Deprofessionalising doctors?

A patient seeing a doctor professionally in the United Kingdom has expectations of professional conduct that far exceed what is expected of citizens generally or employees of most institutions. This sense of professionalism is important to patients as it motivates doctors. The underpinnings of that professionalism, established over 150 years, have in the last 150 days all been questioned. The medical profession in the United Kingdom first emerged through the medical royal colleges in 1505. The 1858 Medical Act united the medical profession and, almost 150 years ago, created the General Medical Council—a structure through which the profession could develop an ethical code,1 systematise education, and punish erring members. The council derives its authority from parliament; its membership includes 25% of lay members, soon to increase to 40%; it elects its own president; and it has been a model for other professions, such as the General Teaching Council. Postgraduate education developed later, and the profession entered into a partnership with the State to regulate it. The Joint Committee on Postgraduate Training for General Practice (JCPTGP) and the Specialist Training Authority (STA) between them control postgraduate training for doctors. Both bodies have …

[1]  P. Croft,et al.  Pragmatic randomised controlled trial of local corticosteroid injection and naproxen for treatment of lateral epicondylitis of elbow in primary care , 1999, BMJ.

[2]  K. Khan,et al.  Overuse tendon conditions: time to change a confusing terminology. , 1998, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[3]  L. Almekinders,et al.  Etiology, diagnosis, and treatment of tendonitis: an analysis of the literature. , 1998, Medicine and science in sports and exercise.

[4]  K. Khan,et al.  Tendinopathy: an Achilles' heel for athletes and clinicians. , 1998 .

[5]  S. Stahl,et al.  The Efficacy of an Injection of Steroids for Medial Epicondylitis. A Prospective Study of Sixty Elbows* , 1997, The Journal of bone and joint surgery. American volume.

[6]  C Backman,et al.  Chronic achilles paratenonitis with tendinosis: An experimental model in the rabbit , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  M. Haug A re-examination of the hypothesis of physician deprofessionalization. , 1988, The Milbank quarterly.

[8]  R. Dahrendorf In Defence of the English Professions , 1984, Journal of the Royal Society of Medicine.

[9]  G. Puddu,et al.  A classification of achilles tendon disease , 1976, The American journal of sports medicine.

[10]  M. Järvinen,et al.  Long-term prognosis of patients with achilles tendinopathy. An observational 8-year follow-up study. , 2000, The American journal of sports medicine.

[11]  N. Westlin,et al.  No effect of piroxicam on achilles tendinopathy. A randomized study of 70 patients. , 1992, Acta orthopaedica Scandinavica.