Long-Term Outcomes of a Remedial Education Program for Doctors With Clinical Performance Deficits

Abstract

Seventy-five percent of doctors who entered remedial education were considered to be practicing at an acceptable standard at the end of remediation. This accords well with international data. A small number of doctors appear to be unresponsive to remediation.

Education or regulation? Exploring our underlying conceptualisations of remediation for practising physicians

“…Our participants’ propensity to conceptualise remediation as an educational process and part of the educational support continuum mirrors the emphasis seen in the literature and appears to be consistent across (at least Western) health care systems. For example, in the UK, where doctors are employees, the National Clinical Assessment Service framework suggests that remediation ‘should still be seen as part of an educational continuum for improving practice’.…”

Getting back on track: a systematic review of the outcomes of remediation and rehabilitation programmes for healthcare professionals with performance concerns

“…Even though most studies reported outcomes on only SUD, it could be that other performance concerns were addressed in the programme too (though not reported in the study). Our reported categories of concerns show similarities to how regulatory authorities structure their work regarding performance concerns of professionals, which usually channel professionals in different management pathways for concerns related to health, competence and conduct 43. Since there is often an overlap of performance concerns, professionals might be part of more than one pathway.…”

“…Of poorly performing physicians that completed a remedial professional development programme, 30%–40% succeeded in improving their performance for record keeping, clinical investigation, diagnostic accuracy and treatment and follow-up 42. A New Zealand study found that 14 out of 19 doctors (73.7%) that entered the remediation programme were considered to be practising at an adequate level at the end of remediation 43. A Canadian study looking at reassessed physiotherapists found that of eight physiotherapists who had a suboptimal outcome at the first assessment and who required remediation, practice enhancement or reassessments, seven (87.5%) scored the best possible outcome at the second assessment and one (12.5%) completed with recommendations 44…”

Dealing with Difficult Medical Colleagues

“…The term “problem doctor” [33,34] and related terms [35,36,37] are used in two ways. Some articles restrictively define “problem doctors” as those with poor clinical skills [33], but in other papers definitions are broader, including physicians who commit sexual offenses, are impaired, are disruptive, or are less than competent.…”

“…Some articles restrictively define “problem doctors” as those with poor clinical skills [33], but in other papers definitions are broader, including physicians who commit sexual offenses, are impaired, are disruptive, or are less than competent. There are no sound investigations on the prevalence of physicians exhibiting problematic behaviors.…”