SOME HELP IN DEFINING THE ROLE OF THE DOCTOR
My Black Cat is here to help with the difficult problem of defining “The Role of the Doctor”
My Black Cat thinks the doctor should at least be able to:
1. “Take a comprehensive patient history.”
2. “Carry out physical examinations.”
3. Use his/her expert knowledge and clinical judgment to identify the differential diagnosis.
4. ” Refer patients for investigations where appropriate.”
5. “Make a final diagnosis.”
6. “Decide on and carry out treatment, including the prescribing of medicines, or refer patients to an appropriate specialist.”
7. “Use his/her extensive practice experience to plan and provide skilled and competent care to meet patient’s health and social care needs, involving other members of the health care team as appropriate.”
8. Ensure the provision of continuity of care including follow-up visits.
9. “Assess and evaluate, with patients, the effectiveness of the treatment and care provided and make changes as needed.”
10. Doctors who are not either consultants or general practitioners work under the supervision of a consultant or a general practitioner, often as part of a health care team.
11. Provide leadership, particularly if the patient’s general practitioner or consultant. If a junior doctor, provide leadership appropriate to the situation under the supervision of the consultant or general practioner.
12. “Make sure that each patient’s treatment and care is based on best practice.”
BOY PRETENDING TO BE DOG
Hey, My Black Cat.
Don’t be silly.
You’re mixed up.
That’s the role of the “Advanced Nurse Specialist”
No it’s not.
How is it different, My Black Cat?
Only doctors who are consultants or GPs can work independently.
The Advanced Nurse Practitioner can work independently.
And take full responsibility?
Are you sure?
Is that what you are saying?
If that’s what the Advanced Nurse Specialist does, do you know then what The Consultant Nurse Specialist does?
You suppose the Consultant Nurse Specialist must take legal responsibility for the very, very difficult patients?
The ones the Consultant Medical Practitioners took responsibility for in the olden days?
Don’t be silly, My Black Cat, the Consultant Medical Practitioners are the ones paying the really hefty Defence Union Fees.
You don’t think they need to any more?
You think the independent non-medical practitioners should pay the really, really hefty Defence Union fees?
Plus a really hefty top-up fee.
Why top up fees?
Because they have not had many years of rigorous medical training, so the actuarial risk of a calamity is higher.
Rubbish, My Black Cat.
The independent non-medical practitioner would just be sacked for not following a protocol somewhere along the line.
No expensive court cases, just sacked.
And probably struck off their competency.
But not their professional body.
WAITING FOR THE RIGHT KIND OF NECK
The consultant’s neck would still be in the noose.
Or the GP’s.
For not giving enough supervision or ensuring enough training or over-delegating.
Or not writing a detailed enough protocol.
Are doctor’s writing protocols for other HCW?
Of course they are, My Black Cat, who else would write a protocol for someone other than a doctor, in order that they can take a history, examine the patient, and make a differential diagnosis?
Who else would be daft enough?
But a doctor…..
One way or another, it all seems a terrible muddle.
Doesn’t it, My Black Cat.
Wonder if Sir John Tooke has anyone in mind capable of sorting out the problem of who is supposed to do what nowadays…….
I don’t suppose that’s his remit.
No doubt a “Defining the Role of the Doctor Committee” will be appointed.
Try to find out if this is happening, My Black Cat, so we can pay a visit to some of the meetings.
a red apple ……………………
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