UK Physicians Fear New Revalidation Procedures Will Reduce Morale, Decrease Time with Patients and Belittle GP Professionalism, According to New TNS Healthcare Research
Half of UK physicians believe that the new five-yearly revalidation process for doctors will belittle their professionalism, and 65% fear it will reduce morale, according to new TNS Healthcare research. In its study of more than 200 GPs across the UK, TNS Healthcare found little support for the new procedure, with 71% of physicians believing it will reduce time with patients and almost two-thirds anticipating that it will be no more than a “tick box” exercise. In fact, almost half are concerned revalidation will serve as a tool to weed out doctors viewed as difficult to manage or uncooperative.
“Doctors clearly are not convinced that the new revalidation process will provide the benefits the government is citing,” says Adam Harris, UK Managing Director of TNS Healthcare. “Less than half agree that revalidation will enhance public confidence in the medical profession or ensure physicians keep more up to date. In addition, only about a third believe that revalidation will raise the standards of practice, and less than half think it will lead to consistent standards of practice across the UK.
“In addition, the vast majority—84%—do not feel that the new procedures will be successful in identifying another Harold Shipman, the GP who murdered more than 200 people over 23 years. As one of our respondents said, ‘Harold Shipman would have passed all of the validation requirements. There is no system which will detect this type of aberrant behavior.’ That view was echoed by most of the GPs in our survey, who pointed out that Shipman was well liked and competent—and that no revalidation system would expose a psychopath.”
Although critics have been calling for a better validation system for UK doctors for years, the concerns about regulating physicians gathered momentum after the Shipman murders, leading to the new revalidation requirements. The new process—which will be drawn up and piloted over the next 18 months—includes a system for re-licensing the UK’s 150,000 doctors to test their basic competence as medics.
Re-licensing will apply to all doctors and be based on a strengthened annual review process. Doctors on the GP and specialist registers also will face specific testing to confirm they can continue in their specialties.
More Support for Colleague Feedback than for Input from Patients or Caregivers
More than half of doctors agree that including feedback from colleagues will enhance the revalidation process. Physicians were not as positive about getting input from patients or caregivers. Only 41% of respondents agree that including patient feedback will improve the revalidation process, and just 27% see value in including caregiver feedback.
More than three quarters of physicians do recognize, however, that their ability to communicate with patients and caregivers is critical, indicating that it is just as important to assess communication skills as prescribing behaviors. In addition, more than two thirds believe that personal issues that could affect professional performance also should be appraised.
“Overall, only about half of GPs see any good in the revalidation process, and even fewer—just 28%—think it is long overdue,” says Harris. “One of our respondents summed up what seems to be the predominant feeling, calling the new process ‘a shallow political gesture [with] no cost benefit evidence to support it.’ Another called it ‘another costly exercise based on an unsound premise that pulls yet more time away from our patients.’ Still others spoke about potentially resigning or moving overseas. Clearly, physicians have grave doubts about the new procedure and its potential effects.”