Rights and Responsibilities of Doctors.pdf

Rights and Responsibilities of Doctors Lecture is updated by Dr. Sabah Al-Harazi MBBS – Year 2 MAHSA University Part A Q1. Dr. Ahmed has sustained a back injury that limits his ability to walk properly. Which of the following is against the rules of his employment upo...

Rights and Responsibilities of Doctors Lecture is updated by Dr. Sabah Al-Harazi MBBS – Year 2 MAHSA University Part A Q1. Dr. Ahmed has sustained a back injury that limits his ability to walk properly. Which of the following is against the rules of his employment upon of his return to work at the hospital? a. Providing Dr. Ahmed with a comfortable chair to sit during work hours. b. Denying Dr. Ahmed a promotion only due to his back injury. c. Allowing Dr. Ahmed to attend rehabilitation sessions during work hours. d. Encouraging Dr. Ahmed to take regular breaks to avoid strain. Q2. Which of the following applies to HIV-positive working doctors? a. They have the right to work as long as they do not endanger others at work. b. Their employment termination policy differs from that for other diseases. c. Despite taking medications on a regular basis, they are not allowed to work. d. They must work in a separate area from other employees. Q3. Dr. Kong has sustained a major trauma that has restricted his ability to work effectively. Which of the following actions should the hospital take upon Dr. Kong's return to work in response to his medical condition? a. Assigning tasks that align with Dr. Kong's physical limitations. b. Terminating Dr. Kong's employment immediately. c. Ignoring Dr. Kong’s medical condition and expecting him to perform regular duties. d. Requesting Dr. Kong to work longer hours to compensate for his injury.  The Public With a new relationship between doctors and their patients; they are less likely to sit passively and accept doctors’opinions and directions. The general public is conscious of the cost of healthcare. They want their doctors to provide them with second opinions  alternative treatments, or medications  The Public They want to be partners in care. Public expectations are high. Patients expect their doctors will be  competent  knowledgeable  skilled  ethical providers They appreciate good communication skills and “quietly demand to be recognized as individuals”.  A Basic Truth The doctor and the patient; both have rights and responsibilities The doctor has a body of knowledge and skills. The patient is the paying agent. The patient has the ability to buy services from a source of his choosing.  (1) The Rights of a doctor A safe working environment A basic provision – inadequate provision in many factory clinics Care and support – counseling – stress management Universal protection when engaged with infectious diseases (SARS, HIV, AIDs etc)  (2) The Rights of a doctor HIV-positive working doctors – stigma, and discrimination in employment, remain a pressing problem in Malaysia. some multinational companies forbid stigmatization and discrimination. universal protection and other requirements  (2) The Rights of a doctor The Human Resources Ministry's Department Code of Practice on Prevention and Management of HIV/AIDS at the workplace. emphasis is on the employer's - non-discriminatory policies for HIV-positive employees. right to work if they do not pose any danger to themselves, their co-workers, and other individuals at work.  (2) The Rights of a doctor "People living with HIV who are on stable effective treatment will have undetectable levels of virus in their blood," says Dr Steve Taylor, an HIV specialist at Birmingham Heartlands hospital "That means the risk of their blood infecting another person through a needle-stick injury is almost nothing”.  (2) The Rights of a doctor The National Health Service (NHS) staff infected with the AIDS virus are allowed to carry out “operations and other invasive procedures ”  ban for more than 20 years  lifted by the Government on April 2014  fears of surgeons or dentists could infect patients are unacceptable and not applicable  (2) The Rights of a doctor Presently: surgeons, dentists, midwives, and nurses with HIV are able to work normally provided they are taking drugs regularly. people will be able to buy HIV self-testing kits that are currently illegal for home use.  (2) The Rights of a doctor doctors have the right to continue to work as long as they do not pose any danger to themselves, their co-workers, and other individuals at work. termination of employment on medical grounds for them should be the same as for any other disease. Clearance and management of healthcare workers living with bloodborne viruses (publishing.service.gov.uk) - Clearance and management of healthcare workers living with bloodborne viruses (publishing.service.gov.uk). - Public Health England. ‘The management of HIV infected healthcare workers who perform exposure prone procedures: updated guidance’. 