Revalidation: what’s the problem?
The AMA has been working with the Medical Board of Australia to develop a suitable approach to revalidation. Australia has an extremely high standard of health care and the last thing the Australian health care system needs is to introduce layers of bureaucracy that don’t actually improve the patient journey or make it safer. The AMA was very glad to see that the Board is not proposing a UK-style model.
One of the issues the Board appears to be grappling with is to clearly identify the problem that such a process would be set up to address, given that only a small proportion of doctors are the subject of formal complaints from patients or colleagues.
A discussion paper on options for revalidation, issued by the Medical Board, proposes that doctors undertake a ‘strengthened’ CPD program. This would include peer review of a doctors’ performance. The plan could mean a review of doctor’s medical records, and peer discussion of critical incidents and requirements to get feedback from multiple sources including medical colleagues, health practitioners and patients.
Simultaneously, there would be a ‘proactive’ screening process to identify and assess doctors who may be performing poorly and potentially pose a risk to patients. Under the Board’s proposals, doctors deemed at risk would be formally assessed via a variety of methods. Doctors who were found to be underperforming through the Board’s proactive screening program would be offered support and mediation to get them back on track.
The AMA would like the Board to outline the problem it wishes to address, and the proposed solutions, in greater detail.
Unfortunately, there is currently not enough detail in the Board’s interim report to come to any conclusion about this. Likewise, the report notes that the costs of the proposed additional CPD and the system to identify and manage poor performance are unknown.
Of some comfort is that the report recommends guiding principles that should apply to all potential approaches:
- smarter not harder: strengthened CPD should increase effectiveness but not require more time and resources;
- integration: all recommended approaches should be integrated with, and draw upon, existing systems and avoid duplication of effort; and
- relevant, practical and proportionate: all recommended improvements should be relevant to the Australian healthcare environment, feasible and practical to implement and proportionate to public risk.
The Board’s next steps are to finalise engagement and collaboration in 2016 and recommend an approach to pilot in 2017.
Consultations close on 30 November. You can have your say in a number of ways via the Board’s consultation webpage http://www.medicalboard.gov.au/News/Current-Consultations.aspx