waikato
Member since 10 Jun 2011
3 posts • Report
The MCNZ document Consensus Statement on the Role of the Doctor in New Zealand is the result of six months of consultation and I think is a perfect distillation of the qualities an ‘ideal’ doctor would aspire to. It is pleasing to see the word ‘compassion’ features as a desirable attribute, and that there is emphasis on patient centred care and advocacy. Comment on the role of the doctor as a leader and healthcare team member suggests the ‘servant-leader’ model[1] is well suited to leadership in medicine at various levels, the model encompassing qualities that have often led to a medical career choice in the first place. The document advocates the use of evidence-based medicine but wisely acknowledges the potential limitations of such knowledge, perhaps best summarised in a recent publication as evidence can never directly dictate care; the evidence cannot tell us when it is best to ignore the evidence. As long as these questions remain unanswered, keeping the focus of clinical practice on the individual will remain the duty of the physician[2]. The role of doctors as health advocates recognises the importance of equity of resource allocation, and of agitating for increased resources to improve health outcomes where indicated. I have seen the tension between use of evidence-based medicine guidelines and rationing of appropriate resources illustrated in the investigation of patients with symptoms suspicious for bowel cancer where national guidelines[3] advise ‘urgent specialist review’ while DHB colonoscopy prioritisation processes then grade the referral as ‘semi-urgent’ with a six to eight month wait for the procedure. The doctor should not abandon his or her role as patient advocate in this situation if belief that an earlier procedure would be in the patient’s best interests should be pursued. The role of the doctor in advising and assisting the patient and whanau with respect to advance care planning in the later stages of chronic illnesses has appropriately been given some prominence in the MCNZ document. Supporting the concept of ‘comfort care’, and providing a high standard of such care, can be reassuring to the terminal patient and their family and avoid the need for, and often indignity of, invasive hospital care at the end of life. I would regard this document as a detailed embodiment of the Modern Version Hippocratic Oath[4].
[1] See http://www.carolsmith.us/downloads/640greenleaf.pdf
[2] Goldman J et Shih T. The Limitations of Evidence-Based Medicine—Applying Population-Based Recommendations to Individual Patients. Virtual Mentor. 2011;13(1)26-30
[3] NZGG. Suspected cancer in Primary Care. 2009.
[4] See http://ethics.ucsd.edu/journal/2006/readings/Hippocratic_Oath_Modern_Version.pdf