2014  https://www.gov.uk/government/publications/management-of-hiv-infected-healthcare-workers-hcw-the-report-ofthe-tripartite-working- groupH. https://www.nat.org.uk/sites/default/files/publications/April%202014_Changes%20to%20occupational%20restrictions%20brief_0.pdf https://www.nat.org.uk/sites/default/files/publications/April%202014_Changes%20to%20occupational%20restrictions%20brief_0.pdf https://www.gov.uk/government/publications/management-of-hiv-infected-healthcare-workers-hcw-the-reportof-the-tripartite-working- groupH. https://www.nat.org.uk/sites/default/files/publications/April%202014_Changes%20to%20occupational%20restrictions%20brief_0.pdf https://www.nat.org.uk/sites/default/files/publications/April%202014_Changes%20to%20occupational%20restrictions%20brief_0.pdf  (3) Rights of a doctor 3. Compensation insurance for occupationally acquired disease when a worker has an incapacity for work, the employer has obligations under the law to help them return to work. obtain relevant information about the worker's capacity for work.  (3) Rights of a doctor consider reasonable workplace support, or modifications to assist in the worker's return to work provide the worker with clear, accurate, and current details of their return to work arrangements, and monitor the worker's progress  (4) and (5) Rights of a doctor Confidentially applicable to doctors about their status of HIV and all other diseases To treat patients with consent, – to the best of his ability – in the best interest of the patient – without any form of discrimination  (6) and (7) Rights of a doctor Refuse all forms of engagement in the torture of prisoners or detainees in any form, even to certify one for corporal punishment (Article 5, Universal Declaration of Human Rights) To refuse all roles in the suicide of a fellow human being  (8) Rights of a doctor Respect the privacy of a patient and observe confidentiality unless by a court order to breach it and to act according to Ministry of Health (MOH), requirements of disclosure – in the interest of the public – when the well-being and health of another person are threatened.  (9) And (10) Rights of a Doctor To give an expert opinion in court…. when ordered to do so. To carry out a physical examination, – including the private parts of an individual, – after proper consent – the presence of a chaperone. Part B Q4. Which of the following is a doctor's responsibility when communicating with patients? a. Being vague when explaining details to patients. b. Being accurate in writing prescriptions. c. Being unclear when giving instructions. d. Ignoring patient complaints. Q5. What should a doctor do if they receive a request for a patient's medical records? a. Ignore the request. b. Provide the records without question. c. Verify the identity of the requester before providing the records. d. Use the records for personal gain. Q6. In which situations may a doctor disclose patient information without consent? a. When disclosing information about a patient is required by law. b. When disclosing information about a patient is for marketing purposes. c. When disclosing information about a patient is for medical teaching or research. d. When disclosing information about a patient is requested by healthcare professionals who are not involved in the patient's care.  Responsibilities of Doctors Doctors have responsibilities…. Society’s basic expectations include …. competent and ethical healthcare providers provision of care that is; safe, effective, appropriate, efficient, and patient-centered.  Responsibilities of a Doctor Many of the Responsibilities of a Doctor are related in one way or another to those summarized below: “The Ten Golden Rules of Good Medical Practice” (Malaysian Medical Council) Doctors are advised to; (1)practice with kindness, ethics, and honesty (2)upgrade professional knowledge and clinical skills  Responsibilities of a Doctor (3) maintain good patient records. (4) maintain good communication with patients and relatives. (5) maintain doctor-patient confidentiality. (6) allow second opinion and referral to colleagues (7) be conscious of the cost of healthcare  Responsibilities of a Doctor (9) avoid publicity, self-promotion, and abuse of position. (10) be a partner in promoting global health. (The Director General of Health, Ministry of Health, Malaysia, Dato’Dr. Hasan bin Abdul Rahman – 2nd June 2011)  Responsibilities of a Doctor Doctors should, 1. practice the art and science of healing with professionalism and self-regulation. 2. keep up with new developments. 3. practice according to the Good Clinical Guild lines, consensus statements, etc. 4. put the interest of the patient above his own interest.  