Rating plan makes life of GPs 'even more unattractive'

A new scheme for patients to rate their doctors will not pick up offenders such as convicted rapist Morgan Fahey, according to a lawyer and a GPs' leader.

The Medical Council will next month start asking doctors' colleagues and their patients to evaluate them - if they first fail to keep up with the requirements for ongoing medical education.

Doctors' medical colleagues will rate them on topics including clinical competence. Patients will rank them from 1 to 5 on communication skills, patient satisfaction, having their questions answered and the clinic's staff and facilities.

The scheme follows cases such as Fahey, the Christchurch GP convicted in 2000 of sex crimes, including rape, against female patients, and Warren Chan, the GP de-registered for repeated malpractice in plastic surgery.

Council spokesman George Symmes, said yesterday: "It's about being pro-active about competence - cutting them off at the pass."

But medical lawyer Harry Waalkens said: "If its target is to catch people like Fahey and some of these more high-profile offenders, it is [based on] extremely simplistic thinking.

"All it's going to do is make general practice in this country even more unattractive for the 99 per cent of doctors this isn't aimed at."

Medical Association GP council chairman Dr Peter Foley also thought it unlikely the scheme would pick up Fahey-type cases.

In a pilot of the scheme, the council will soon start auditing 300 of New Zealand's 10,000 practising doctors to see if they are complying with the requirements for ongoing medical education.

This follows a smaller trial last year after which the council said many of the doctors involved supported the idea, despite initial misgivings.

Each doctor will be audited every decade, if the pilot is judged a success.

The surveys, based on a Canadian system, are not meant to be a pass/fail system, but, if they reveal patient risk, a doctor could face council assessment, further training or even suspension.

Doctors could influence which patients are involved are surveyed.

They must arrange to distribute leaflets to patients and collect 20 signed consent forms from those willing to take part, from whom the council chooses 10 to survey confidentially.

Mr Symmes said doctors' receptionists would handle the leaflets and consents, preserving the scheme's independence. But Dr Foley said the failure to adopt a random sampling method undermined the scheme, which anyway seemed an unnecessary addition to the professional-development work required of doctors by the medical and surgical colleges.

"We cannot handle more bureaucratic hoops to jump through which may be duplicating what we are already doing."

Auckland Women's Health Council co-ordinator Lynda Williams said the scheme might have picked up some malpractice cases earlier, but patient confidentiality worried her.

"I would feel quite uncomfortable about giving an opinion about my doctor.

"If I was reasonably honest and critical I would be worried the doctor would track it back to me and that it would adversely affect the kind of relationship I had with the doctor, " she said.

Doctor check-ups

* Doctors who do not keep up with continuing-education requirements will undergo further checks.
* They will be rated by colleagues and patients in a pilot scheme starting next month.
* The doctor nominates 16 colleagues and 20 patients who agree to take part.
* The Medical Council chooses 10 of the patients patients to survey by phone or on-line.