Published: 17/11/2005 Volume 115 No. 5982 Page 21
Do we care what our doctor does in his or her private life? Until now, we haven't. Good Medical Practice, the General Medical Council document drawn up 10 years ago to set out the principles to which a practising doctor must adhere, rightly commands doctors to avoid abusing their professional position.
But once the white coat comes off, all they have to do is stay within the law. Their private life is just that - private. And none of the GMC's business, or anyone else's for that matter.
But this sensible, decade-old document is being redrawn. The GMC has appointed a worthy panel to come up with a new Good Medical Practice. This Standards and Ethics Committee draft differs significantly from its predecessor, as it requires doctors to be on their best behaviour, whether or not they are on duty.
With a wagging Victorian finger, it states: 'You must ensure that your conduct at all times justifies the trust which patients place in you, and the public places in the profession.' The new draft document demands that a doctor must behave with 'probity'. This is defined as, 'moral excellence, integrity, rectitude, uprightness, conscientiousness, honesty, sincerity'.
Doctors, in other words, both in their sitting rooms and their surgeries, have to be saints.
In a series of public consultations, the GMC thought of a scenario in which this new puritanism might apply. A lauded heart surgeon, with an impressive medical record, is having an affair with a 16-year-old.
She is not his patient - so There is no professional misconduct - but the teenager's father is unhappy with his daughter's unorthodox relationship.
The parent reports the surgeon to the GMC, asking them to investigate his behaviour, reprimand him, and bring an end to the affair.
Under the new Good Medical Practice, this hypothetical surgeon would be in real trouble. The distressed parent could argue that, even though the surgeon behaved impeccably in theatre, patients' trust could be dented by his extracurricula activities.
And he would clearly fall short of reaching the new requirement for 'moral excellence'. (Wouldn't we all? ) The surgeon has committed no crime and performed excellently in his professional capacity. But worryingly, under the new guidelines, the GMC's moral police could find him at fault.
This witch hunt is not the only way in which the revised Good Medical Practice should concern us. (It is still only a draft, so we can write in with our views. ) What was once a sensible document has become little more than a showpiece in a shallow attempt to make the GMC seem politically correct.
In the original document, the prime duty of a doctor was clear - 'Make the care of your patient the first concern.' But this solid aim has now been knocked from number one. In the revised draft, the first duty of a doctor is to 'Respect human rights.' No attempt is made to clarify what might constitute human rights - we all know how woolly and debatable they are.
If a doctor unavoidably has to inflict some pain while administering medicine, are they infringing my rights? Could I sue?
It is as meaningless as saying doctors should be ever so nice to you. And, ironically, 'Make the care of your patient your first concern' is now listed as a doctor's second concern.
I suspect the GMC is trying to improve its image. Often portrayed as a conservative institution and over-protective of the medical profession, this new document is a sad, desperate attempt to appear in tune with new thinking.
There is huge emphasis on working 'in partnership with patients', 'listening', 'respecting', 'sharing' and 'responding to their concerns': all reading like language borrowed from a government think tank.
It is rather like a stiff elderly aunt suddenly deciding that listening to rap music and wearing hoodies is an OK activity for young people after all. The GMC wants to appear hip.
It also, I imagine, wants to banish stories from the newspapers about misbehaving medics; the 'Rural GP ran off with vicar's wife' headline That is the staple of the tabloid Sunday market.
Under the new Good Medical Practice, run off with someone else's spouse and you risk being struck off.
But what on earth has this got to do with the standard of care a patient receives, the laudable call to 'make the care of your patient your first concern' that the original document expounded?
I do not care how my doctor behaves in his private life; he can dress up in leathers, hang from the ceiling and pay a pensioner to whip him as far as I am concerned.
And I certainly do not want, as I sit in the surgery, my doctor to be worrying about whether she's respecting my human rights, whatever that might mean. I want them to give me the best medical treatment possible.
If I have a choice between an adulterous surgeon who performs a successful operation and a Godfearing monogamous one who's less clinically competent, I would be daft not to choose the former. I do not see a doctor to engage in an act of pateach-other-on-the-back political correctness. I see a doctor to give myself the best chance of getting better.
Let's hope the GMC's standard and ethics committee sees sense and makes sure that doctors behave well when they visit us, in our bedroom, and doesn't concern itself with how they behave in their own time.
Dea Birkett is a writer on health and social care issues. She can be contacted through www. deabirkett. com. Next week's column will be written by Simon Stevens of UnitedHealth and former health adviser to the prime minister.
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