Responsibilities of a Doctor 5. good communication skills and soft skills; consultations and ward rounds 6. observe proper dress code 7. follow the MMC requirements for a proper practice place – signboard, waiting and consultation rooms, nursing staff etc. 8. calling cards should be according to MMC guidelines  Responsibilities of a Doctor 9. keep proper medical records and reports and record on Dangerous drugs and controlled items. 10. know the limits to publicity. 11.should have adequate medical cover /insurance. 12.should cultivate relationships with pharmaceutical and equipment firms only on a professional basis.  Responsibilities of a Doctor 13. listen carefully to patients; – pay attention to patients’complaints. – be clear when explaining details to patients. – be specific when giving instructions. – be accurate in writing prescriptions. 14. provide a chaperone when examining the opposite sex. 15. suggest a second opinion if needed.  Responsibilities of a Doctor 16. follow the norm of consultation fees. 17 relate appropriately with relatives and friends of the patient. 19. be a team player. 20. not to make adverse comments on colleagues.  Responsibilities of a Doctor 21.treat all patients equally and do not discriminate amongst patients 22. deal with complaints promptly and effectively 23.follow the International Code of Medical Ethics and the Declaration of Geneva. Summary https://mmc.gov.my/wp-content/uploads/2019/12/GMP-Final-Edited-Amended-Version.pdf  What are some of the responsibilities of doctors towards their patients? 1. Practicing the art and science of healing with professionalism and self-regulation. 2. Keeping up with new developments in the medical field. 3. Practicing according to the Good Clinical Guidelines, consensus statements, etc. 4. Putting the interest of the patient above their own interest. 5. Listening carefully to patients;  Paying attention to their complaints.  Being clear when explaining details to patients.  Being specific when giving instruction. Doctors should provide specific instructions to patients regarding their treatment plan, medication usage, and any necessary lifestyle changes. Clear instructions help patients follow the prescribed course of action effectively.  Being accurate in writing prescriptions. Doctors have a responsibility to accurately write prescriptions, ensuring the correct medication, dosage, and instructions are provided. This helps prevent medication errors and ensures patient safety. - Malaysian Medical Council (2019) Good Medical Practice 2019. 43. - file:///D:/oalibj_2021062516400459-ETHICS.pdf.  What are some of the responsibilities of doctors towards their patients? 6. Providing a chaperone when examining patients of the opposite sex. To maintain patient comfort and dignity, doctors should offer a chaperone when conducting examinations on patients of the opposite sex. 7. Suggesting a second opinion if needed If a patient requests or if the situation requires it, doctors should be open to suggesting a second opinion from another healthcare professional. This helps ensure that patients receive the most appropriate and comprehensive care. Doctors should make necessary arrangements and provide all relevant information and investigation results to avoid inaccurate clinical judgement by the referred doctor. 8. Know the Limits to Publicity Doctors should maintain the confidentiality and privacy of their patients. They must get the patient’s expressed consent if identifiable information is to be disclosed for purposes other than their care or clinical audit, unless the disclosure is required by law or can be justified in the public interest. - Malaysian Medical Council (2019) Good Medical Practice 2019. 43. - Confidentiality-guidelines.pdf (mmc.gov.my). https://mmc.gov.my/wp-content/uploads/2019/11/Confidentiality-guidelines.pdf.. - file:///D:/oalibj_2021062516400459-ETHICS.pdf  What are some of the responsibilities of doctors towards their patients? 9. should have adequate medical cover /insurance Medical insurance is essential for doctors for several reasons. Firstly, it provides financial protection by covering medical treatments, hospitalization, operations, and other healthcare services. This helps reduce the financial burden on doctors and their families in case of unexpected medical bills. Secondly, medical insurance provides professional liability protection to doctors in case of medical malpractice claims or lawsuits. Thirdly, it offers peace of mind by protecting doctors from unexpected medical expenditures and legal penalties. Lastly, with enough medical coverage/insurance, doctors have access to excellent healthcare when they need it.  In Malaysia, medical insurance is a necessary requirement for private practitioners, while the Malaysian government covers government doctors. Annual indemnity cover is mandatory for the issuance of APC. - -All You Need To Know About Getting Medical Insurance In Malaysia | Prudential Malaysia. - Insurance, indemnity and medico-legal support - information for doctors on the register - GMC (gmc-uk.org). - What Types of Insurance Do Doctors Actually Need? » The Prudent Plastic Surgeon. - Why Do Doctors Need Medical Malpractice Insurance? (lerablog.org) - Malaysian Medical Council (2019) Good Medical Practice 2019. 