LEFO - Legeforskningsinstituttet

Institute for Studies of the Medical Profession

2008 Conference: Handling concerns about the performance of doctors

Handling concerns about the performance of doctors

How do we deal with dysfunctional health personnel? This was one of the questions that delegates from 11 countries were discussing at an international conference in Oslo.

As the practice of medicine becomes more transparent and more accountable, the eccentric or dysfunctional doctors - the colleagues of dr. House  - who may be masters in the operating theatre, but show unacceptable behaviour and a lack of communication skills, are having a hard time.

Disruptive behaviour
Unacceptable behaviour from doctors can roughly be divided into three categories: excessive alcohol- or drug use, violation of sexual boundaries, and "disruptive" behaviour. There are also doctors with sub-standard performance that do not belong to any of these categories.

Naturally, such problems belong primarily to the individual doctor, but several different bodies are inevitably involved: professional organisations that through their ethical regulations are responsible for the "collective conscience" of the health professionals, universities that experience how some students are clearly unfit for medical work, health boards and inspectorates that deal with complaints and sanctions, and of course the different licensing authorities. Fortunately there also seems to be a growth in various "back on track" offers for doctors and other health personnel.

Back on track - abroad
In June 2005 NCAS (National Clinical Assessment Service) in the UK arranged a meeting in Greenwich, London entitled "European Workshop on handling concerns about the performance of doctors: Sharing international experience". This initiative was a first step of looking into such problems on a European level as seen from a research and evidence based perspective. 

The conference in Oslo was a continuation of this initiative, and all the participants at the Greenwich meeting, plus several others, were therefore invited to Oslo. Although the conference focused mainly on the behaviour of doctors, other health professionals were of course welcomed.

Courses for doctors
At the 2006 AMA/CMA International Conference on Physician Health in Ottawa, Canada, delegates from The Research Institute of The Norwegian Medical Association met a group from the Center for Professional Health, Vanderbilt University Medical Center, Nashville, Tennesee, USA, who are doing scientific evaluations of their various courses for doctors with unacceptable behaviour. We found this very interesting, and invited them to present some of their data and experiences.
The venue was Soria Moria Conference Hotel, situated beautifully on the hills overlooking Oslo (unless fog forbids it). The dates were January 31st and February 1st 2008.