43. - file:///D:/oalibj_2021062516400459-ETHICS.pdf.  What are some of the responsibilities of doctors towards their patients? 11. Having good communication skills and soft skills during consultations and ward rounds. 12. Observing proper dress code. 13. Following the requirements for a proper practice place, such as having a signboard, waiting and consultation rooms, and nursing staff. 14. Ensuring that calling cards are according to guidelines set by the MMC The doctor's calling card should just include name, qualifications, address, and contact information. Calling cards should not be provided to the public for marketing or placed on counters for easy access/pick up by anyone. 15. Maintaining good patient records - Records must be clear, accurate, legible, comprehensive, and up-to-date. - Recorded notes should not be erased or altered. Instead, errors should be neatly deleted but still readable, and changes or additions made should always be dated. Proper stock inventory should be maintained for all medications in the facility, including dangerous and controlled drugs, as highlighted in the Malaysian guideline. - Malaysian Medical Council (2019) Good Medical Practice 2019. 43. - file:///D:/oalibj_2021062516400459-ETHICS.pdf.  What are some of the responsibilities of doctors towards their patients? 16. Maintaining good communication with patients and their relatives. Doctors should maintain open and effective communication with patients and their relatives. This includes providing updates on the patient's condition, explaining treatment plans, and addressing any concerns or questions. 17. Maintaining doctor-patient confidentiality. Doctors have a duty to maintain the confidentiality of patient information. They should respect patient privacy and only disclose information with the patient's consent or when required by law. If a patient with TB refuses to take measures to prevent its spread, the doctor may have to notify public health authorities. Another example. If a patient is driving under the influence of drugs or alcohol and endangers public safety, the doctor may have to notify the relevant authorities. - Malaysian Medical Council (2019) Good Medical Practice 2019. 43. - file:///D:/oalibj_2021062516400459-ETHICS.pdf. - Confidentiality-guidelines.pdf (mmc.gov.my). https://mmc.gov.my/wp-content/uploads/2019/11/Confidentiality-guidelines.pdf..  What are some of the responsibilities of doctors towards their patients? 18. Being conscious of the cost of healthcare. Doctors should be mindful of the cost of healthcare and consider the financial implications for patients. They should strive to provide care that is both effective and efficient, taking into account the patient's financial situation. 19. be a team player. 20.not to make adverse comments on colleagues. - Malaysian Medical Council (2019) Good Medical Practice 2019. 43. - file:///D:/oalibj_2021062516400459-ETHICS.pdf.  Optional Slides Slides No 51-56 General Medical Council , UK.  Duties of a Doctor - GMC Duties of a doctor The duties of a doctor registered with the GMC Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and make sure your practice meets the standards expected of you I in four domains.  Duties of a Doctor - GMC (1) Knowledge, skills and performance – Make the care of your patient your first concern. – Provide a good standard of practice and care. Keep your professional knowledge and skills up to date. Recognise and work within the limits of your competence.  Duties of a Doctor - GMC (2) Safety and quality Take prompt action if you think that patient safety, dignity or comfort is being compromised. Protect and promote the health of patients and the public.  Duties of a Doctor - GMC (3) Communication, partnership and teamwork Treat patients as individuals and respect their dignity. – Treat patients politely and considerately. – Respect patients' right to confidentiality.  Duties of a Doctor - GMC (3) Work in partnership with patients. – Listen to, and respond to, their concerns and preferences. – Give patients the information they want or need in a way they can understand. – Respect patients' right to reach decisions with you about their treatment and care. – Support patients in caring for themselves to improve and maintain their health. Work with colleagues in the ways that best serve patients' interests.  Duties of a Doctor - GMC (4) Maintaining trust Be honest and open and act with integrity. Never discriminate unfairly against patients or colleagues. Never abuse your patients' trust in you or the public's trust in the profession. You are personally accountable for your professional practice and must always be prepared to justify your decisions and actions. Thank you